Pathology of Non-Hodgkin Lymphoma

Question 1

Multiple myeloma is positive for what protein markers?

Answer 1

CD38+, CD138+

Question 2

True/False. Non-aggressive types of non-Hodgkin lymphoma are often not curable.

Answer 2

True - they are less responsive to chemotherapy than aggressive NHLs

Question 3

This type of non-Hodgkin lymphoma has a “starry sky” appearance on histology.

Answer 3

Burkitt Lymphoma

Question 4

Diffuse Large B-Cell lymphoma with this molecular marker carry the worst prognosis.

Answer 4

MYC tanslocations

Question 5

What is the immunephenotype for mantle cell lymphoma?

Answer 5

CD20+, CD5+, CyclinD1/BCL1+

Question 6

What chromosomal translocation causes Burkitt lymphoma and the corresponding effect?

Answer 6

t(8;14) causing upregulation of c-MYC

Question 7

True/False. Non-Hodgkin lymphomas are more likely to remain in a set of lymph nodes.

Answer 7

False - NHL is more likely to appear sporadically, whereas Hodgkin lymphoma presents regionally

Question 8

What chromosomal translocation causes the non-Hodgkin lymphoma associated with MALT (mucosa-associated lymphoid tumors)?

Answer 8

Marginal Zone Lymphoma - t(11;18)

Question 9

What is Waldenstrom macroglobulinemia?

Answer 9

A hyperviscosity syndrome caused by hypersecretion of IgM in lymphoplasmacytic lymphoma

Question 10

What virus is present in nearly all cases of Burkitt Lymphoma?

Answer 10

EBV

Question 11

A patient is diagnosed with a type of non-Hodgkin lymphoma that is CD30+ and has rearrangements of ALK and wreath cells on histology. What is the diagnosis?

Answer 11

Anaplastic T-Cell Lymphoma

Question 12

Follicular lymphoma is most common in what age population?

Answer 12

Older adults

Question 13

Excess free light chains are excreted in the urine by patients with multiple myeloma. What are these chains called?

Answer 13

Bence Jones Proteins

Question 14

This plasma cell disorder is an early stage of multiple myeloma development.

Answer 14

Monoclonal Gammopathy of Undetermined Significance (MGUS)

Question 15

Cells in the germinal center of a lymph follicle generally stain positive for what CD marker?

Answer 15

CD10+

Question 16

What is the clinical presentation of multiple myeloma?

Answer 16

Hypercalcemia, renal dysfunction, anemia, bone lesions

Question 17

Lymphoplasmacytic lymphoma is associated with mutations of what gene?

Answer 17

MYD88 - increases NF-kB activity

Question 18

Follicular lymphoma stains positive for what immune markers?

Answer 18

CD20+, CD10+, BCL2+

Question 19

An M spike due to monoclonal M on a serum protein electrophoresis is characteristic of what type of lymphoma?

Answer 19

Multiple Myeloma

Question 20

What is the immunohistological profile of the non-Hodgkin lymphoma with “soccer ball” nuclei?

Answer 20

Small Lymphocytic Leukemia - CD20+, CD5+, CD23+

Question 21

What is the clinical presentation of Burkitt lymphoma?

Answer 21

Endemic BL - tumor of the jaw and face

Sporadic BL - abdominal masses

Question 22

Upregulation of BCL6 is most association with what lymphoma type?

Answer 22

Diffuse Large B-Cell Lymphoma (also BCL2+ and MYC+ in some cases)

Question 23

Patients with multiple myeloma have high amounts of what antibody chains?

Answer 23

IgG heavy chain and kappa light chain

Question 24

What is the most common and deadly plasma cell neoplasm?

Answer 24

Multiple myeloma

Question 25

What is the most common type of non-Hodgkin lymphoma?

Answer 25

Diffuse Large B-Cell

Question 26

What bones are most commonly affected by multiple myeloma?

Answer 26

Vertebral column

Question 27

What chromosomal translocation is associated with Follicular Lymphoma the result?

Answer 27

t(14;18) leading to upregulation of BCL2

Question 28

What is the histologic appearance of mantle cell lymphoma?

Answer 28

Thickened and expanded mantle zone with irregular lymphocytes

Question 29

This is a B-cell neoplasm in which cells undergo differentiation to plasma cells and secrete IgM.

Answer 29

Lymphoplasmacytic Lymphoma

Question 30

This type of non-Hodgkin lymphoma is due to a t(11;14) that causes overexpression of cyclin D.

Answer 30

Mantle Cell Lymphoma

Question 31

Smudge cells characterize chronic lymphocytic leukemia. What cells characterize the tissue version of CLL?

Answer 31

Small Lymphocytic Lymphoma - cells with soccer ball nuclei

Question 32

Cells in the mantle zone of lymph follicles generally stain positive for what CD marker?

Answer 32

CD5+

Question 33

What is tumor lysis syndrome and what non-Hodgkin lymphoma is most associated with the disorder?

Answer 33

Burkitt Lymphoma - Tumor lysis syndrome is massive tumor cell lysis causing hyperuricemia, hyperuricosuria, hyperkalemia, and hypophophatemia that leads to renal failure

Question 34

This type of non-Hodgkin lymphoma presents with diffuse sheets of mature B cells.

Answer 34

Diffuse Large B-Cell Lymphoma

Question 35

What histological findings are characteristic of multiple myeloma?

Answer 35

Flame cells and Mott cells and Russell or Dutcher bodies

Question 36

This is a common indolent non-Hodgkin lymphoma that presents with hyperplasia of mature B cells in the germinal centers.

Answer 36

Follicular Lymphoma