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B&L Unit 3 > Plasma Cell Disorder and Hodgkin Lymphoma > Flashcards

Plasma Cell Disorder and Hodgkin Lymphoma Flashcards

1
Q

Most Plasma Cell Neoplasms originate as bone marrow tumors and are detectable by measuring ______ in the serum or urine

A

monoclonal protein (M protein)

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2
Q

What does CRAB stand for?

A

hyperCalcemia, Renal insufficiency, Anemia, Bone lesions

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3
Q

When CRAB accompanies 20% nucleated cells in bone marrow, what is the diagnosis?

A

Plasma Cell Myeloma.

CRAB is the most important criteria for PCM

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4
Q

Bone marrow is normally 3%, in PCM it can be ____

A

about 30-40%

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5
Q

elevated creatinine is related to ____

A

kidney disfunction

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6
Q

in PCM which immunoglobulins are you looking to be elevated?

A

IgM and IgA. Other types of PCM include light chain only, and nonsecretory also IgD, IgE but these are rare.

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7
Q

In testing for PCM what does it mean if in a serum protein immunofixation test there are very high levels of one type of heavy chain and one type of light chain?

A

This is positive for PCM. The abnormal plasma cells all arise from one progenitor, have same ABs.

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8
Q

Which chain appears on urine test?

A

only the light chain.

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9
Q

What is rouleaux formation?

A

occurs in PCM. Its when RBCs stack on top of each other because of all the antibodies. ABs are + charged and RBCs are - charged. Occurs with high m protein serum levels

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10
Q

What do you use SPEP and SPI for?

A

SPEP to see which AB is high, SPI to see which AB (will show a band as opposed to a smear).

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11
Q

True or False: If you see the nucleolus in a plasma cell it is neoplastic.

A

true

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12
Q

Hematologic tumor is systemic or local?

A

systemic, can metastasize everwhere

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13
Q

What is MGUS?

A

presence of monoclonal antibody in the serum or urine with no evidence of a plasma cell myeloma.

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14
Q

T or F- MGUS is a precursor to PCM?

A

T

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15
Q

What is Solitary plasmacytoma?

A

just the singular version of PCM (which is also called multiple myeloma). a single plasmacytoma of bone which is a localized tumor of bone.

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16
Q

T or F? Solitary plasmacytoma of bone involves the bone marrow?

A

F. If it does then it is PCM.

17
Q

Diagnostic criteria for Solitary plasmacytoma of bone

A

No CRAB. absent or low serum M protein, single bone lesion

18
Q

Diagnostic criteria for MGUS?

A

M-spike but no CRAB or other multiple myeloma features.

19
Q

What is extraosseous plasmacytoma and where do they typically occur?

A

localized plasma cell tumors that arise in tissues outside of the bone marrow. 75% occur in the upper respiratory tract.

20
Q

CHL (Classic Hogkin Lymphoma) and NLPHL (nodular lymphocyte-predominant Hodgkin’s lymphoma) are both lymphomas involving what?

A

B cells

21
Q

CHL and NLPHL both originate where?

A

B cells in the germinal center

22
Q

What are the four types of CHL?

A
  1. Nodular sclerosis most common 70% of all cases
  2. Lymphocyte-rich (best prognosis)
  3. Lymphocyte depleted (most aggressive)
  4. Mixed cellularity (associated with Eosinophils)
23
Q

What are RS cells?

A

Reed sternberg cells. Found in CHL.

  • They are large B cells
  • multiple lobulated nuclei
  • nucleolus is large and pink-big cytoplasm
  • “owl eye” nuclei
24
Q

What markers do RS cells have? What do they lack that is significant?

A

Have CD30 and CD 15

Lack common leukocyte antigen CD45

25
Q

What is the morphology of Nodular sclerosis?

A
  • Classic Presentation is an enlarging cervical or mediastinal lymph node in a young adult, usually female.
  • Lymph node is divided by bands of sclerosis most important
  • RS cells are present in lacunar cells.
26
Q

What is mixed cellularity CHL?

A
  • Second most frequent subtype, 20-30%
  • Lack of broad bands of collagen seen in nodular sclerosis CHL* probably most important.*
  • Frequent in children and older patients
  • B symptoms

Epstein-Barr virus (EBV) infection in ~75% of cases

27
Q

What is lymphocyte rich CHL?

A

Not much on this one…

  • Classic RS cells are present though rare most important
  • lacks the broad bands of collagen seen in NSHL patients -B cell symptoms
28
Q

When do you typically see lymphocyte depleted CHL?

A

in older patients and those with HIV

29
Q

Typical characteristics of lymphocyte depleted CHL?

A

numerous RS cells many of which will look cancerous. The RS cells are abundant and can form clusters.

30
Q

What is a typical radiographic finding of plasma cell myeloma?

A

Bone “punch outs” where osteoclasts have thinned the bone out significantly.

31
Q

What is a smoldering myeloma?

A

Well its like a fire that has gone out… the coals still smolder but they are inactive as far as firemaking goes.

Smolderimg myeloma is inactive myeloma. It is AKA indolent myeloma

32
Q

Where are the typical locations of plasma cell myelomas and plasmacytomas?

A 
PCM= marrow
Plasmacytoma= bone and extraosseous

B&L Unit 3 (9 decks)

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