Plasma cell dyscrasias Flashcards
Lymphoma
malig neoplasm consisting of a clonal population of lymphocytes
Pre-B lymphomas
TdT+
CD19+
CD10+
Pre-T lymphomas
CD1+
CD2+
CD5+
CD7+
Bad prognosis of Pre-B and T lymphoma
age >2
adolescent or adult
blasts > 100,000
unfavorable genetics (Ph chromosome)
Most common leukemia of adults in the western world
CLL/SLL
Immunophenotype of CLL/SLL
CD19+ (B)
CD20+ (B)
CD23+ (T)
CD5+ (T)
Most common NHL in the US
Follicular lymphoma CD19+ CD20+ CD10+ Slg+ BCL6+
Follicular lymphoma
14;18 xslocation
bcl2, anti apoptotic
indolent course, but incurable
“butt cell”
Diffuse Large B-Cell Lymphoma
common type of NHL --> aggressive and rapidly enlarging 60-70% of aggressive lymphomas C-MYC mutations some have t14;18 CD19+ CD20+ bcl6+ --> dysregulation Slg+
Mantle cell lymphoma
CD19+ / CD20+ / CD5+ CD23- t11;14 --> inc cyclin D1 poor prognosis xsformation uncommon often in tissue with autoimmune disease
Burkitt Lymphoma
Africa (endemic) / HIV pop / sporadic mature B / surface IgM CD19+ / CD20+ / CD10+ / bcl6+ C-MYC on chromosome 8;14 EBV related 30% childhood lymphomas "starry sky"
Peripheral T-cell and NK-cell neoplasms
CD2+ / CD5+ / CD3+ / CD4 or 8 (sometimes)
monoclonal rearrangement of at least one T cell receptor locus
will see eosinophilia
aggressive; poor prog
Anaplastic Large cell Lymphoma
rearrangement of ALK gene on 2p23
children and young adults
older adults lack ALK –> poorer prognosis
see Reed cells
Mycosis Fungoides/Sezary Syndrome
Tumor of CD4+ T-cells
skin –> plaque to tumor phase
sezary cells –> cerebriform nuclei
xsformation to a large cell is a terminal event
Hodgkin Lymphoma
malig neoplasm of lymph nodes Reed-Sternberg cells --> neoplastic cell normal lympho, histio, plasma cells, and eosinophils spreads predictably young adults
Types of Hodgkin Lymphoma
Nodular sclerosis --> most common Mixed cellularity Lymphocyte rich Lymphocyte depleted --> less common variant Lymphocyte predominant
Stage 1 Ann Arbor System
involvement of single node or extra nodal site
Stage II Ann Arbor System
involvement of two or more node groups on SAME side of diaphragm
Stage III Ann Arbor System
involvement of nodes on both sides of the diaphragm / may include spleen
Stage IV Ann Arbor System
multiple foci of involvement of extra lymphatic organs
Nodular Sclerosis Hodgkin Lymphoma
most common type lacunar cells collagen bands background of eosin, macro, and plasma cells CD15+ / CD30+ / CD45- / Tcell marker -
Mixed Cellularity HL
males
strongly assoc w/ EBV
Lymphocyte Depleted HL
less common variant strongly assoc w/ EBV lots of RS cells; fewer lymph Diff Dx: Large cell Lymphoma older pt and HIV less favorable prognosis than other types
Lymphocyte rich HL
uncommon form reactive lymph are in the majority RS: CD45- / CD20- / CD15+ / CD30+ still assoc w/ EBV excellent to good prog
Lympho predom HL
nodular small lymphs and histiocytes popcorn cells CD20+ / bcl6+ males / young cervical or axillary adenopathy excellent prognosis
Multiple Myeloma
malig neoplasm of plasma cells
arranged in sheets
lytic aggregates of plasma cells in bone (skull)
