Plasma cell dyscrasias

Question 1

Lymphoma

Answer 1

malig neoplasm consisting of a clonal population of lymphocytes

Question 2

Pre-B lymphomas

Answer 2

TdT+
CD19+
CD10+

Question 3

Pre-T lymphomas

Answer 3

CD1+
CD2+
CD5+
CD7+

Question 4

Bad prognosis of Pre-B and T lymphoma

Answer 4

age >2
adolescent or adult
blasts > 100,000
unfavorable genetics (Ph chromosome)

Question 5

Most common leukemia of adults in the western world

Answer 5

CLL/SLL

Question 6

Immunophenotype of CLL/SLL

Answer 6

CD19+ (B)
CD20+ (B)
CD23+ (T)
CD5+ (T)

Question 7

Most common NHL in the US

Answer 7

Follicular lymphoma
CD19+
CD20+
CD10+
Slg+
BCL6+

Question 8

Follicular lymphoma

Answer 8

14;18 xslocation
bcl2, anti apoptotic
indolent course, but incurable
“butt cell”

Question 9

Diffuse Large B-Cell Lymphoma

Answer 9

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+

Question 10

Mantle cell lymphoma

Answer 10

CD19+ / CD20+ / CD5+
CD23-
t11;14 --> inc cyclin D1
poor prognosis
xsformation uncommon
often in tissue with autoimmune disease

Question 11

Burkitt Lymphoma

Answer 11

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"

Question 12

Peripheral T-cell and NK-cell neoplasms

Answer 12

CD2+ / CD5+ / CD3+ / CD4 or 8 (sometimes)
monoclonal rearrangement of at least one T cell receptor locus
will see eosinophilia
aggressive; poor prog

Question 13

Anaplastic Large cell Lymphoma

Answer 13

rearrangement of ALK gene on 2p23
children and young adults
older adults lack ALK –> poorer prognosis
see Reed cells

Question 14

Mycosis Fungoides/Sezary Syndrome

Answer 14

Tumor of CD4+ T-cells
skin –> plaque to tumor phase
sezary cells –> cerebriform nuclei
xsformation to a large cell is a terminal event

Question 15

Hodgkin Lymphoma

Answer 15

malig neoplasm of lymph nodes
Reed-Sternberg cells --> neoplastic cell
normal lympho, histio, plasma cells, and eosinophils
spreads predictably
young adults

Question 16

Types of Hodgkin Lymphoma

Answer 16

Nodular sclerosis --> most common
Mixed cellularity
Lymphocyte rich
Lymphocyte depleted --> less common variant
Lymphocyte predominant

Question 17

Stage 1 Ann Arbor System

Answer 17

involvement of single node or extra nodal site

Question 18

Stage II Ann Arbor System

Answer 18

involvement of two or more node groups on SAME side of diaphragm

Question 19

Stage III Ann Arbor System

Answer 19

involvement of nodes on both sides of the diaphragm / may include spleen

Question 20

Stage IV Ann Arbor System

Answer 20

multiple foci of involvement of extra lymphatic organs

Question 21

Nodular Sclerosis Hodgkin Lymphoma

Answer 21

most common type
lacunar cells
collagen bands
background of eosin, macro, and plasma cells
CD15+ / CD30+ / CD45- / Tcell marker -

Question 22

Mixed Cellularity HL

Answer 22

males

strongly assoc w/ EBV

Question 23

Lymphocyte Depleted HL

Answer 23

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

Question 24

Lymphocyte rich HL

Answer 24

uncommon form
reactive lymph are in the majority
RS: CD45- / CD20- / CD15+ / CD30+
still assoc w/ EBV
excellent to good prog

Question 25

Lympho predom HL

Answer 25

nodular small lymphs and histiocytes
popcorn cells
CD20+ / bcl6+
males / young 
cervical or axillary adenopathy
excellent prognosis

Question 26

Multiple Myeloma

Answer 26

malig neoplasm of plasma cells
arranged in sheets
lytic aggregates of plasma cells in bone (skull)