Small B-Cell Lymphomas Flashcards by Ben Saylor

Monocyte markers?

CD45+, CD14+, CD114+, CD11a+, CD11b, CD16+, CD91+

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B-cell markers?

CD45+, CD19+, CD20+, CD24+, CD38+, CD22+, PAX5+, CD79a+

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NK Cell Markers

CD16+, CD56+, CD3-, CD31+, CD30+, CD38+

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Pro B Markers (B-ALL)

Tdt+, Cd34+, CD19+, CD10+, PAX5+/-, CD20-

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Pre-B Markers (B-ALL)

Has Pre BCR

Tdt+, CD34+, CD19+, CD10+, PAX5+ (different from Pro B), CD79a+, CD20-

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Immature B-cell (B-ALL)

Tdt+/- (pre B and Pro B +)
CD34+/- (pre B and Pro B +)

CD20+ (pre B and Pro B +)
CD19+
CD10+
PAX5+
CD79a+
Has some surface IgM

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Naive B (incluidng Ig types)
2 Cancers with this pheonotype?

IgM and D
TdT-

CD10+ (first time this is positive)
PAX5+
CD20+
CD79a+
Burkitt Lymphoma and Mantle

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Centroblast (Phenotype and 1 associated cancer with phenotype)

CD19+
CD10+
PAX5+
CD20+
CD79a+
BCL6+ (normally found inside germinal centers)
High grade follicular lymphoma

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Small Cell Lymphoma CD5+ CD10+?
CD5- CD10+?
CD5- and CD10-?

CD5+ CD10+= CLL (CD23+) or Mantle (Cyclin D1 +, CD23-)
Follicular (CD5-, CD10+)
Marginal Zone and Lymphoplasma Cytic

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Post-transplant lymphoproliferatrive disorder associated diseases (and viral cause)?

EBV+
Non-=destructive PTLD, polymorphic PTLD, monomorphic PTLD, Classic Hodgkin lymphoma PTLD

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HIV related lymphomas

Burkitt
Diffuse large B-cell lymphoma
Primary effusion
Plasmablastic lymphoma
Lymphoma from HHV8+ Castleman

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CLL/SLL Phenotype
Classic Cell Morphology and Classic “finding”

CD19+, DIM CD20+, CD22+, CD79+, Dim IgM/D, CD5+, CD23+
CD10-, FMC7-, CyclinD1-

Clumped chromatin, scant cytoplasm (Soccer ball)
Diffuse effacement with Proliferation Centers (lack Tingible body macrophages)
Small lymphocytes, prolymphocytes, and paraimmunoblasts

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CLL transformation into DLBCL called?

Good vs Bad CLL Prognosis genes

Richter syndrome (DLBCL) 2-8%, <1% into Hodgkin

Good: Mutated IGHV, Memory Like Cases, Isolated 13q14

Bad: Unmutated, Zap70+, CD38+ CD49d+, Del 11q or 17p, 13q, and more

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What is Monoclonal B lymphocytosis?

Clonal B-cells with CLL phenotype
Low count: <0.5e9/L, insignificant
High: >0.5e9/L, 1-2% CLL/yr

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B-cell Prolymphocytic leukemia (Surface antigens, affected gene, surface antigens)

*CLL with Prolymphocytes**
*t(11;14) or SOX11-**leukemic variant MCL

IgM/IgD, CD5+/CD23+ 25% of cases

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Mantle Cell Lymphoma (survival rate?)
Morphology?
Phenotype?

5 year survival low

Small medium cell, irregular nuclei, inconspicuous nucleoli, scant cytoplasm
Mitosis common
Admixed histeocytes
CD20Bright, CD5+, CD43+, BCL2+, Cyclin D1+, SOX11+
CD10-, CD23-, BCL6-

Rare CD5- or CD23+, RARE Cyclin D1- (Cyclin D2+, SOX11+)

Mantle Cell Lymphoma (genes/translocations)

What can it create in the colon?

Aggressive Variant?

IGH and IGL rearranged but unmutated
t(11;14) CCND1/BCL1 and IgH (CCND1 is cyclin D1 and can be missing)

Lymphomatous Polyposis

Blastoid (can be CD5-, CD10+, BCL6+); Pleomorphic

What is Mantle Cell In situ?

Preserved architecture, low grade, Cyclin D1+ confined to mantles
Most SOX11 negative

Follicular lymphoma (phenotype, grading, translocation)?

CD21+/CD23+ meshwork, is it preserved?

sIg+, CD20+, CD10+, BCL6+, CD5-, CD43-

t(14;18) IGH/BCL2; 90%; BCL6 in 15%

Meshwork preserved

Follicular Grading Criteria

Follicular Bone Marrow Finding

Grade 1-2 (low); 0-15 centroblasts (larger more cleared out)/hpf

Grade 3 >15 centoblasts/hpf

Grade 3A: Centrocytes present; 3B centrocytes absent

Diffuse areas of grade 3= diffuse large B-cell lymphoma

Paratrabecular aggregates

What is duodenal-type FL?

Phenotype and Gene rearrangement?

Rare 2nd part of duodenum

CD20+, CD10+, CD5-, BCL6+, BCL2+

BCL2, t(14;18)

Pediatric type nodal FL (phenotype, prognosis, genes)?

Boys
CD10+, BCL2+, BCL2-/dim, MUM1-, CD43+/-, Ki67 high

IGH rearranged; BCL2 and 6 no translocation

Good prognosis

Lymphoplasmacytic lymphoma (what paraprotein, survival, association)? Waldenstrom macroglobulinemia requirements? Morphology and Phenotype? Gene association?

Indolent survival (rare DLBCL); **HCV and Mast Cells** WM: LPL with bone marrow involvement and IgM monoclonal gammopathy Diffuse interfollicular open sinsuses Small lymphocytes, plasma cells, **plasmacytoid cells (Dutcer bodies. nuclear)** **CD20+bright, sIg+, cig+, CD38+, MUM1+,** CD5-, CD10-, CD23-, BCL6- *MYD88*; L265P

Marginal Zone Lymphoma (Association, common location) Morphology (also common finding)? Phenotype?

Aoosciated with chronic inflammation (stomach, occular adnex, common)? Heterogenous small-B-cells; (centrocyte-like, **with cytoplasm**) can represent monocytoid cells Rare plasmacytoid diffentiation **Lymphoepithelial lesions (lymphocytes in glandular epithelium)** CD20+, CD79a+, PAX5+, CD43+/-, **CD5-, CD10-**

MALT locations and translocations? Stomach? Intestine? Ocular/Orbital? Salivary Gland? Lung? Skin? Thyroid?

Stomach: H. Pylori t(11;18) API2-MLT Intestine: Camp jejuni mixture +3 or +18 Ocular/Orbital: C. psittaci +3 Salivary Gland: Sjogren +3 Lung: t(11;18) API2-MLT Skin: B. Burgorferi +3 Thyroid: t(3;14), FOXP1-IgH

Nodal MZL (where do cells reside?)

Adults ~60 yrs, Peripheral LN and bone marrow Marginal zone of reactive follicles and extend into **follicular region**

Splenic Marginal Zone (location?) Classic Morphology? Phenotype? Mutations? Prognosis?

\>50 yrs, spleen, splenic hilar LN, BM, peripheral blood **Villous lymphocytes (projections on one side****)**, small round cells replacing white pulp germinal centers, efface follicle mantle CD20+, CD79a+, **CD5-, CD10-, CD23-, CD43-, CD103-, AnnexinA1-, Cyclin D1-,m LEF1-** Deletion 7q (30%), NOTCH 2 Indolent

Translocations Follicular Mantle Marginal

Follicular: t(14;18)(q32;q31); IgH-BCL2 Mantle: t(11;14) (q13;q32): IgH-CCND1 Marginal: t(11;18) (q21;q21): API-MALT1

Hairly Cell Leukemia (age, location in body, tissue patterns) Mutation Phenotype Classic morphology (Peripheral blood and bone marrow)

Adults middle age to elderly M\>W, W\>B; Patchy, Diffuse solid, hypocellular **BRAF V600E** **CD103+ CD11c+, DBA.44, Annexin A1+ (most specific),** Trap+, CD25+, Cyclin D1+, **CD123+,** CD200+, **CD10-, CD5-** PB: Hairly cells (projections 360 deg), BM: Fried Egg

Hairy cell leukemia variant Features, Phenotype

Leukocytosis, no monocytopenia **Round to oval nuclei, prominent nucleoi, rare cytoplasmic projections** CD103+, CD11c+, DBA.44+, T-bet+, **TRAP-, CD25-, Cyclin D1-,m Annexin A1-, CD123+/-, CD200weak** Poor outcome (vs HCL which has good outocme)