Small B-Cell Lymphomas COPY

Question 1

Monocyte markers?

Answer 1

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

Question 2

B-cell markers?

Answer 2

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

Question 3

NK Cell Markers

Answer 3

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

Question 4

Pro B Markers (B-ALL)

Answer 4

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

Question 5

Pre-B Markers (B-ALL)

Answer 5

Has Pre BCR

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

Question 6

Immature B-cell (B-ALL)

Answer 6

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

Question 7

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

Answer 7

IgM and D
TdT-

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

Question 8

Centroblast (Phenotype and 1 associated cancer with phenotype)

Answer 8

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

Question 9

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

Answer 9

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

Question 10

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

Answer 10

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

Question 11

HIV related lymphomas

Answer 11

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

Question 12

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

Answer 12

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

Question 13

CLL transformation into DLBCL called?

Good vs Bad CLL Prognosis genes

Answer 13

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

Question 14

What is Monoclonal B lymphocytosis?

Answer 14

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

Question 15

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

Answer 15

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

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

Question 16

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

Answer 16

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+)

Question 17

Mantle Cell Lymphoma (genes/translocations)

What can it create in the colon?

Aggressive Variant?

Answer 17

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

Question 19

What is Mantle Cell In situ?

Answer 19

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

Question 20

Follicular lymphoma (phenotype, grading, translocation)?

CD21+/CD23+ meshwork, is it preserved?

Answer 20

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

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

Meshwork preserved

Question 21

Follicular Grading Criteria

Follicular Bone Marrow Finding

Answer 21

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

Question 22

What is duodenal-type FL?

Phenotype and Gene rearrangement?

Answer 22

Rare 2nd part of duodenum

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

BCL2, t(14;18)

Question 24

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

Answer 24

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

IGH rearranged; BCL2 and 6 no translocation

Good prognosis

Question 25

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

Answer 25

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

Question 26

Marginal Zone Lymphoma (Association, common location)

Morphology (also common finding)?

Phenotype?

Answer 26

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-

Question 27

MALT locations and translocations?
Stomach?
Intestine?
Ocular/Orbital?

Salivary Gland?
Lung?

Skin?

Thyroid?

Answer 27

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

Question 28

Nodal MZL (where do cells reside?)

Answer 28

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

Question 29

Splenic Marginal Zone (location?)

Classic Morphology?

Phenotype?

Mutations?

Prognosis?

Answer 29

>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

Question 30

Translocations
Follicular
Mantle

Marginal

Answer 30

Follicular: t(14;18)(q32;q31); IgH-BCL2

Mantle: t(11;14) (q13;q32): IgH-CCND1

Marginal: t(11;18) (q21;q21): API-MALT1

Question 31

Hairly Cell Leukemia (age, location in body, tissue patterns)

Mutation

Phenotype

Classic morphology (Peripheral blood and bone marrow)

Answer 31

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

Question 32

Hairy cell leukemia variant
Features, Phenotype

Answer 32

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)