T cell/NK cell, WBC III, Putthoff, lec

Question 1

Patient has lymphadenopathy, eosiniphilia and fever with weight loss
+ CD2 3 and 5
pleomorphic mixture malignant T cells
what is Dx and prognosis?

Answer 1

peripheral T cell lymphoma unspecifiec

worse prognosis than B cell analogues

Question 2

rearrangements on chrom 2 p23 cause what

Answer 2

ALK fusion gene that activates tyrosine kinase for RAS JAK/STAT

Question 3

blood smear shows horse shoe shaped nuclei with “hallmark Cells”
Dx

Answer 3

anaplastic large cell lymphoma

Question 4

which cancer is ALK+? prognosis?

Answer 4

anaplastic large cell lymphoma

in children good prognosis

Question 5

where does anaplastic large cell lymphoma invade

Answer 5

cluster venules and infiltrate lymphoid sinuses

Question 6

anaplastic large cell lymphoma has what CD +

Answer 6

CD30 +

Question 7

Which cancer is associated with patients infected with HTLV-1

Answer 7

acute T cell leukemia/lymphoma

Question 8

where is HTLV-1 endemic

Answer 8

S japan, W africa and caribbean basin

Question 9

Sx Adult T cell leukemia/lymphoma

Answer 9

skin lesions, generalized lymphadenopathy, HSM, lymphocytosis, hypercalcemia

Question 10

clover leaf or flower cells are indicative of what

Answer 10

adult T cell leukemia/lymphoma

Question 11

what is prognosis of adult T cell leukemia/lymphoma

Answer 11

rapidly prgressive

fatal in mo to eyars

Question 12

What is sezary syndrome and when is it seen

Answer 12

exfoliative erythroderma with leukemia sezary cells that have cerebriform nuclei
mycosis fungoides

Question 13

phases of mycosis fungoides

Answer 13

premycotic
plaque
tumor

Question 14

what does mycosis fungoides express on surface

Answer 14

CLA, CCR4, CCR10

Question 15

prognosis and complication with mycosis fungoides

Answer 15

8-9 yrs

can progresss to T cell lymphoma

Question 16

what cancer is associated with cerebriform nuclei

Answer 16

sezary cells so mycosis fungoides

Question 17

CD3- CD56+

Answer 17

NK variant of large granular lymphocytic leukemia
or!!
extranodal NK/T cell lymphoma
need to differentiate based on clincal presentation

Question 18

what will you see on smear of large granular lymphocytic leukemia

Answer 18

large lymphocytes with blue cytoplasm and azurophilic granules

Question 19

What are the main clinical features of large granular lymphocytic leukemia

Answer 19

neutropenia and anemia

Question 20

What is felty syndrome and what is it assoc with

Answer 20

triad of RA, splenomegaly and neutropenia

sometimes seen in large granular lymphocytic leukemia

Question 21

What gene is mutated in large granular lymphocytic leukemia

Answer 21

STAT3

Question 22

What are CD markers for variants of large granular lymphocytic leukemia

Answer 22

T cell is CD3+

NK is CD3- and CD56+

Question 23

which type of large granular lymphocytic leukemia is more aggressive

Answer 23

NK

Question 24

Asian patient with EBV and destructive nasopharyngeal mass and azurophlic granules in blood
Dx? what will CD show

Answer 24

extranodal NK/T cell lymphoma

CD3- CD56+

Question 25

Tx for extranodal NK/T cell lymphoma

Answer 25

aggressive | radiation not chemo

Question 26

Hodgkins comes form what cell lineage

Answer 26

B cell, neplastic giant cells called reed sternberg

Question 27

what is characteristic of RS cells and which variant does not have them

Answer 27

owl eyed nucleus | not seen in lymphocyte predominace, see L &H cells there

Question 28

how are hodgkins lymphomas ranked

Answer 28

staging because spread in orderly fasion

Question 29

What is population affected by hodgkins

Answer 29

age 32 avg Dx age | common cancer in young adults

Question 30

what do RS do

Answer 30

release cytokines and factors that cross talk with other cells and increase # reactice lymphocytes, macrophages and granulocytes

Question 31

What is most common type of hodgkins and characteristics

Answer 31

nodular sclerosis, desposition of collagen bands, lower cervical and supraclavicular adenopathy not assoc with EBV

Question 32

What are the markers for classical hodgkins

Answer 32

PAX5+ CD15+ CD30+ | CD45-

Question 33

EBV is associated with which types of hodgkins in order of most likley

Answer 33

lymphocyte depletion mixed cellulartiy lymphocyte rich

Question 34

Which variants of hodgkins have systemic Sx

Answer 34

mixed cellularity, depletion and rich

Question 35

What is the nonclassical hodgkins and why? | characteristics?

Answer 35

have B cell markers CD20+, BCL6+, CD15- CD30- lymphocyte predominance multilobated nucleus "popcorn cell" L&H cells not RS

Question 36

What age group is affected by the lymphocyte predominance hodgkins

Answer 36

males <35 with cervical or axillary adenopathy

Question 37

which hodgkins has less favorable outcome

Answer 37

lymphocyte depletion

Question 38

which hodgkins can transform to a tumor resembling DLBCL

Answer 38

lymphocyte predominance

Question 39

What is used in Tx for hodgkins

Answer 39

anti CD30 Ab

Question 40

overall general Sx of hodkgins

Answer 40

painless lymphadenopathy