W4-LP-LYMPHOID NEOPLASM Flashcards
List 3 functions of the lymph node
- lymphopoiesis
- Filtration of lymph
- Processing of antigens
What are the 2 main disoders of lymphoid cells?
- Proliferations:
-Reactive
-Neoplastic - Deficiencies
Name the CD surface membrane receptors on the surface of B cells, T cells, and Macrophages
B cells-CD 19 & CD 20
T cells- CD 3
Macrophages- CD 68
Name the visible immunological markers that mark these CD receptors by light microscopy.
- immunoperoxidase
- immunohistochemical stains
CLINICAL ASSESSMENT OF A PATIENT WITH SUSPECTED LYMPHOMA
- History:
Presence of non-painful lymphodenopathy, accompained by: fever, sweating, weight loss, malaise, weakness and
pruritis. These symptoms usually suggest advanced, widespread disease - Physical examination
- Diagnostic tests
a). Formal lymph node biopsy:
Perform biopsy on the largest lymph node as it is most likely
to show specific abnormalities.
-The entire lymph node should be resected; partial
resection or needle biopsies are not acceptable in the initial workup of the patient
as they may miss the involved areas of the node.
-If infection is
suspected, lymph node tissue should also be submitted for microbiology culture
b) bone marrow examination – aspirate and trephine biopsy
c) less commonly, mediastinal biopsy and liver biopsy may be
performed
- Blood tests: full blood count, erythrocyte sedimentation rate, liver and renal function tests
- Radiological investigations: chest X-ray, CT scan, ultrasound in some cases. PET
scans are starting to be used to detect disease as wel
Malignant neoplasms that arise from B-cells, T-cells.
Lymphomas
What are the 2 main groups of lymphomas?
- The non-Hodgkin lymphomas (NHL)
- Hodgkin Lymphoma (HL)
T/F
Both Hodgkin Lymphoma (HL) and Non-Hodgkin Lymphoma (NHL) are types of malignant lymphomas.
TRUE
What differentiates the Hodkin’s lymphoma (HL) from the non-Hodkin’s lymphoma (NHL)?
Presence of large neoplastic Reed-Sternberg cells in the HL
What is the common location of NHL in the body?
nodal in location and may involve any one or more of the lymph node groups in the body.
May involve other lymphoreticular organs or tissues such as spleen, bone marrow, liver, tonsils or extranodal lymphoid tissue in many organs. It may even involve tissue such as the skin, thyroid and brain in which lymphoid tissue is not normally seen
NHL
2-5 times more frequent than Hodgkin’s lymphoma
NHL
List 4 histological types of B cell NHL and outline how they distribute among different age groups
- Lymphoblastic lymphoma most commonly affects children and young adults.
- Small lymphocytic lymphoma affects men more than women. It is a disease of the elderly.
- Endemic Burkitt’s lymphoma is a tumour of childhood. The sporadic form also
affects children and young adults. - Large cell anaplastic lymphoma has a bimodal age distribution, affecting
children and the elderly.
Group of neoplasms composed of immature precursor B or T lymphocytes,
referred to as blasts
Precursor neoplasms:
Acute lymphoblastic lymphoma/leukaemia (ALL)
Name all PERIPHERAL B CELL NHLs
- B cell small lymphocytic lymphoma/Chronic lymphocytic leukaemia
- Mantle cell lymphoma
- Follicular lymphoma
- Diffuse large B cell lymphoma
- Immune deficiency associated large B cell lymphoma
- Body cavity large B cell lymphoma
- Burkitt’s lymphoma (BL)
- Primary extranodal lymphomas
B cell small lymphocytic lymphoma/Chronic lymphocytic leukaemia.
Neoplasms composed of small lymphocytes that may present as either lymphomas or leukaemias.
*incidence increases after the age of 50 years.
Discuss the histology of Small Lymphocytic Lymphoma or leukemia
- Small lymphocytic neoplasms show a monotonous infiltration (uniform appearance of the cells infiltrating the affected tissues) of small cells, which
- express B cell markers, and surface markers CD5 and CD23.
- Smudge cells are a tell-tale sign