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Principles of Physiopathology > WBC Disorders: Lymphoma > Flashcards

WBC Disorders: Lymphoma Flashcards

1
Q

What is a lymphoma?

A

Malignant neoplasms of cells native to lymphoid tissue predominantly node, and most often of B-cell origin

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2
Q

What are the two types of lymphoma?

A
  • Hodgkin lymphoma
  • Non-Hodgkin lymphoma
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3
Q

In all lymphomas, what is the general symptomology?

A

No symptomology or any combination of:
* Lymphadenopathy
* Elevated WBC count
* Infection
* Weight loss
* Fever
* Malaise

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4
Q

Which presentation in leukemias and lymphomas has a better prognosis: nodular or diffuse?

A

Nodular has little better prognosis
Diffuse is usually more severe

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5
Q

With non-Hodgkin lymphoma, the potential for spread from a single node to other nodes is…

A

non-predictable/non-contiguous

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6
Q

What is the result of non-Hodgkin lymphoma “spilling” into blood?

A

Dissemination to non-nodal tissue (spleen, liver, bone marrow)

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7
Q

What is the clinical presentation of non-Hodgkin lymphoma?

A
  • Lymphadenopathy
  • Non-tender nodal involvement
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8
Q

80-85% of non-Hodgkin lymphomas are of what origin?

A

B cell origin

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9
Q

Non-Hodgkin lymphoma cancer can be…

A

slow growing or aggressive

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10
Q

40% of adult non-Hodgkin lymphoma is what type?

A

Follicular lymphoma

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11
Q

4% of adult non-Hodgkin lymphoma is what type?

A

Small lymphocytic lymphoma/ chronic lymphocytic leukemia

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12
Q

Follicular lymphoma is of exclusively which origin?

A

B cell origin

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13
Q

With follicular lymphoma, organ metastases are…

A

uncommon

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14
Q

What percentage of follicular lymphoma cases will progress to large B cell lymphoma?

A

30%

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15
Q

Describe the growth and treatment success of follicular lymphoma

A

Very indolent/slow growing but difficult to cure

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16
Q

Describe the histology of follicular lymphoma

A

Little follicles/nodules of neoplasm

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17
Q

Describe the lymphocytes in small lymphocytic lymphoma/chronic lymphocytic leukemia

A

Small, compact, unstimulated lymphocytes not producing antibodies

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18
Q

What percent of small lymphocytic lymphoma spills into blood?

A

60%

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19
Q

Which leukemia is small lymphocytic lymphoma identical to?

A

Chronic lymphocytic leukemia

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20
Q

Describe the course of small lymphocytic lymphoma/chronic lymphocytic leukemia

A

Slow, indolent course

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21
Q

What percentage of patients with large B cell lymphoma achieve remission with intensive chemotherapy?

A

60-80%

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22
Q

Without treatment, what is the course of large B cell lymphoma?

A

Spills into blood and organs
Aggressive; rapidly fatal

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23
Q

Which lymphoma has bone, brain, and GI tract involvement?

A

Large B cell lymphoma

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24
Q

If B cells are large, they are…

A

poorly differentiated

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25
Q

40% of childhood lymphomas are…

A

acute lymphoblastic lymphoma

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26
Q

What can be found in 50-70% of patients with acute lymphoblastic lymphoma?

A

Mediastinal mass

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27
Q

What is the appearance of the morphology of acute lymphoblastic lymphoma?

A

“Starry sky” appearance

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28
Q

What is the course of acute lymphoblastic lymphoma?

A

Aggressive and rapidly progressive

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29
Q

The African form of Burkitt’s lymphoma is associated with…

A

prior EBV infection

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30
Q

Does the sporadic form of Burkitt’s lymphoma have association with EBV infection?

A

No

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31
Q

Where does the African form of Burkitt’s lymphoma present?

A

Maxilla/mandible presentation in children

32
Q

What does the African form of Burkitt’s lymphoma respond well to?
What is the issue with this?

A

Responds well to chemotherapy
Issue is healthcare access

33
Q

What is Hodgkin disease/lymphoma?

A

A neoplasm of lymphoid tissue arising in a single node or a chain of nodes (contiguous)

34
Q

What is the most common malignancy in young adults 20-40 years old?

A

Hodgkin disease/lymphoma

35
Q

Survivors of Hodgkin lymphoma have increased risk of…

A

developing secondary cancer

36
Q

What is the etiology of Hodgkin lymphoma?

A

Unknown

37
Q

What cells can be found with Hodgkin lymphoma?

A

Reed Sternberg cell and non-neoplastic inflammatory cells

38
Q

What are the symptoms of Hodgkin lymphoma?

A

Non-specific symptomology

39
Q

How many histological variants does Hodgkin lymphoma have?

A

Four

40
Q

What cell is necessary for Hodgkin lymphoma?

A

Reed Sternberg cell

41
Q

What are Reed Sternberg cells?

A

Large binucleate or bilobed symmetrical nucleus with “owl-eye” morphology and unknown origin

42
Q

Describe a stage I lymphoma

A

Involvement of a single lymph node region (or extralymphatic site)

43
Q

Describe a stage II lymphoma

A

Two or more nodal regions on the same side of diaphragm (or more than one extralymphatic site)

44
Q

Describe stage III lymphoma

A

Involvement of nodes on both sides of diaphragm (or extralymphatic sites)

45
Q

Describe stage IV lymphoma

A

Diffuse, disseminated involvement in non lymph organs

46
Q

Which stage of lymphoma has the lowest survival rate?

A

Stage IV lymphoma

47
Q

What is the predictable course of Hodgkin lymphoma?

A

Lymph nodes –>
Spleen –>
Liver –>
Bone marrow

48
Q

Hodgkin lymphoma spreads…

A

contiguously

49
Q

Where are lacunar cells characteristically seen?

A

Nodular-sclerosing type I Hodgkin lymphoma

50
Q

What is the space cleared by lacunar Reed Sternberg cells?

A

Artefactual space

51
Q

What is the most common form of Hodgkin lymphoma?

A

Nodular-sclerosis Hodgkin lymphoma

52
Q

What is the morphology of nodular-sclerosis Hodgkin lymphoma?

A

Contains “lacunar cell” and collagen banding; slow-growing and histologically distinct from others

53
Q

Are females or males more likely to have nodular-sclerosis Hodgkin lymphoma?

A

Females more likely

54
Q

What is the prognosis for nodular-sclerosis Hodgkin lymphoma?

A

Excellent prognosis

55
Q

Describe the architecture of nodular-sclerosis Hodgkin lymphoma

A

Nodular architecture in which lymphoid tissue is surrounded by fibrosis

56
Q

Nodular-sclerosis Hodgkin lymphoma accounts for ___% of chronic Hodgkin lymphoma

A

70%

57
Q

Which ages will most cases of nodular-sclerosis Hodgkin lymphoma occur?

A

20-30 years old

58
Q

Mediastinal involvement is most common in which lymphoma?

A

Nodular sclerosis Hodgkin lymphoma

59
Q

Nodular sclerosis Hodgkin lymphoma tends to manifest as…

A

lower cervical, supraclavicular, and mediastinal adenopathy (stage II)

60
Q

What is the prognosis for untreated nodular sclerosis Hodgkin lymphoma?

A

Fatal; 10 year survival rate of only 1%

61
Q

What is the prognosis for nodular sclerosis Hodgkin lymphoma with irradiation and chemotherapy?

A

70% cure rate can be achieved

62
Q

Which variant of Hodgkin lymphoma contains HRS cells against a mixed inflammatory background of eosinophils, neutrophils, macrophages, and plasma cells?

A

Mixed-cellularity Hodgkin lymphoma

63
Q

What is the histology of mixed cellularity Hodgkin lymphoma?

A

Like that of nodular-sclerosis variety, but collagen bands are missing
Numerous, typical RS cells (non-neoplastic inflammatory cells)

64
Q

What is the second most common form of Hodgkin lymphoma?

A

Mixed cellularity Hodgkin lymphoma

65
Q

What is the involvement of lymph nodes with mixed cellularity Hodgkin lymphoma?

A

Diffuse involvement of nodes

66
Q

With mixed cellularity Hodgkin lymphoma, what is the ratio of Reed Sternberg cells to WBCs?

A

1:1

67
Q

What is the most frequent Hodgkin lymphoma subtype in HIV-1 infected patients?

A

Mixed cellularity Hodgkin lymphoma

68
Q

Is there mediastinal involvement with mixed cellularity Hodgkin lymphoma?

A

Uncommonly

69
Q

How common is lymphocyte rich Hodgkin lymphoma?

A

Uncommon variant (>6%)

70
Q

Describe the histology of lymphocyte rich Hodgkin lymphoma

A
  • Diffuse infiltrate of mature lymphocytes and macrophages (non-neoplastic)
  • Typical RS cells difficult to find
  • Nodular nodal pattern
71
Q

What are the symptoms of lymphocyte rich Hodgkin lymphoma?

A

Highly asymptomatic
Fever/weight loss uncommon

72
Q

What is the prognosis for lymphocyte rich Hodgkin lymphoma?

A

Excellent prognosis

73
Q

What is the least common type of chronic Hodgkin lymphoma?

A

Lymphocyte depleted Hodgkin lymphoma

74
Q

What is the histology of lymphocyte depleted Hodgkin lymphoma?

A

Predominance of tumor cells and a marked absence of background lymphocytes

75
Q

Lymphocyte depleted Hodgkin lymphoma is frequently associated with…

A

HIV infection

76
Q

Which type of Hodgkin lymphoma has the worst prognosis without treatment?

A

Lymphocyte depleted Hodgkin lymphoma

77
Q

Most patients with lymphocyte depleted Hodgkin lymphoma are positive for…

A

EBV

Principles of Physiopathology (36 decks)

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