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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
40% of childhood lymphomas are...
acute lymphoblastic lymphoma
26
What can be found in 50-70% of patients with acute lymphoblastic lymphoma?
Mediastinal mass
27
What is the appearance of the morphology of acute lymphoblastic lymphoma?
"Starry sky" appearance
28
What is the course of acute lymphoblastic lymphoma?
Aggressive and rapidly progressive
29
The African form of Burkitt's lymphoma is associated with...
prior EBV infection
30
Does the sporadic form of Burkitt's lymphoma have association with EBV infection?
No
31
Where does the African form of Burkitt's lymphoma present?
Maxilla/mandible presentation in children
32
What does the African form of Burkitt's lymphoma respond well to? What is the issue with this?
Responds well to chemotherapy Issue is healthcare access
33
What is Hodgkin disease/lymphoma?
A neoplasm of lymphoid tissue arising in a single node or a chain of nodes (contiguous)
34
What is the most common malignancy in young adults 20-40 years old?
Hodgkin disease/lymphoma
35
Survivors of Hodgkin lymphoma have increased risk of...
developing secondary cancer
36
What is the etiology of Hodgkin lymphoma?
Unknown
37
What cells can be found with Hodgkin lymphoma?
Reed Sternberg cell and non-neoplastic inflammatory cells
38
What are the symptoms of Hodgkin lymphoma?
Non-specific symptomology
39
How many histological variants does Hodgkin lymphoma have?
Four
40
What cell is necessary for Hodgkin lymphoma?
Reed Sternberg cell
41
What are Reed Sternberg cells?
Large binucleate or bilobed symmetrical nucleus with "owl-eye" morphology and unknown origin
42
Describe a stage I lymphoma
Involvement of a single lymph node region (or extralymphatic site)
43
Describe a stage II lymphoma
Two or more nodal regions on the same side of diaphragm (or more than one extralymphatic site)
44
Describe stage III lymphoma
Involvement of nodes on both sides of diaphragm (or extralymphatic sites)
45
Describe stage IV lymphoma
Diffuse, disseminated involvement in non lymph organs
46
Which stage of lymphoma has the lowest survival rate?
Stage IV lymphoma
47
What is the predictable course of Hodgkin lymphoma?
Lymph nodes --> Spleen --> Liver --> Bone marrow
48
Hodgkin lymphoma spreads...
contiguously
49
Where are lacunar cells characteristically seen?
Nodular-sclerosing type I Hodgkin lymphoma
50
What is the space cleared by lacunar Reed Sternberg cells?
Artefactual space
51
What is the most common form of Hodgkin lymphoma?
Nodular-sclerosis Hodgkin lymphoma
52
What is the morphology of nodular-sclerosis Hodgkin lymphoma?
Contains "lacunar cell" and collagen banding; slow-growing and histologically distinct from others
53
Are females or males more likely to have nodular-sclerosis Hodgkin lymphoma?
Females more likely
54
What is the prognosis for nodular-sclerosis Hodgkin lymphoma?
Excellent prognosis
55
Describe the architecture of nodular-sclerosis Hodgkin lymphoma
Nodular architecture in which lymphoid tissue is surrounded by fibrosis
56
Nodular-sclerosis Hodgkin lymphoma accounts for ___% of chronic Hodgkin lymphoma
70%
57
Which ages will most cases of nodular-sclerosis Hodgkin lymphoma occur?
20-30 years old
58
Mediastinal involvement is most common in which lymphoma?
Nodular sclerosis Hodgkin lymphoma
59
Nodular sclerosis Hodgkin lymphoma tends to manifest as...
lower cervical, supraclavicular, and mediastinal adenopathy (stage II)
60
What is the prognosis for untreated nodular sclerosis Hodgkin lymphoma?
Fatal; 10 year survival rate of only 1%
61
What is the prognosis for nodular sclerosis Hodgkin lymphoma with irradiation and chemotherapy?
70% cure rate can be achieved
62
Which variant of Hodgkin lymphoma contains HRS cells against a mixed inflammatory background of eosinophils, neutrophils, macrophages, and plasma cells?
Mixed-cellularity Hodgkin lymphoma
63
What is the histology of mixed cellularity Hodgkin lymphoma?
Like that of nodular-sclerosis variety, but collagen bands are missing Numerous, typical RS cells (non-neoplastic inflammatory cells)
64
What is the second most common form of Hodgkin lymphoma?
Mixed cellularity Hodgkin lymphoma
65
What is the involvement of lymph nodes with mixed cellularity Hodgkin lymphoma?
Diffuse involvement of nodes
66
With mixed cellularity Hodgkin lymphoma, what is the ratio of Reed Sternberg cells to WBCs?
1:1
67
What is the most frequent Hodgkin lymphoma subtype in HIV-1 infected patients?
Mixed cellularity Hodgkin lymphoma
68
Is there mediastinal involvement with mixed cellularity Hodgkin lymphoma?
Uncommonly
69
How common is lymphocyte rich Hodgkin lymphoma?
Uncommon variant (>6%)
70
Describe the histology of lymphocyte rich Hodgkin lymphoma
* Diffuse infiltrate of **mature** lymphocytes and macrophages (non-neoplastic) * Typical RS cells difficult to find * Nodular nodal pattern
71
What are the symptoms of lymphocyte rich Hodgkin lymphoma?
Highly asymptomatic Fever/weight loss uncommon
72
What is the prognosis for lymphocyte rich Hodgkin lymphoma?
Excellent prognosis
73
What is the least common type of chronic Hodgkin lymphoma?
Lymphocyte depleted Hodgkin lymphoma
74
What is the histology of lymphocyte depleted Hodgkin lymphoma?
Predominance of tumor cells and a marked absence of background lymphocytes
75
Lymphocyte depleted Hodgkin lymphoma is frequently associated with...
HIV infection
76
Which type of Hodgkin lymphoma has the worst prognosis without treatment?
Lymphocyte depleted Hodgkin lymphoma
77
Most patients with lymphocyte depleted Hodgkin lymphoma are positive for...
EBV

Principles of Physiopathology (36 decks)

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