Week 4 Friday Flashcards
Mantle cell lymphoma
t(11,14) translocation (heavy chain)
Low grade NHL
Follicular lymphoma
t(14,18) back to back follicles Grade 1-3 (3 bad) Low grade NHL Can spread to other tissues as white dots (which are follicules) hang out next to trabecular
Follicular lymphoma blood smear:
Little cells with slit
“Butt cells”
Low grade NHL
Marginal zone lymphoma
low grade NHL
Malt lymphoma
Associated with w helicobacter pylori
mycosis fungoides / sezary syndrome
low grade NHL skin lesions blood involvement *cerebriform lymphocytes (look like brains) *t-cell immunophenotype
sezary syndrome
end resuld of mycosis fungoides low grade NHL
pautrier microabscess
found in mycosis fungoides. in the skin.
Benign lymph node enlargement
most common
caused by infection
soft when palpating
can be painful
Malignant lymphadenopathy
most common cause is metastatic carcinoma
Hard when palpating
Painless
diffuse large cell lymphoma
large B cells
extranodal involvement, large cells that grows fast
bad prognosis
High grade NHL
lymphoblastic lymphoma
type types: t and b lymphoblasts diffuse pattern Same as ALL often seen in teenage MALE with mediastinal mass High grade NHL
Burkitt lymphoma
Children, extranodal mass
STARRY SKY PATTERN
african type (jaw) and non african type (abdomen)
t(8;14) (same as burkitt leukemia)
Starry sky pattern
Found in burkitt lymphoma
white dots are tingle body macrophages
Adult t-cell leukemia/lymphoma
japan/caribbean basin
HTLV-1 (virus)
skin lesions, hypercalcemia
very aggressive
tingle body macrophage
non malignant macrophage just eating up all debris from high turnover. See them in germinal centers or any tumor that grows fast
T cell lymphomas?
Adults t-cell leukemia and mycosis fungoides
Burkitt leukemia microscope:
starry sky patterns. Cells have clear dots (vacoules)
Hodgkins vs NHL
Hodgkins is contigous spread
NHL is very sporadic and most are B cells
Hodgkins nodules are larger on liver and spleen
Hodgkins lymphoma must know:
younger patients, good prognosis
Even spread
Five subtypes
Reed-sternberg cell
Reed sternberg cell
Very large cell with 2/nuclei that are as big as lymphocytes “owl eyes”
Hodgkins lymphoma!
Malignant part of the disease. Release cytokines to recruit cells, but recruited cells are not malignant
Hodgkins lymphoma subtypes
Nodular lymphocyte predominance
Classical: nodular sclerosis lymphocyte rich mixed cellularity lymphocyte depletion
Nodular lp hodgkin lymphoma
good prognosis
usually asymptomitc and young male with cervical lymphadenopathy
Bcell origin with POPCORN cells
nodular sclerosis hodgkin lymphoma
*
good prognosis
most common of classicaly subtype
LACUNAR cell
Fibrotic bands that seperate nodules
mixed cellularity hodgkin lymphoma
Bad prognosis
Classic reed-sternberg cells with mixed background of cells
lymphocyte rich HL
uncommon
popcorn cells
Treatment for HL
Surgery, chemo, radiation
Prognosis depends on STAGE
Danger: second malignancies
Small lymphocytic lymphoma
Low grade NHL small mature lymphocytes Same as CLL Bcell lesions w/CD5 Long course Richter transformation
Richter Transformation
Sound in SLL/CLL
Low grade NHL
older patients
incurable
small mature cells
non-destructive
High grade NHL
children
aggressive
big ugle cells
destructive
Symptoms of NHL
Painless firm lymphadenopathy
Extranodal manifestations
B symptoms make it worse: weight loss, night sweats, fever
Follicular hyperplasia
large, irregular follices
mixture of cells in germ centers
tingible body macrophages
B-cell response to some immune stimulus
Interfollicular hyperplasia
Expanded between follicles
mixture of cells
Partial effacement
T-cell response to some immune stimullus!!
Chronic lymphoproliferative disorders musk know:
Many disorders: CLL most important
ONLY in adults
Long course
CLL must know
small, mature lympocytes
B-cell, with CD5+ (normally on only tcell)
TdT Negative
Long course
HYPOGAMMAGLOBULINEMIA
Pathophysiology of CLL
bcl-2 gene rearrangement
bcl-2 prevents apoptosis
Gets stuck next to gene that turns it on at all times
Treat conservative. death usually from infection
Hairy cell leukemia
CLD
Hairy cells
Splenomegaly WITHOUT LYMPHADENOPATHY
pancytopenia
TRAP+ STAIN
Hairy cell leukemia bone marrow aspiration
HARD to pull out bone marrow. Bone marrow stuck together with fibrosis
Hairy cell leukemia chem and immunophenotype. Labs?
TRAP +
Positive for B-cell antigen, CD25 AND CD11C
Negative for CD5
Always MONOCYTOPENIA
Prolymphocytic leukemia
CDL
splenomegaly WITHOUT LYMPADENOPATHY
rare and aggressive
Nucleoli show through on blood smear
Large granulated lymphocyte leukemia must know:
Large granulated lymphocytes
T CELL
Neutropenia with long survival
