White Blood Cell Disorders 2 Flashcards
follicular lymphomas arise from ______
germinal center B cells
what is the characteristic immunophenoytpe for follicular lymphoma
CD19, CD20, CD10+
what is the characteristic translocation of follicular lymphoma
t(14,18)
14: Ig heavy chain
18: Bcl2 (anti-apoptotic)
what other organs can be affected in follicular lymphoma?
spleen will show prominent nodules that represent white pulp follicles that are expanded by follicular lymphoma cells (similar pattern seen with SLL, mantle cell and marginal zone lymphoma)
________ is used to stain for follicular lymphoma
BCL2 stain:
in reactive follicles, the BCL2 is present in mantle zone cells but NOT in follicular center B cells
in follicular lymphoma, there is strong BCL2 staining in germinal center
follicular lymphoma can transform into a more aggressive lymphoma, most commonly _____
DLBL
_________ lymphoma can present as an extra nodal mass (GI, skin, etc) but also can present in LN’s as a single enlarging mass
DLBL (diffuse large B cell lymphoma)
flow cytometry shows: CD19, CD20, CD10+; what is your diagnosis
follicular lymphoma
at diagnosis of DLBL, what stage do you usually find it at? With or without BM involvement
Stage I/II with negative BM
compare to follicular lymphoma: Stage IV w/ positive BM
describe the manifestation of DLBL on the spleen
a single large mass; other B cell lymphomas usually produces small nodules all over the spleen as expansion of the white pulp
______ is the most common adult leukemia
CLL (chronic lymphocytic leukemia)
“smudge” cells and small mature looking lymphocytes on peripheral blood smear is seen in what B cell neoplasm
CLL
what immune phenotype by flow cytometry of someone with SLL/CLL
- CD19, CD20, CD5, CD23, CD43 +
what are the most common causes of death in someone with SLL/CLL
- infections/bleeding due to progressive pancytopenia
- tranformation to a more aggressive neoplasm with larger cells
what are some normal mucosa associated lymphoid tissue?
- adenoids and tonsils
- Peyer’s patches
these are places you would NOT see MALTomas
other than the stomach, what are other common sites of marginal zone lymphoma
- salivary and thyroid gland on top of autoimmune inflammation
__________ lymphoma remains localized for long periods of time and often recurs or spreads to other mucosal sites
marginal zone lymphoma
EBV infection is associated with which lymphoma?
Burkitt Lymphoma (African)
“starry sky” pattern is seen in ______ and is explained by:
Burkitt lymphoma; diffuse infiltrate of medium sized cells with high mitotic rate and apoptosis → many macrophages to clean up dead cells
what is the characteristic immunohistochemistry pattern of Burkitt lymphoma
- CD19, CD20, CD10, surface Ig
similar to follicular lymphoma
describe the translocation (gene and chromosome) of Burkitt lymphoma
t(8,14) > t (2,8) > t (8,22)
c-myc oncogene on chromosome 8 is translocated to either Ig heavy or light chain loci
Bukitt lymphomas presents as extra nodal mass at what preferred sites?
- mandible
- abdominal viscera: kidneys, ovaries, adrenal glands
who as better prognosis of treating burkitt lymphoma with high dose chemotherapy: kids or adults
kids
translocation of what gene is seen in Burkitt lymphoma
c- myc oncogene
middle aged males that present with pancytopenia and splenomegaly is a common presentation of B cell neoplasm?
Hairy cell leukemia
describe the spleen’s appearance in someone with hairy cell leukemia
- beefy red appearance due to red pulp infiltration
what is the characteristic immunophenotype of hairy cell leukemia
- CD20, CD11c, CD25, CD103+
TRAP stain is used to visualize what neoplasm?
hairy cell leukemia
What are plasma cell neoplasms?
these are B cell neoplasms with some plasma cell differentiation that secrete monoclonal immunoglobulins
what are the findings in the blood and urine in plasma cell neoplasms
blood: M component (monoclonal Ig)
urine: Bence Jones proteins (monoclonal light chains of kappa or lambda)
what are the bone marrow findings in hairy cell leukemia?
fried egg appearance; dry tap (also seen in aplastic anemia)
which monoclonal immunoglobulin is secreted by multiple myeloma which is a plasma cell neoplasm
IgG
presentation of follicular lymphoma
waxing and waning of painless lymphadenopathy
