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From Flashcardlet > Pathology - Exam 3 - lymphoma and myeloma > Flashcards

Pathology - Exam 3 - lymphoma and myeloma Flashcards

1
Q

Leukemia (summary)

A

Malignancy of hematopoietic cells
Starts in bone marrow, can spread to blood, nodes
Myeloid or lymphoid
Acute or chronic

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2
Q

Lymphoma (summary)

A

Malignancy of hematopoietic cells
Starts in lymph nodes, can spread to blood, marrow
Lymphoid only
Hodgkin or non-Hodgkin

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3
Q

what is seen histologically in the germinal center of a benign (yet reactive) lymph node

A

tangible body macrophages
benign macrophages eating the rapidly turning over cells

*malignant lymph node would not have these tangible body MO’s

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4
Q

most common Cause (overall) of lymphadenopathy

A

benign reaction to infection

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5
Q

most common malignant cause of lymphadenopathy

A

metastatic carcinoma

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6
Q

Non-Hodgkin Lymphoma: summary

A

Malignant proliferation of lymphoid cells (blasts or mature cells) in lymph nodes

  • Skips around
  • Many subtypes
  • Most are B cell
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7
Q

Symptoms of NHL

A
  • Painless, firm lymphadenopathy
  • Extranodal manifestations (i.e anemia and thrombocytopenia etc…)
  • “B” symptoms: weight loss, night sweats, fever (SEVERE!!)
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8
Q

why are “B” symptoms something to consider in these patients?

A

these are the patients that tend to do worse

“A” symptoms = “absence of these symptoms”

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9
Q

NHL oral manifestations

A

gingival lesions

(local or diffuse and not in specific areas)

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10
Q

features of Low-grade vs. High grade: patient type

A 
Low-grade:
Older patients
Indolent (incurable!)
Small, mature cells
Non-destructive
High Grade:
Children, sometimes
Aggressive (curable?)
Big, ugly cells
Destructive
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11
Q

features of Low-grade vs. High grade: curable? or not?

A

LG: not curable (“indolent”)
HG:curable but aggressive

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12
Q

features of Low-grade vs. High grade: what size cells?

A

LG: small, mature cells
HG: Big, ugly cells

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13
Q

features of Low-grade vs. High grade: destructive or not?

A

LG: non-destructive
HG: desrctive

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14
Q

Types of Low-grade NHL

A

Small lymphocytic lymphoma
Malt lymphoma
Follicular lymphoma
Mycosis fungoides

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15
Q

types of high-grade NHL

A

Large cell lymphoma
Lymphoblastic lymphoma
Burkitt lymphoma

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16
Q

Small Lymphocytic Lymphoma: things we must know

A

Small mature lymphocytes
Same thing as CLL
CD5+
Long course; death from infection

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17
Q

MALT Lymphoma: where does it occur?

A

Occurs in mucosa-associated lymphoid tissue

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18
Q

MALT Lymphoma: what bacteria is it associated with?

A

Associated with Helicobacter pylori

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19
Q

MALT Lymphoma: can it be cured? how?

A

Early on, can be cured with antibiotics

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20
Q

Follicular Lymphoma: things to know

A

Follicular pattern (later diffuse)
Small cleaved cell, mixed or large cell
Grade 1, 2, or3
t(14;18) - IgH and bcl-2

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21
Q

Follicular Lymphoma: what is the genetic default that makes this happen

A

translocation 14:18

IgH next to bcl-2: since IgH expressed all the time, the bcl-2 gets expressed (bad!)

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22
Q

Follicular Lymphoma - which “cell size” has best prx?

A

small better?

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23
Q

Follicular Lymphoma - what size corresponds with which grade.

A

grade 1 = little cells
grade 2 = middle size/mix
grade 3= large cells (worst prx)

24
Q

FL: what surface characteristic is seen on the WBC’s in a blood smear (what are they called - funny name)

A

see deep cleft in WBC’s = butt cells

25
Q

Staging and Prognosis of Follicular Lymphoma: stage 1

A

just lymph node involvement

combined with stage 2 = 90% 5yr survive

26
Q

Staging and Prognosis of Follicular Lymphoma: stage 2

A

more than one lymph node but on same side of diaphragm

combined with stage 2 = 90% 5yr survive

27
Q

Staging and Prognosis of Follicular Lymphoma: stage 3

A

Lymph nodes on both sides

of the diaphragm

28
Q

Staging and Prognosis of Follicular Lymphoma: stage 4

A

Diffuse extranodal

involvement

29
Q

what does the “A” designator mean after a “stage or grade”.

A

no additional symptoms

30
Q

B symptoms of follicular lymphoma - what are they

A

weight loss, night sweats, fever
worse prx when pt has these
was also seen in NHL

31
Q

Mycosis Fungoides/Sézary Syndrome: what do you see on skin?

A

early stage: cigarette paper skin = eczema looking
mid
stage: diffuse involvement that is severely erythmetous

advanced end stage = mushroom lumps
on face = lion face (she said latin term but i didn’t catch it)

32
Q

Mycosis Fungoides/Sézary Syndrome: what unique thing is seen (of the cells) on a blood smear

A

collections of tumor cells that have (convoluted contours of the cell outline) = “cerebriform lymphocytes”

33
Q

Mycosis Fungoides/Sézary Syndrome: things to know

A

Skin lesions
Blood involvement
Cerebriform lymphocytes
T-cell immunophenotype??

34
Q

extra slide can’t delete

A

extra slide

35
Q

Diffuse Large-Cell Lymphoma: cells involved

A

large B bells

36
Q

Diffuse Large-Cell Lymphoma: things to know

A

Large B cells
Extranodal involvement
Grows rapidly
Bad prognosis

37
Q

Lymphoblastic Lymphoma: typical pt?

A

teen male w/ thymic involvement & mediastinal mass

38
Q

Lymphoblastic Lymphoma: how do the lymphoblasts “present”

A

lymphoblasts in diffuse pattern

39
Q

Lymphoblastic Lymphoma: same as which other disease

A

some ALL’s see flow chart that she put up (I didn’t know)

40
Q

Burkitt Lymphoma: typical pt

A

children\young adults

41
Q

Burkitt Lymphoma: what type of mass is seen

A

fast-growing, extra nodal mass

42
Q

Burkitt Lymphoma: why is this fast growing mass “better”

A

bc the aggressive ones are more responsive to treatment

43
Q

Burkitt Lymphoma: what “characteristic pattern” is seen in bone marrow?

A

sheets of dark blue cells with tangible body macrophages “starry-sky pattern”

same as seen in benign lymph node

44
Q

Burkitt Lymphoma: same as which disease?

A

same as B-cell ALL

45
Q

Hodgkin Lymphoma: typical pt

A

younger (late teens early 20’s)

good prognosis

46
Q

Hodgkin Lymphoma: what kind of spread?

A

contiguous spread

contributes to the prognosis

47
Q

Hodgkin Lymphoma: has how many subtypes

A

5

48
Q

Hodgkin Lymphoma: what is the typical cell unique to this.

A

*Reed-Sternberg cell

does not mark like any lymphocyte that we have
few and far between
these are the malignant cells
spread out - hard to find

49
Q

Clinical Features of Hodgkin Lymphoma

A

Younger patients
Disease often localized
Prognosis generally good
Danger: second malignancies

but if you had to get one lymphoma - you would want this one

50
Q

Multiple Myeloma: “definition”

A

Malignant proliferation of plasma cells

rarely goes out into the blood - stays in bone marrow

51
Q

Multiple Myeloma: these malignant plasma cells are making lots of Ig –> what is the fancy name for this ? how do you detect it?

A

monoclonal gammopathy - malignant plasma cells make identical Ig’s - tons and tons of copies of this stuff -

  • using serum protein electrophoresis to search for it - have these drastic peaks (vs. gentle curve of normal pt)
  • also have to test pee - bc if only make the light chain Ig - you will pee it out.
52
Q

Multiple Myeloma: tons of plasma cells - what do plasma cells look like

A

nucleus pushed off to side with “clock face” chromatin

53
Q

Multiple Myeloma: what unique occurrence with the RBC’s do you see in a blood smear

A

rouleux = RBC stacking on top of each other.
this usually doesn’t happen bc of the zeta potential that naturally forces/repels RBC apart from each other. when lots of Ig n the blood, it gets in the way of these natural repellant force and the RBC’s stack

54
Q

Multiple Myeloma: clinical features

A

*Weakness
*Infections
*Renal failure
(these pts are making too much immunoglobin Ig plugs tubules in kidney)
*Bone pain - (due to osteolytic lesions)
*Hypercalcemia - (bc ripping bone up)

55
Q

Treatment of Multiple Myeloma

A

Bone marrow transplant
Chemo and radiation
5 year survival with chemo only: 20%

(take the marrow out and kill the tumor cells then freeze it and put back in after chemo and radiation = autologous transplant)

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