3-Lymphomas

Question 1

What is the order of chain rearrangements in a maturing lymphoid cell?

Answer 1

Heavy (V -> D ->J ) then light (V -> J)

Question 2

What are the CD’s on a B precursor before heavy chain rearrangement?

Answer 2

CD19, 34. (19 stays always, even when mature)

Question 3

What are the CD’s on a B precursor after heavy chain rearrangement?

Answer 3

CD10 (and still 19)

Question 4

What are the CD’s on a pre-B cell? Which chain rearrangements have taken place at this stage?

Answer 4

• CD20 (and still 10 and 19)

- both heavy and light chain rearrangements

Question 5

Mature T cells (2 types) display what CD’s?

Answer 5

• Cytotoxic: CD 8, 3 (3 is a marker for all T cells)

- Helper: CD 4, 3

Question 6

So, what markers does a mature B cell have?

Answer 6

Same as “pre-B” cell!
CD 20, (from final stage)
10, (only if in an active germinal center)
19 (from early precursor stage)

Question 7

Now let’s think of it the other direction….

Answer 7

:)

Question 8

What cells display CD 19?

Answer 8

precursor B & mature B

Question 9

So all in all, what CD’s are on B precursors?

Answer 9

19, 34, then 10.

Question 10

What cells display CD 20?

Answer 10

mature B

Question 11

What cells display CD 10?

Answer 11

precursor & germinal center cells

Question 12

What cells display CD 3?

Answer 12

All T

Question 13

What cells display CD 4?

Answer 13

cortical thymocytes & Helper T

Question 14

What cells display CD 8?

Answer 14

cortical thymocytes & cytotoxic T

Question 15

What cells display CD 34?

Answer 15

myeloid and lymphoid precursors

Question 16

Germinal centers of lymph node contain?

Answer 16

follicular dendritic cell meshwork (stains w/ CD21) and other cells…

Question 17

What causes a lymph cell to become larger, and gain prominent nucleoli and more cytoplasm?

Answer 17

antigen exposure

Question 18

T/F lymphomas can originate from a tissue other than lymph nodes?

Answer 18

T

Question 19

A lymphoma lymph node looks histologically different from a REACTIVE lymph node how?

Answer 19

lymphoma has effacement of architecture

Question 20

Most important prognostic feature in a non-Hodgkin lymphoma is?

Answer 20

histologic subtype

[in Hodgkin it is stage]

Question 21

Which tissues are PRIMARY lymphoid tissues?

Answer 21

ones T or B’s mature in (thymus, marrow)

[secondary would be anything else]

Question 22

As T cells mature they move which direction in thymus?

Answer 22

toward medulla

[pos then neg selection]

Question 23

T/F the T cell receptor is expressed during T cell maturation in thymus?

Answer 23

T

Question 24

Where is MALT found?

Answer 24

Waldeyer’s ring, Peyer’s patch, and bronchus

Question 25

What do M cells do?

Answer 25

uptake antigen

Question 26

What's in PALS? What about in white pulp?

Answer 26

- T cells | - B cells

Question 27

What's in cords of bilroth?

Answer 27

macrophages

Question 28

If red pulp of spleen expands, it's due to?

Answer 28

``` blood issue (congestion, leukemia etc) [where white expansion would be lymph reaction or cancer] ```

Question 29

Nodular lesion in spleen =?

Answer 29

Hodkin or diffuse B lymphoma (no mets cuz no lymph afferents and all those immune cells kill blood-borne mets!)

Question 30

What does a centroblast do?

Answer 30

Matures in a germinal center to a large cleaved, then small cleaved, then centrocyte (plasma or memory cell). It moves to lighter zone as it matures.

Question 31

Follicular dendritic meshwork stains with what CD?

Answer 31

21 [same as what EBV uses to enter B cells!]

Question 32

What does a B cell do when if finds antigen?

Answer 32

-Becomes proliferating immunoblast in interfollicular area -migrates to primary follicle, becomes a centroblast that undergoes somatic hypermutation/prolif to become plasma or memory cell (centrocyte). [Tingible body macrophages eat the dead B's]

Question 33

etiology of lymphadenOPATHY?

Answer 33

unkown (lymphadenitis is known pathogen)

Question 34

Asteroid bodies mean what?

Answer 34

granulomatous lymph node

Question 35

T/F reactive lymphoid hyperplasia regresses w/ antibiotics?

Answer 35

F | [and node is tender!]

Question 36

BCL-2 is important why?

Answer 36

anti-apoptotic. Find in follicular lymphoma. (BCL-6 is opposite. apoptotic)

Question 37

Many centroblasts and few centrocytes means?

Answer 37

cancer

Question 38

EBER is a stain for what?

Answer 38

EBV RNA

Question 39

Geographic necrosis of lymph node=?

Answer 39

bartonella henselae

Question 40

How do you dx toxoplasma?

Answer 40

IgM test. note proliferation of monocytoid B cells.

Question 41

How do you dx toxoplasma?

Answer 41

IgM test. note proliferation of monocytoid B cells.