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Hematology and Oncology > EXAM #3: PATHOLOGY OF LYMPHOMA > Flashcards

EXAM #3: PATHOLOGY OF LYMPHOMA Flashcards

1
Q

Draw the cortex of the lymph node, label the location of Follicilar, Marginal, and Mantle cell lymphoma.

A

N/A

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2
Q

What is the gross appearance of a Follicular Lymphoma?

A

Nodular

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3
Q

What is the typical age of onset of Follicular Lymphoma?

A

Middle age

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4
Q

What are the clinical findings associated with Follicular Lymphoma?

A

1) LAD

2) Splenomegaly

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5
Q

What cells compose Follicular Lymphoma? How do you tell the difference?

A

Follicle germinal center cells:

  • Centroblasts= loose/ less dense nucleus
  • Centrocytes
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6
Q

What is the difference between a low grade and high grade Follicular Lymphoma?

A 
Low= centrocytes 
High= centroblasts i.e. less differentiated
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7
Q

What translocation is associated with Follicular Lymphoma?

A

t(14:18)

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8
Q

What protein is overexpressed in Follicular Lymphoma?

A

Bcl-2, which inhibits apoptosis i.e. is anti-apoptotic

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9
Q

What is the immunostaining phenotype of Follicular Lymphoma?

A

CD10*
CD19
CD20
Bcl-2*

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10
Q

What is Mantle Cell Lymphoma? How is the gross appearance different from Follicular Lymphoma?

A

Neoplastic proliferation of small B-cells in the mantle zone of the lymph node

Lymph nodes are SMOOTH grossly

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11
Q

What is the typical presentation of Mantle Cell Lymphoma?

A

Painless lymphadenopathy in late adulthood (5th-6th decade)

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12
Q

What is the translocation associated with Mantle Cell Lymphoma?

A

t(11:14)

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13
Q

What protein is overexpressed in Mantle Cell Lymphoma?

A

Cyclin D1, which mediates G1–>S-phase transition

Pro-proliferative

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14
Q

What is the immunophenotype of Mantle Cell Lymphoma?

A

CD5
CD19
CD20
Cyclin D1

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15
Q

What is Burkitt’s Lymphoma?

A

Neoplastic proliferation of INTERMEDIATE sized CD20+ B-cells

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16
Q

What is the classic presentation of Burkitt’s Lymphoma?

A

Extranodal mass in a child or young adult

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17
Q

What is the difference between the African and Sporadic forms of Burkitt’s Lymhoma?

A

African= involves the jaw and seen in kids between 4 and 7 years old

Sporadic= involves the abdomen (ileocecal) and median age is 30

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18
Q

What is immunodeficiency-associated BL?

A

HIV+ patients present with Burkitt’s Lymphoma, a manifestation of progression to AIDS

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19
Q

What viral infection is associated with Burkitt’s Lymphoma?

A

EBV

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20
Q

What translocation is associated with Burkitt’s Lymphoma?

A

t(8:14)

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21
Q

What protein is Burkitt’s Lymphoma?

A

C-myc

22
Q

What are the characteristics of Burkitt’s Lymphoma on microscopy?

A

1) Diffuse monomorphic infiltrate with High mitotic index

2) “Starry-sky” appearance

23
Q

What are tingable body macrophages?

A

Tingable= stainable

Macrophages found in germinal centers containing phagocytozed apoptotic cells (tingable bodies)

24
Q

What is the immunophenotype of Burkitt’s Lymphoma?

A

CD10
CD19
CD20
C-myc

25
Q

What is Adult T-cell Leukemia/ Lymphoma?

A

Neoplastic proliferation of CD4+ T-cells

26
Q

What virus is Adult T-cell Leukemia/ Lymphoma associated with?

A

HTLV-1

*Seen in Japan, Central Africa, Caribbean

27
Q

What population is affected by Adult T-cell Leukemia/ Lymphoma?

A

Adults ONLY

28
Q

What are the common clinical findings associated with Adult T-cell Leukemia/ Lymphoma??

A

1) Rash
2) Generalized LAD
3) Hepatosplenomegaly
4) Lytic bone lesions
5) Hypercalcemia

29
Q

How does the morphology of cells in Adult T-cell Leukemia/ Lymphoma vary?

A

Immature= smooth

Mature= Flower cells

30
Q

What disease are Flower Cells associated with?

A

Adult T-cell Leukemia/ Lymphoma

31
Q

What is the prognosis for Adult T-cell Leukemia/ Lymphoma?

A

Death within 1 year

32
Q

What drug is used to treat Adult T-cell Leukemia/ Lymphoma?

A

Anti-CD52

33
Q

What is Mycosis Fungoides?

A

Neoplastic proliferation of CD4+ T-cells that INFILTRATE THE SKIN

34
Q

What are the characteristics of malignant cells in MF?

A
  • Cerebriform nuclei

- Highly folded nuclear membrane

35
Q

What are the two phases of skin lesions in MF? What part of the skin is involved in each phase?

A

Plaque= smooth–> epidermis

Tumor= rough–> dermis

36
Q

What is Sezary Syndrome?

A

CD4+ T-cells of MF that spread to involve the blood

37
Q

What are the principle manifestations of Sezary Syndrome?

A

1) Leukemia

2) Exfoliative erythroderma

38
Q

What is T-ALL?

A

Neoplastic proliferation of T-cell lymphoblats

39
Q

What is the mnemonic to remember T-ALL?

A

Thymic mass that presents in Teenagers

Note that thymic mass is referred to as being in the anterior mediastinum*

40
Q

What is the marker for lymphoblasts?

A

TdT

41
Q

What is the immunophenotype of T-ALL?

A

TdT
CD2-8
NOT CD10

CD3-cytoplasmic, CD4, CD7*

42
Q

What is the morphology of T-ALL?

A

Sheets of blasts

Seen in lymph nodes, soft tissue, bone marrow*

43
Q

What factors indicate a poor prognosis for T-ALL?

A

1) Patient under 2 y/o
2) Presentation in adolescence or adulthood
3) t(9:22) or translocation involving the MLL gene on chromosome 11
4) WBC greater than 100,000

44
Q

What is Anaplastic Large Cell Lymphoma (ALCL)?

A

NHL

45
Q

What stage is ALCL typically in when it presents?

A

Stage III or IV

46
Q

What protein is associated with ALCL?

A

ALK-1

47
Q

What does ALK-1 positive staining indicate about prognosis? What age group is this typically seen in?

A

Better prognosis–younger

48
Q

What does ALK-1 negative staining indicate about prognosis? What age group is this typically seen in?

A

Poor prognosis–elderly

49
Q

What is the morphology of ALCL?

A

Pleomorphism with “hallmark” cells

50
Q

What are hallmark cells? What type of lymphoma are these cells characteristic for?

A
  • Medium sized
  • Abundant cytoplasm
  • Kidney shaped nuclei
  • Paranuclear eosinophilic region (pink)

Seen in ALCL*

51
Q

What is the immunophenotype of ALCL?

A

CD30+

ALK-1 +/-

52
Q

What is Large Granular Lymphocytic Leukemia?

A

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Hematology and Oncology (38 decks)

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