Lymphomas

Question 1

What is seen in a lymph node telling you it is a reactive process not lymphoma?

Answer 1

Tingible body macrophages

Question 2

WHO classification of lymphoid neoplasms?

Answer 2

1. ) Neoplasms of immature B cells
2. ) Neoplasms of mature B cells
3. ) Neoplasms of immature T cells
4. ) Neoplasms of mature T cells and NK cells
5. ) Neoplasms of Reed-Sternberg cells and variants

Question 3

Hairy Cell Leukemia:

Answer 3

• Neoplastic proliferation of naive B cells
• BM fibrosed
• Splenomegaly
• No lymphadenopathy

Question 4

Adult T-cell Leukemia/Lymphoma:

Answer 4

• Neoplastic proliferation of naive B cells
• Caused by HTLV-1
• Rash with lytic bone lesions

Question 5

Mycosis Fungoides:

Answer 5

• Neoplastic proliferation of mature CD4+ T-cells
• Rash with Pautrier Microabscess
• Sezary Syndrome: Cerebriform nuclei in T cells

Question 6

Chronic Lymphocytic Leukemia:

Answer 6

• Neoplastic proliferation of naive B cells
• CD5 and CD20 Co-expression
• Enter lymph nodes causing small lymphocytic lymphoma
• Hypo IgG and autoimmune hemolytic anemia

Question 7

Lymph node from innermost to outermost layers:

Answer 7

Follicle zone
Mantle zone
Marginal zone

Question 8

Non-Hodgkin Lymphoma subsets:

Answer 8

All are neoplastic B-cells:

• Follicular lymphoma (small B cell)
• Mantle cell lymphoma (small B cell)
• Marginal zone lymphoma (small B cell)
• Burkitt lymphoma (intermediate B cell)
• Diffuse Large B cell Lymphoma (large B cell)

Question 9

Follicular lymphoma:

Answer 9

• CD10 CD20 B cells
• Form follicle like nodules
• 14 (IgH); 18 (bcl2) -> over expression of bcl2
• Lack of tingible body macrophages in germinal center

Question 10

Mantle cell lymphoma:

Answer 10

• CD20+ B cells
• Over-expansion of mantle zone
• 11 (cyclin D); 14 (IgH) -> over expression of bcl2

Question 11

Marginal zone lymphoma:

Answer 11

• CD20+ B cells
• Associated with chronic inflammatory states
• H. pylori-> can cause this to turn to MALToma

Question 12

Burkitt Lymphoma:

Answer 12

• CD20+ B cells
• Associated with EBV
• Extranodal Masses form
• African form-> Jaw mass
• Sporadic form-> Abdominal mass
• 8 (c-myc); 14 (IgH)
• Highly mitotic-> STARRY NIGHT blood smear

Question 13

Diffuse Large B cell Lymphoma:

Answer 13

• CD20+ B cells
• Most common NHL
• Does not affect any specific LN area
• Aggressive
• Can arise sporadically from follicular lymphoma transformation
• 14 (IgH); 18 (bcl2) -> over expression of bcl2
• Smaller % have myc translocation but poor prognosis if they do and chemo-radiation (same as Burkitt)

Question 14

Hodgkin Lymphoma distinct characteristics:

Answer 14

• Reed-Sternberg cells

- CD15+ and CD30+ B-cells NOT CD20+

Question 15

Hodgkin Lymphoma Subtypes:

Answer 15

• Nodular Sclerosis
• Lymphocyte Rich
• Mixed Cellularity
• Lymphocyte Depleted

Question 16

Nodular Sclerosis:

Answer 16

• Hodgkin Lymphoma
• Enlarged cervical or mediastinal lymph nodes
• LN biopsy reveals bands of fibrosis separating LN into nodules
• Lacunar cells: Reed-Sternberg cells in big empty spaces

Question 17

Hodgkin Lymphoma B-cell Symptoms:

Answer 17

• Painless LAD
• Night sweats
• Fever of unknown origin
• Weight loss
• Fatigue

Question 18

Linear progression of organ involvement in Hodgkin lymphoma:

Answer 18

1. ) Node
2. ) Spleen
3. ) Liver
4. ) Marrow