Flashcards in EXAM #3: PATHOLOGY OF LYMPHOMA Deck (52):
Draw the cortex of the lymph node, label the location of Follicilar, Marginal, and Mantle cell lymphoma.
What is the gross appearance of a Follicular Lymphoma?
What is the typical age of onset of Follicular Lymphoma?
What are the clinical findings associated with Follicular Lymphoma?
What cells compose Follicular Lymphoma? How do you tell the difference?
Follicle germinal center cells:
- Centroblasts= loose/ less dense nucleus
What is the difference between a low grade and high grade Follicular Lymphoma?
High= centroblasts i.e. less differentiated
What translocation is associated with Follicular Lymphoma?
What protein is overexpressed in Follicular Lymphoma?
Bcl-2, which inhibits apoptosis i.e. is anti-apoptotic
What is the immunostaining phenotype of Follicular Lymphoma?
What is Mantle Cell Lymphoma? How is the gross appearance different from Follicular Lymphoma?
Neoplastic proliferation of small B-cells in the mantle zone of the lymph node
****Lymph nodes are SMOOTH grossly****
What is the typical presentation of Mantle Cell Lymphoma?
Painless lymphadenopathy in late adulthood (5th-6th decade)
What is the translocation associated with Mantle Cell Lymphoma?
What protein is overexpressed in Mantle Cell Lymphoma?
Cyclin D1, which mediates G1-->S-phase transition
What is the immunophenotype of Mantle Cell Lymphoma?
What is Burkitt's Lymphoma?
Neoplastic proliferation of INTERMEDIATE sized CD20+ B-cells
What is the classic presentation of Burkitt's Lymphoma?
Extranodal mass in a child or young adult
What is the difference between the African and Sporadic forms of Burkitt's Lymhoma?
African= involves the jaw and seen in kids between 4 and 7 years old
Sporadic= involves the abdomen (ileocecal) and median age is 30
What is immunodeficiency-associated BL?
HIV+ patients present with Burkitt's Lymphoma, a manifestation of progression to AIDS
What viral infection is associated with Burkitt's Lymphoma?
What translocation is associated with Burkitt's Lymphoma?
What protein is Burkitt's Lymphoma?
What are the characteristics of Burkitt's Lymphoma on microscopy?
1) Diffuse monomorphic infiltrate with High mitotic index
2) "Starry-sky" appearance
What are tingable body macrophages?
Macrophages found in germinal centers containing phagocytozed apoptotic cells (tingable bodies)
What is the immunophenotype of Burkitt's Lymphoma?
What is Adult T-cell Leukemia/ Lymphoma?
Neoplastic proliferation of CD4+ T-cells
What virus is Adult T-cell Leukemia/ Lymphoma associated with?
****Seen in Japan, Central Africa, Caribbean***
What population is affected by Adult T-cell Leukemia/ Lymphoma?
What are the common clinical findings associated with Adult T-cell Leukemia/ Lymphoma??
2) Generalized LAD
4) Lytic bone lesions
How does the morphology of cells in Adult T-cell Leukemia/ Lymphoma vary?
Mature= Flower cells
What disease are Flower Cells associated with?
Adult T-cell Leukemia/ Lymphoma
What is the prognosis for Adult T-cell Leukemia/ Lymphoma?
Death within 1 year
What drug is used to treat Adult T-cell Leukemia/ Lymphoma?
What is Mycosis Fungoides?
Neoplastic proliferation of CD4+ T-cells that INFILTRATE THE SKIN
What are the characteristics of malignant cells in MF?
- Cerebriform nuclei
- Highly folded nuclear membrane
What are the two phases of skin lesions in MF? What part of the skin is involved in each phase?
Plaque= smooth--> epidermis
Tumor= rough--> dermis
What is Sezary Syndrome?
CD4+ T-cells of MF that spread to involve the blood
What are the principle manifestations of Sezary Syndrome?
2) Exfoliative erythroderma
What is T-ALL?
Neoplastic proliferation of T-cell lymphoblats
What is the mnemonic to remember T-ALL?
Thymic mass that presents in Teenagers
****Note that thymic mass is referred to as being in the anterior mediastinum*****
What is the marker for lymphoblasts?
What is the immunophenotype of T-ALL?
****CD3-cytoplasmic, CD4, CD7*****
What is the morphology of T-ALL?
Sheets of blasts
****Seen in lymph nodes, soft tissue, bone marrow*****
What factors indicate a poor prognosis for T-ALL?
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
What is Anaplastic Large Cell Lymphoma (ALCL)?
What stage is ALCL typically in when it presents?
Stage III or IV
What protein is associated with ALCL?
What does ALK-1 positive staining indicate about prognosis? What age group is this typically seen in?
What does ALK-1 negative staining indicate about prognosis? What age group is this typically seen in?
What is the morphology of ALCL?
Pleomorphism with "hallmark" cells
What are hallmark cells? What type of lymphoma are these cells characteristic for?
- Medium sized
- Abundant cytoplasm
- Kidney shaped nuclei
- Paranuclear eosinophilic region (pink)
****Seen in ALCL*****
What is the immunophenotype of ALCL?