EXAM #3: PATHOLOGY OF LYMPHOMA Flashcards Preview

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

Flashcards in EXAM #3: PATHOLOGY OF LYMPHOMA Deck (52):
1

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

N/A

2

What is the gross appearance of a Follicular Lymphoma?

Nodular

3

What is the typical age of onset of Follicular Lymphoma?

Middle age

4

What are the clinical findings associated with Follicular Lymphoma?

1) LAD
2) Splenomegaly

5

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

Follicle germinal center cells:
- Centroblasts= loose/ less dense nucleus
- Centrocytes

6

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

Low= centrocytes
High= centroblasts i.e. less differentiated

7

What translocation is associated with Follicular Lymphoma?

t(14:18)

8

What protein is overexpressed in Follicular Lymphoma?

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

9

What is the immunostaining phenotype of Follicular Lymphoma?

CD10*
CD19
CD20
Bcl-2*

10

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****

11

What is the typical presentation of Mantle Cell Lymphoma?

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

12

What is the translocation associated with Mantle Cell Lymphoma?

t(11:14)

13

What protein is overexpressed in Mantle Cell Lymphoma?

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

****Pro-proliferative****

14

What is the immunophenotype of Mantle Cell Lymphoma?

CD5
CD19
CD20
Cyclin D1

15

What is Burkitt's Lymphoma?

Neoplastic proliferation of INTERMEDIATE sized CD20+ B-cells

16

What is the classic presentation of Burkitt's Lymphoma?

Extranodal mass in a child or young adult

17

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

18

What is immunodeficiency-associated BL?

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

19

What viral infection is associated with Burkitt's Lymphoma?

EBV

20

What translocation is associated with Burkitt's Lymphoma?

t(8:14)

21

What protein is Burkitt's Lymphoma?

C-myc

22

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

1) Diffuse monomorphic infiltrate with High mitotic index
2) "Starry-sky" appearance

23

What are tingable body macrophages?

Tingable= stainable

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

24

What is the immunophenotype of Burkitt's Lymphoma?

CD10
CD19
CD20
C-myc

25

What is Adult T-cell Leukemia/ Lymphoma?

Neoplastic proliferation of CD4+ T-cells

26

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

HTLV-1

****Seen in Japan, Central Africa, Caribbean***

27

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

Adults ONLY

28

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

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

29

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

Immature= smooth

Mature= Flower cells

30

What disease are Flower Cells associated with?

Adult T-cell Leukemia/ Lymphoma

31

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

Death within 1 year

32

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

Anti-CD52

33

What is Mycosis Fungoides?

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

34

What are the characteristics of malignant cells in MF?

- Cerebriform nuclei
- Highly folded nuclear membrane

35

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

36

What is Sezary Syndrome?

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

37

What are the principle manifestations of Sezary Syndrome?

1) Leukemia
2) Exfoliative erythroderma

38

What is T-ALL?

Neoplastic proliferation of T-cell lymphoblats

39

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*****

40

What is the marker for lymphoblasts?

TdT

41

What is the immunophenotype of T-ALL?

TdT
CD2-8
NOT CD10

****CD3-cytoplasmic, CD4, CD7*****

42

What is the morphology of T-ALL?

Sheets of blasts

****Seen in lymph nodes, soft tissue, bone marrow*****

43

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

44

What is Anaplastic Large Cell Lymphoma (ALCL)?

NHL

45

What stage is ALCL typically in when it presents?

Stage III or IV

46

What protein is associated with ALCL?

ALK-1

47

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

Better prognosis--younger

48

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

Poor prognosis--elderly

49

What is the morphology of ALCL?

Pleomorphism with "hallmark" cells

50

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*****

51

What is the immunophenotype of ALCL?

CD30+
ALK-1 +/-

52

What is Large Granular Lymphocytic Leukemia?

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