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Botany > HEMA 2 LEC - Mature B Cell Lymphomas Part 1 > Flashcards

HEMA 2 LEC - Mature B Cell Lymphomas Part 1 Flashcards

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1
Q

Type of lymphoma

• Derived from various stages of B cell differentiation

A

MATURE B CELL LYMPHOMAS

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2
Q

Type of lymphoma

All produce monoclonal light chain Ig, clonal Ig gene rearrangements, or both

A

MATURE B CELL LYMPHOMAS

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3
Q

Type of lymphoma

Most common subtypes: follicular lymphoma and B cell lymphoma

A

MATURE B CELL LYMPHOMAS

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4
Q

• Accumulation of small lymphoid cells in PB, BM, lymphoid organs

A

Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

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5
Q

type of lymphocytic leukemia or lymphoma presents mostly in PB and BM

A

CLL

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6
Q

type of lymphocytic leukemia or lymphoma presents mostly in LN

A

SLL

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7
Q

Morphology
• Soccer-ball : small lymphoid cells with coarse chromatin, absent or subtle nucleoli, scant cytoplasm
•
•

A

CLL

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8
Q

Morphology

Prolymphocytes (up to 55% of cells)

A

CLL

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9
Q

Morphology

Lymphoid cells with cleaved nuclei

A

CLL

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10
Q

FAB CLassification of CLL

>90% small mature lymphocytes,

A

Typical CLL

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11
Q
  • Smudge cells (disintegrated lymphoid cells) – unique feature
  • BM: nodular, diffuse, interstitial infiltrates of small lymphoid cells
A

CLL

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12
Q
  • Effacement of normal nodal architecture by a diffuse proliferation of small, round lymphoid cells (Pathognomonic)
  • Pseudofollicles/growth or proliferation centers
A

SLL

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13
Q

Used to distinguish CLL/SLL from mantle cell lymphoma: (5)

A

CD23, LEF1, absence of FMC7, cyclin D1, SOX11

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14
Q

What condition

A

• Monoclonal B-cell lymphocytosis:

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15
Q

• Asymptomatic at diagnosis, 1st indication: lymphocytosis

A

CLL/SLL

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16
Q

Two Divisions of CLL:

indolent, median survival: 24 years

A

Mutated IVGH (Ig heavy chain)

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17
Q

Two Divisions of CLL:

aggressive, median survival: 8 years

A

Unmutated IVGH

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18
Q

5% of patients of CLL/SLL patients develop _____ high-grade diffuse large B cell lymphoma with survival of

A

Richter syndrome

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19
Q

> 55% of circulating lymphoid cells have prolymphocyte morphology

A

prolymphocytic leukemia

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20
Q

Pathognomonic cell of B cell PLL:

A

prolymphocyte of medium size, round nucleus, distinct punched out nucleolus

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21
Q

LN involvement more common in what type of PLL (B or T cell)

A

T cell

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22
Q

how to distinguish B CELL PLL from CLL/SLL

A

To distinguish from CLL/SLL: cell size (2x normal) and prominent central nucleolus (PUNCHED OUT)

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23
Q
  • BM: interstitial and/or nodular proliferation of prolymphocytes
  • Infiltrated white and red splenic pulp
A

B CELL PLL

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24
Q
  • BM: small to medium size neoplastic cells with round or irregular nuclei, resembling Sezary cells
  • Cytoplasmic blebbing
A

T CELL PLL

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25
high incidence of mutation in TP53 what subclass of PLL
B cell PLL
26
Treatment for PLL
monoclonal Ab against CD52
27
Definition | Small B lymphocytes with abundant cytoplasm and fine/hairy cytoplasmic projections
Hairy Cell Leukemia
28
Cell of origin of HCL
peripheral b cell of post-germinal center stage (memory B cell)
29
Found in BM and red pulp of spleen, RARE LN involvement
HCL
30
Inc in reticulin fibers
HCL
31
Expression of CD11c, CD25, CD103, TRAP
HCL
32
most specific markers; differentiates HCL from splenic marginal zone lymphoma
CD123, Annexin A1
33
In MIDDLE aged
HCL
34
Signs of this disease are splenomegaly and pancytopenia
HCL
35
Definition | • Medium-sized lymphoid cell with irregular nuclear outlines derived from follicular mantle zone
Mantle Cell Lymphoma
36
• Main site of presentation of MCL
LN
37
replacement of normal nodal architecture with a diffuse proliferation of monotonous, medium-sized lymphoid cells with irregular nuclear outlines
MCL
38
irregular nuclear outlines
MCL
39
PB involvement may mimic PLL
MCL
40
this cytogenetic abnormality is a defining feature of mantle cell lymphoma
t(11;14)
41
proto-oncogene involved in the regulation of G1 to S phase progression
Cyclin D1 (BCL1)
42
constitutively expressed through its translocation to the immunoglobulin heavy chain gene, t(11;14)
Cyclin D1 (BCL1)
43
Origin of Follicular lymphoma
Germinal center B cells
44
Morphology | • Numerous closely spaced follicles
Follicular Lymphoma
45
Morphology | Neoplastic proliferation may extend into the perinodal adipose tissue
Follicular Lymphoma
46
* Mantle zone and polarization are not present | * Neoplastic follicles with medium-sized lymphoid cells with angular or indented nuclei
Follicular Lymphoma
47
• Cytologically similar to centrocytes, with a variable admixture of large lymphoid cells
Follicular Lymphoma
48
• Prognostic significance: relative proportion of medium-sized and large lymphoid cells
Follicular Lymphoma
49
grade of FL | rare scattered large lymphocytes
grade 1-2
50
grade of FL | numerous centroblasts
Grade 3
51
Neoplastic cells express BCL-2 protein
Follicular lymphoma
52
responsible for the decreased sensitivity to apoptosis in follicular lymphoma allows the accumulation of neoplastic lymphocytes
BCL-2 protein
53
The expression of BCL-2 by follicular lymphoma cells is due to the _______, which places the BCL2 gene under a promoter of the immu noglobulin heavy chain gene
t(14;18)(q32;q21)
54
This cytogenetic abnormality is present in 95% of follicular lymphoma
t(14;18)(q32;q21)
55
3 subtypes of Marginal Zone Lymphoma of MALT
1) nodal, 2) extranodal, 3) splenic
56
heterogenous neoplastic proliferation, small and medium lymphocytes, plasma cells, scattered large lymphoid cells
Extranodal Marginal Zone Lymphoma of MALT
57
Associated with autoimmune conditions (e.g., Sjögren syndrome, Hashimoto thyroiditis) or previous infections (Helicobacter pylori gastritis or hepatitis C)
Extranodal Marginal Zone Lymphoma of MALT
58
Characteristic feature: lymphoepithelial lesions
Extranodal Marginal Zone Lymphoma of MALT
59
helpful feature in diagnosing marginal zone lymphoma when there is a significant residual reactive component
CD43 antigen
60
• 30% of cases show a translocation involving apoptosis-inhibitor gene API2 and the MLT gene, the t(11;18)(q21;q21).
Extranodal Marginal Zone Lymphoma of MALT
61
API2 and the MLT gene, the t(11;18)(q21;q21) | What lymphoma
Extranodal Marginal Zone Lymphoma of MALT
62
most common site of Extranodal Marginal Zone Lymphoma of MALT
GIT

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