Hodgkin Lymphomas

Question 1

acute leukemia morphology

Answer 1

immature cells (blasts)

Question 2

chronic leukemia morphology

Answer 2

mature or maturing cells

Question 3

acute leukemia cellular mechanism

Answer 3

maturation arrest

Question 4

chronic leukemia cellular mechanism

Answer 4

increased proliferation or decreased apoptosis

Question 5

acute leukemia clinical symptoms

Answer 5

bone marrow failure leads to bleeding, infections, fatigue

Question 6

chronic leukemia clinical symptoms

Answer 6

nonspecific: organ infiltration, leukocytosis, late marrow failure

Question 7

neoplastic cell in hodgkin lymphomas

Answer 7

reed sternburg cell: binucleated cell with prominent eosinophilic inclusion like nuclei. owl eyes

Question 8

epidemiology of hodgkin lymphoma

Answer 8

uncommon, bimodal age curve (15-35 and 50+), both sexes evenly

Question 9

clinical presentation of HL

Answer 9

painless lymphadenopathy (mostly cervical), fever, night sweats, weight loss, infections

Question 10

pattern of HL spread

Answer 10

unifocal, contiguous, lymphatic spread. doesn’t jump around. goes in order

Question 11

characteristic of HL lymph node biopsy

Answer 11

less than 1% of cells will be reed stern burg cells. 99% are reactive, nonmalignant cellular infiltrate

Question 12

origin of HL neoplasms

Answer 12

B cells from germinal center

Question 13

classical HL

Answer 13

nodular sclerosis, mixed cellularity, lymphocyte depletion or enrichment. diffuse or nodular growth.

Question 14

immunophenotype of classic HL

Answer 14

CD15+ (mature myeloid antigen)
CD30+ (not lineage specific)
PAX5+ (B cell)

Question 15

nodular lymphocyte prodominant HL

Answer 15

only about 5% of HLs. nodular growth, popcorn like cells with small lymphocytic background

Question 16

tage 1

Answer 16

one region

Question 17

stage 2

Answer 17

two regions but on same side of diaphragm

Question 18

stage 3

Answer 18

both sides of diaphragm. but confined to lymphatic system

Question 19

stage 4

Answer 19

disseminated beyond lymphatics

Question 20

hodgkin prognosis

Answer 20

function of stage, but typically 80% survival

Question 21

definition of HL

Answer 21

lymphoma that contains a minority of neoplastic Reed-Sternburg cells and a much larger, pleomorphic background of non-neoplastic, reactive inflammatory cells

Question 22

staging the disease

Answer 22

to determine how far the disease has disseminated throughout the body

Question 23

EBV

Answer 23

herpes virus. might be causative or might be an epiphenomenon.

Question 24

HL and NFkB

Answer 24

constitutive activity in HL. likely protects the cell from the hostile environment of the germinal center

Question 25

B symptoms

Answer 25

constitutive symptoms (night sweats, fever, weight loss)

Question 26

what is needed to diagnose?

Answer 26

a whole, intact, excisional lymph node biopsy

Question 27

requirements to definitively diagnose HL

Answer 27

RS cell, presence of appropriate milieu of inflammatory cell background, nodal architecture effacement

Question 28

most common type of classic HL

Answer 28

nodular sclerosis

Question 29

difference between therapeutic decisions in HL vs NHL

Answer 29

HL: based essentially on stage rather than classification

Question 30

treatment of early stage HL

Answer 30

abbreviated course of combination chemotherapy followed by involved field radiotherapy

Question 31

treatment of late stage HL

Answer 31

chemotherapy with radiotherapy sometimes