L. Hodgkins Lymphoma (L12)

Question 1

The presence of what cell type is necessary for the diagnosis of Hodgkins Lymphoma?

Answer 1

Reed Sternberg

Question 2

What is the appearance of Reed Sternberg Cells?

Answer 2

• Large binucleated cells with abundant cytoplasm & multiple nucleoli
• “Owl eyes”

Question 3

A majority of the mass in hogkins lymphoma is made up of what?

Answer 3

Inflammatory cells that where recruited to the lymph node by cytokines released by the

Question 4

A majority of the mass in Non-Hodgkin’s Lymphoma made up of what?

Answer 4

Neoplastic cells

Question 5

What surface markers do Reed Sternberg Cells have?

Answer 5

CD30 & CD15

Question 6

What is the origin of Reed Sternberg Cells?

Answer 6

• Monoclonal germinal center B cells

Question 7

How does the likelihood of getting Hodgkins lymphoma change with age?

Answer 7

• Bimodal

* Higher risk in teenagers/young adults and then in the over 50 population

Question 8

How is the incidence of Hodgkins lymphoma changing? How about NHL?

Answer 8

Incidence is increasing slightly for HL

Large increase in NHL

Question 9

Does NHL and/or HL have prominent background cells?

Answer 9

• Hodgkins does and NHL doesn’t

Question 10

Do males or females generally get Hodgkins lymphoma more often? Exception?

Answer 10

• Males

* Except in sclerosing type (young females most common)

Question 11

What other conditions increase the risk for Hodgkins Lymphoma?

Answer 11

• EBV

* HIV & other immunodeficiencies

Question 12

What are B symptoms? Are they present in HL or NHL? What causes them?

Answer 12

• Fever
• Night Sweats
• Fatigue
• Weight Loss
• HL, not NHL
• Caused by cytokines being released by Reed Sternberg

Question 13

How does Hodgkins Lymphoma Present?

Answer 13

• Painless lymphadenopathy
• B symptoms
• Itchy skin
• Continuous spread through body/lymph nodes

Question 14

Does continuous spread through lymph nodes/tissue suggest HL or NHL?

Answer 14

Hodgkins Lymphoma

Question 15

What is the most common subtype of Hodgkin’s Lymphoma?

Answer 15

Nodular Sclerosis

Question 16

Who is most likely to get Nodular Sclerosis?

Answer 16

Young Females

Question 17

Lacunar Cells and fibrous bands through bone marrow are signs of what condition?

Answer 17

• Nodular Sclerosis (Hodgkins Lymphoma)

Question 18

What is the general prognosis for Hodgkin’s Lymphoma Patients?

Answer 18

• Pretty good, about 80% 5 yr survival rate

Question 19

Does NHL or HL have the better prognosis?

Answer 19

HL

Question 20

Is Hodgkin’s Treatment based more on staging or morphological features?

Answer 20

Staging

Question 21

Is extranodal disease characteristic of NHL or HL?

Answer 21

NHL

Question 22

How much of the mass in Hodgkin’s Lymphoma is made up of neoplastic cells?

Answer 22

• Small percentage

* Few Reed Strenberg Cells which secrete cytokines to bring in inflammatory cells

Question 23

Which Hodgkin’s subtype has the best prognosis? Worst Prognosis?

Answer 23

• Lymphocytic Rich

* Lymphocytic Depleted

Question 24

What are the neoplastic cells in Hodgkins Lymphoma?

Answer 24

Reed Sternberg Cells

Question 25

Which is more common, HL or NHL?

Answer 25

NHL

Question 26

Are systemic symptoms seen in HL or NHL?

Answer 26

HL

Question 27

Is “multicentric” disease suggestive of NHL or HL?

Answer 27

NHL

Question 28

Are Reed Sternberg cells monoclonal or polyclonal?

Answer 28

Monoclonal

Question 29

Where in the body does Nodular sclerosis most often present?

Answer 29

Mediastinum

Question 30

How is flow cytometry used to diagnose HL?

Answer 30

• It isn’t useful for this purpose

Question 31

What are the two main subtypes of HL? Which is more common?

Answer 31

Classical HL Nodular Lymphocytic Predominant HL CHL account for about 95% of HL

Question 32

What are the 4 types of Classical HL?

Answer 32

``` Nodular sclerosis (NS) Lymphocyte depletion (LD) Lymphocyte rich (LR) Mixed cellularity (MC) ```

Question 33

Is HL curable?

Answer 33

Yes (about 75% of the time)

Question 34

Is NHL curable?

Answer 34

Sort of (<50% of the time)

Question 35

What is the cell type that is neoplastic in NHL? What stage of differentiation is present?

Answer 35

``` B cells (85%) & T cells (15%) Various stages of differentiation ```

Question 36

HL makes up what percentage of lymphomas?

Answer 36

40%

Question 37

Are NL & NHL related to neoplastic lymphocytes and/or granulocytes?

Answer 37

Lymphocytes only

Question 38

The ingestion of what can worsen the itching seen in some patients with HL?

Answer 38

Alcohol

Question 39

What causes Reed Sternberg Cells?

Answer 39

During fixation reed staernberg cells pull away from surrounding leaving an empty space around them that is an artifact

Question 40

Cytokines released from Reed Sternberg Cells do what 2 things?

Answer 40

Recruit inflammatory background cells | Cause B symptoms