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Hematology > LIMFOAME > Flashcards

LIMFOAME Flashcards

1
Q

Limfom - def

A

neo al sist imunitar - afect ggl limfatici, splina, amigdale, mo in principal

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2
Q

Limfom Hodgkin - def

A

neo limfoida caract prin prez cel Reed-Sternberg

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3
Q

LH - clinic

A

debut insidios cu adenopatii laterocervicale
semne gen
durere in ariile limfatice interes dupa cons alcool
prurit
sdr compresiv

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4
Q

LH - biopsie ggl

A

GRANULOM HODGKIN = CRS/H + pop polimorfa reactiva (Ly, Eo, Mfg)
cel REED STERNBERG - cel mare, nucl vol, polilobal, nucleoli vol (“bufnita”)
cel HODGKIN - var a CRS (uninucleata, uninucleolata)
ambele provin din linia B (CD 19, 20, 22, 30, 15, 25)

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5
Q

LH clasic - caract

A

CRS & CH exprima CD15, CD 30

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6
Q

LH clasic - scleroza nodulara

A

fibroza nod in jurul nodulilor limfoizi
CRS lacunare
prez frecv mediastinala, mai frecv la femei

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7
Q

LH clasic - celularitate mixta

A

pop cel polimorfa - Ly, Mfg, PMN, eo, pl

frecv in stadii avansate

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8
Q

LH clasic - bogat in Ly

A

infiltrat predominant cu ly mici, pred T in jurul CRS

prez cervic inalta

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9
Q

LH clasic - depletie Ly

A

disparitia limfocitozei react

stadii avans la debut, prognostic nefav

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10
Q

LH cu predominanta Ly si disp nodulara

A

cel neo rare cu nucl unic, lob = cel popcorn
CD20 +, CD 15, 30 -
adenopatii loc
evol indolenta

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11
Q

LH - hlg

A

anemie

LEU crescute cu neutrofilie, eozinofilie, limfopenie

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12
Q

Stadializarea ANN-ARBOR

A

I - afect unui singur ggl/ gr ggl
II - afect a >2 gr ggl sit de aceeasi parte a diafragmului
III - interes limfatica supra si sub diafragmatica
IV - stadiul de visceraliz prin disemin hematogena

+ A (fara semne gen)/B (cu semne gen)

+E (extindere viscerala prin contiguitate)

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13
Q

LH - evol, prognostic

A

evol var, prognostic bun
FR - tip histo CM, DL, varsta >40 ani, sex masculin, VSH >40 mm/h, semne gen, stafiu III/IV, forma bulky, interes viscerala prin contig

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14
Q

LH - tratament

A 
linia 1 - chimioterapie (ABDV, BEACOPP) + radioterapie (forme bulky)
linia 2 (refract, recidiv) - DHAP/IGEV, chimio high doze + autotransplant, Ac monoclon (adcetris - anti CD30; nivolumab - anti PD1)
linia 3  (refract, a doua recidiv) - alta chimio, allogrefa de cel stem
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15
Q

LNH - fact predispozanti

A

fact genetic
imuno - deficite imune congenit, SIDA, b autoimune
mediu - infectii bact (HP), infectii virale (HTLV, EBV, HCV), radiatii, chimicale

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16
Q

LNH - anomalii citogenetice

A 
\+ c-myc (protooncogena) t(8,14) -> limfom burkitt
\+ bcl2 t(14,18) - limfom folicular
t(11,14) ciclina D1 - de manta
t(2,5) gena ALK - limfom anaplastic
oncogene fam bcl
translocatii care intereseaza TCR
17
Q

LNH - patogeneza

A

prolif policlonala (+ Atg) -> acum anomalii citogen -> o clona capata avantaj de crestere => selectia clonei resp

18
Q

LNH - clinic

A 
asimptomatici
adenopatii - dimens, consist var, generaliz, cu ext centrifuga, cu salt peste anumite statii ggl
hepatosplenomegalie
simpt gen
det limfomatoase cut
det GI (diaree, malabs, subocl)
19
Q

LNH - biopsie ggl

A

marimea cel, grad de dif, dispozitia

20
Q

LNH cu grad redus de malignitate

A

cel mici, mature, disp nod

21
Q

LNH cu grad inalt de malignitate

A

cel mari, imat, disp difuz

22
Q

LNH - hlg, BOM

A

N/ leucocitoza+anemie+trombopenie

infiltrat limfomatos in mo

23
Q

LNH indolente cu cel B

A

LNH limfocitic (LLC)
limfoplasmocitoid/ MGW
tip MALT
folicular gr I, II

24
Q

LNH agresive cu cel B

A 
LNH folic gr III
LNH cel de manta
LNH difuz cu cel mari
LNH limfoblastib B (LAL B)
Burkitt
25
Q

LNH indolente cu cel T

A

Leucemia cu limfocite mari granulare

mycosis fungoides

26
Q

LNH agresive cu cel T

A 
LNH T perif
LNH angioimunoblastic
LNH anaplazic T
LNH limfoblastic T
leucemia/limfomul cu cel T adulte
27
Q

LNH indolente - evolutie, prognostic

A

evolutie lunga, indolenta
stab dg - generaliz
nu sunt curabile
sv 5 ani 70-80%

28
Q

LNH agresive - evolutie, prognostic

A

evol rapide
surprinse in stad I, II
pot curabile (30-40%)
sv 5 ani - 30-40%

29
Q

LNH - index prognostic international

A 
varsta > 60 ani
IP > 2
stad III, IV
>1 interes extraggl
LDH crescut
0-1 - risc scazut, 2 risc scazut/mediu, 2-3 mediu/crescut, 4-5 risc crescut
30
Q

LNH ale tes limfoide asoc muc (MALT)

A

de obicei indolente
prolif LyB mici
atingere extraggl izolat
disemin lenta cu invad altor MALT

31
Q

LNH gastric

A

etio - HP

erad HP -> vindec limfom in stadii incipiente

32
Q

LNH cutanata cu cel T - Mycosis fungoides

A

eritrodermie descuamativa +/- tu cut
infiltrat dermic cu LyT CD4+
cel maligne in sg perif - sdr Sezary

33
Q

LNH - tratament

A

observare - limfoame indolente
radioterapie - forme bulky, irad superf cu electroni (MF)
chimioterapia - R-CHOP
polichimioterapie de salvare - DHAP
high dose chimio + autotransplant de CSH
imunoterapie - rituximab, alemtuzumab (anti CD52)
radioimunoterapie - anti CD20 + iod/yttrium radioactiv

Hematology (12 decks)

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