Flashcards in Lymph Nodes Deck (343)
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270
Peripheral T-cell lymphoma, NOS: Typical patient.
Middle-aged or elderly male.
271
Peripheral T-cell lymphoma, NOS:
A. Typical presentation.
B. Prognosis.
A. Advanced disease.
B. Poor.
272
Peripheral T-cell lymphoma, NOS: Pattern of infiltrate.
Paracortical, follicular, or diffuse.
273
Peripheral T-cell lymphoma, NOS: Tumor cells (3).
Medium-sized or large, pleomorphic, and monotonous.
Cells form sheets.
Clear cells or Reed-Sternberg cells may be visible.
274
Peripheral T-cell lymphoma, NOS: Other cells (4).
Small lymphocytes, plasma cells, eosinophils, histiocytes.
275
Peripheral T-cell lymphoma, NOS: Additional possible histologic feature.
Large high-endothelial venules.
276
Peripheral T-cell lymphoma, NOS: Histologic variants (3).
Lymphoepithelioid (Lennert's lymphoma): Small tumor cells are obscured by epithelioid histiocytes.
Follicular: Atypical clear cells in germinal centers or in mantle zones.
T-zone: Perifollicular growth with minimal cytologic atypia.
277
Peripheral T-cell lymphoma, NOS: Expression of T-cell antigens (3).
Frequent loss of CD5 and CD7.
CD4 is usually expressed.
CD8 is more often expressed in Lennert's lymphoma.
278
Peripheral T-cell lymphoma, NOS: Expression of CD30.
Absent, weak, or focal.
279
Peripheral T-cell lymphoma, NOS: Rate of proliferation.
High.
280
Peripheral T-cell lymphoma, NOS: Association with EBV.
Present in the Reed-Sternberg-like cells.
281
Peripheral T-cell lymphoma, NOS: Additional immunohistochemistry.
Some tumors (esp. the follicular variant) express markers of follicular T-helper cells:
- CD10.
- Bcl-6.
- PD-1.
- CXCL13.
282
Peripheral T-cell lymphoma, NOS, T-zone variant: Differential diagnosis.
Reactive paracortical hyperplasia:
- No loss of T-cell antigens.
- Normal ratio of CD4-positive to CD8-positive lymphocytes.
283
Peripheral T-cell lymphoma, NOS vs. angioimmunoblastic T-cell lymphoma.
AITCL: Expanded FDC networks.
284
Nodular lymphocyte-predominant Hodgkin's lymphoma: Proportion of all Hodgkin's lymphomas.
5%.
285
Nodular lymphocyte-predominant Hodgkin's lymphoma: Epidemiology.
Young patients.
Strong male predominance.
286
Nodular lymphocyte-predominant Hodgkin's lymphoma: Typical presentation.
Localized lymphadenopathy.
287
Nodular lymphocyte-predominant Hodgkin's lymphoma: Names of large tumor cell.
Lymphocyte-predominant.
Lymphocytic and histiocytic.
Popcorn.
288
Nodular lymphocyte-predominant Hodgkin's lymphoma: What should not be seen (4).
Neutrophils.
Eosinophils.
Fibrosis.
Necrosis.
289
Nodular lymphocyte-predominant Hodgkin's lymphoma: Antigens expressed by tumor cells (8).
CD45.
CD20, CD79a, Pax-5.
Bcl-6, EMA.
Both Oct-2 and Bob.1 are expressed.
290
Nodular lymphocyte-predominant Hodgkin's lymphoma: Antigens not expressed by tumor cells (4).
CD30, CD15, EBV, fascin.
291
Nodular lymphocyte-predominant Hodgkin's lymphoma: Antigens expressed by the T lymphocytes in the nodules (4).
CD3, CD4, CD57, PD-1.
292
Nodular lymphocyte-predominant Hodgkin's lymphoma: Additional immunohistochemistry (2).
CD21 and CD23 highlight the expanded FDC meshworks.
293
Nodular lymphocyte-predominant Hodgkin's lymphoma:
A. Flow cytometry.
B. PCR.
A. May reveal CD4/CD8 double-positive T cells.
B. Does not detect clonal rearrangement of IGH.
294
Nodular lymphocyte-predominant Hodgkin's lymphoma vs. T-cell/histiocyte-rich DLBCL
T-cell/histiocyte-rich DLBCL:
- Diffuse, not nodular; complete effacement of architecture.
- CD21 and CD23 reveal no expansion of FDC meshworks.
- No rosettes of PD-1-positive T cells.
295
Nodular lymphocyte-predominant Hodgkin's lymphoma: Prognosis (3).
Cured if excised early.
Otherwise:
- Relapses and recurrences are frequent.
- Patients are predisposed to develop DLBCL.
296
Nodular-sclerosis Hodgkin's lymphoma: Most common sites.
Cervical lymph nodes.
Mediastinum (involved in 80% of cases).
297
Nodular-sclerosis Hodgkin's lymphoma: Variants of Reed-Sternberg cells (4).
Hodgkin's cells: Mononuclear.
Wreath cells: Multinucleate.
Mummified cells: Condensed cytoplasm, pyknotic nuclei.
Lacunar cells: Due to formalin-induced retraction of cytoplasm.
298
Nodular-sclerosis Hodgkin's lymphoma: Non-neoplastic cells (5).
Small lymphocytes.
Histiocytes.
Eosinophils.
Plasma cells.
Neutrophils occasionally.
299