lympho

Question 1

Non hodgkin

Answer 1

Haphazard mode of spread
Leukemia phase
Involves extranodal sites

Question 2

Secondary site of production of lymphocytes

Answer 2

Lymph node
spleen
peyer’s patches

Question 3

Tertiary lymphoid organs

Answer 3

Acquired lymphoid tissues in stomach, skin, respiratory and reproductive tracts

Question 4

major cells in cortex of lymph node

Answer 4

B cells

Question 5

major cells in paracortex

Answer 5

T cells

Question 6

implication of expansion of paracortex

Answer 6

CMI response

Question 7

majority of T cells are CD4+

True or false

Answer 7

true

Question 8

which cells do medullary cordds contain

Answer 8

Transformed lymphoid cells and plasma cells

Question 9

lypmphocytes from circulation enter node via

Answer 9

high endothelial venules in paracortex

Question 10

do follicles in newborn have germinal centres

Answer 10

no

Question 11

where does lymph eventually drain to

Answer 11

thoracic duct and SVC

Question 12

LAP anatomical site and disease

Post auricular node
occipital nodes
post cervical nodes
axillary node

Answer 12

Rubella
Scalp infections
toxoplasmosis
infection of arm

Question 13

type of lymphadenopathy in TB

Answer 13

Granulomatous lympadenitis

Question 14

Suppurative granulomatous LAP seen in

Answer 14

LGV

Cat scratch disease

Question 15

types of reactive hyperplasia

Answer 15

Follicular hyperplasia
Paracortical expansion
sinus histiocytosis
dermatopathic lymphadenopathy(xterised by lipomelanic reticulosis)

Question 16

Sinus histiocytosis with massive lymphadenopathy(Rosai-Dorfman syndrome)

Answer 16

febrile disease in children and young adults. bilateral cervical LAP. some patients have immune deficiency

Question 17

kikuchi disease

Answer 17

necrotizing histiocytic
SLE like disease
cervical LN

Question 18

AIDS related LAP

Answer 18

Severe follicular hyperplasia
- Regressive follicular hyperplasia
- Follicular involution, progressing to
lymphocyte depletion. Helper T-cells are reduced and suppressor T-cells are increased in the germinal centres

Question 19

which malignant lesions may seen in AIDS

Answer 19

Kaposi sarcoma
HL
NHL

Question 20

On what basis do we classify lymphomas as HL Or NHL

Answer 20

presence or absence of Reed-Stenberg cells

Question 21

lymphomas may be only nodal

Answer 21

false

can be extranodal

Question 22

Apart from R-S cells, which other cells can be found in HL

Answer 22

Lacunar cells
Lymphocytic cells
Histiocytic(popcorn)
Hodgkin cell

Question 23

Hodgkin lymphoma

Answer 23

tumor of germinal centre B - cell with non-productive Ig gene arrangements

Question 24

Characteristic giant cell in HL

Answer 24

H-RS cell

Question 25

Characteristic giant cell in NLPHL(nodular lymphocyte predominant hodgkin lymphoma)

Answer 25

L and H cell it is a type of Hodgkin lymphoma but not a classical one. mature b cell lymphoma

Question 26

term given to how or why HRS cell escape apoptosis

Answer 26

fail to undergo negative selection

Question 27

role of NFKB in HL pathogenesis

Answer 27

upregulates pro-proliferative and anti-apoptotic gene expression programme in lymphocytes in inflammation

Question 28

which gene is highly mutated in HL and what's its function

Answer 28

A20 regulates activity of NFKB

Question 29

Is A20 mutatiion only found in HL

Answer 29

No also in DLBCL Extranodal MZL

Question 30

Mechanisms by which HRS cells are resistant to apoptosis

Answer 30

``` expression of CFLIP (antiapoptic protein) inhibition of caspase 8 cleavage a20 mutation lack b cell receptor lineage promiscuity more in monozygotic twins ```

Question 31

role of EBV

Answer 31

Via LMPS- latent membrane proteins 2 - shuts down BCR expression 1 - leads to NFKB activation. 2 can do same. this upregulation inhibits fas signalling

Question 32

key difference between NLPHL and HRS

Answer 32

HRS cells of CHL lack Bcl-6 proteins

Question 33

what HRS cells secrete

Answer 33

TH 2 cells cytokines and chemokines

Question 34

Classification of HL

Answer 34

Nodular sclerosis mixed cellularity lymphocyte depleted lymphocyte rich

Question 35

nodular sclerosis

Answer 35

predilection for mediastinal lymph nodes dominated by lacunar cells graded 1 and 2 with 2 being worse

Question 36

mixed cellularity

Answer 36

younger age | EBV+

Question 37

Lymphocyte depletion

Answer 37

previously diagnosed as anaplastic carcinomas or high grade NHLs HIV+ Aggressive but curable

Question 38

lymphocyte rich

Answer 38

no eosinophils rare ebv negative

Question 39

Staging of Hodgkin lymphoma

Answer 39

I – A single lymph node or a single extralymphatic organ II- 2 or more groups of lymph nodes on the same side of diaphragm or localized involvement of an extralymphatics organ or site(IIE) III- Lymph nodes on different side of diaphragm without or with involvement of an extralymphatic organ or site (IIIE) IV- Diffuse involvement of 1 or more extralymphatic organs or sites with or without lymphatic involvement

Question 40

Etiology of NHL

Answer 40

``` Congenital and acquired immune state Ebv T cell leukemia GMZL H pylori Sunlight EM field Herbs, pesticides Hep C virus Hair dressing Petrochemicals ```

Question 41

2 types of lymphoid leukemia

Answer 41

B cell acute or lymphoblastic leukemia or lymphoma | T cell acute or lymphoblastic leukemia or lymphoma

Question 42

Follicular lymphoma in gastric biopsy

Answer 42

CD 10 | Bcl 2

Question 43

Which sites does Burkitt Lymphoma usually affect

Answer 43

Jaw | Abdominal organs

Question 44

What two factors govern the geographical distribution of BL

Answer 44

Temperature... Over 60F 15.5C | Humidity.... High

Question 45

BL Belt

Answer 45

10 15 N S equator

Question 46

Where is BL rare

Answer 46

High land Dry arid area Cold area

Question 47

Etiology of Burkitt Lymphoma

Answer 47

EBV infects B cells and nasopharyngeal epithelium. T cell immunity required for control of EBV infection. Deficiency in t cell immunity Malaria... T cell immunodeficiency Translocation of cmyc oncogene

Question 48

Translocation of cmyc oncogene

Answer 48

8 14 8 22 2 8

Question 49

Clinical presentation of BL

Answer 49

Jaw more in maxilla than mandible Abdominal mass CNS Other organs repro thyroid kidneys

Question 49

Clinical presentation of BL

Answer 49

Jaw more in maxilla than mandible Abdominal mass CNS Other organs repro thyroid kidneys

Question 50

Appearance in histology

Answer 50

Starry sky appearance

Question 51

Markers in BL

Answer 51

CD 20 CD 10 Ki67 Negative for bcl2

Question 52

Indolent disease Ema Positive with pop corn cells and respond to local chemotherapy

Answer 52

NLPHL

Question 53

Staging of BL

Answer 53

A - single extra abdominal mass B - Multiple extra abdominal mass C - Abdominal mass with or without facial tumor D - Abdominal mass with sites of tumor other than facial or bone marrow AR - Abdominal mass with >90 of tumor resected