Lymphoma

Question 1

Histological Features of Hodgkin Lymphoma (HL)

Answer 1

Reed-Sternberg cells (RS cells)

Question 2

HL positive for ……… , but often negative for standard B-cell markers (CD19, CD20, CD21, CD22).

Answer 2

CD15+ and CD30+

Question 3

Clinical Features of HL :
Most commonly presents as lymphadenopathy :

Answer 3

o Neck (cervical, supraclavicular nodes) most common.
o Non-tender, firm, rubbery nodes.
o May present as an anterior mediastinal mass.

Question 4

Predictable spread for HL

Answer 4

from one lymph node group to the next.

Question 5

Key diagnostic test: for HL

Answer 5

Lymph node biopsy.
o Presence of Reed-Sternberg cells confirms HL.

Question 6

Risk factors for HL

Answer 6

o Epstein-Barr virus (EBV) infection.
o Immunosuppression (HIV, transplant).
o Autoimmune diseases (RA, SLE).

Question 7

WHO Classification of HL

Answer 7

Classical Hodgkin Lymphoma (cHL)
Nodular Lymphocyte-Predominant HL (NLPHL) (rare).

Question 8

Classical Hodgkin Lymphoma (cHL)

Answer 8

o Nodular Sclerosing HL (most common, 60-80%).
o Mixed Cellularity HL (inflammatory infiltrate).
o Lymphocyte-Rich HL (excellent prognosis).
o Lymphocyte-Depleted HL (poor prognosis).

Question 9

Staging via PET/CT scan (Lugano classification) for HL

Answer 9

1. Stage I: Single node or group.
2. Stage II: Multiple nodes on one side of the diaphragm.
3. Stage III: Nodes on both sides of the diaphragm.
4. Stage IV: Extranodal disease (e.g., liver, bone marrow).

Question 10

Treatment:of HL

Answer 10

o Chemotherapy + radiation.
o Common regimen (ABVD):
 Adriamycin (Doxorubicin).
 Bleomycin.
 Vinblastine.
 Dacarbazine

Question 11

Classification of NHL

Answer 11

1. Based on Cell Type:
   o B-cell NHL (most common).
   o T-cell NHL.
2. Based on Growth Pattern:
   o Aggressive (rapid growth, B symptoms).
   o Indolent (slow-growing, waxing/waning course).

Question 12

Most common NHL.

Answer 12

Diffuse Large B-Cell Lymphoma (DLBCL

Question 13

CD19+, CD20+

Answer 13

Diffuse Large B-Cell Lymphoma

Question 14

Diffuse Large B-Cell Lymphoma treatment

Answer 14

rituximab (anti-CD20 antibody).

Question 15

t(14;18) translocation → BCL2 overexpression.

Answer 15

Follicular Lymphoma:

Question 16

Can transform into DLBCL (poor prognosis)

Answer 16

Follicular Lymphoma

Question 17

t(11;14) translocation → Cyclin D1 overexpression.

Answer 17

Mantle Cell Lymphoma:

Question 18

Poor prognosis (median survival: 3-4 years).

Answer 18

Mantle Cell Lymphoma

Question 19

Associated with chronic inflammation

Answer 19

Marginal Zone Lymphoma (MZL)

Question 20

Marginal Zone Lymphoma (MZL)
o Associated with chronic inflammation
Include

Answer 20

 MALToma (H. pylori infection → stomach lymphoma).
 Sjogren’s syndrome (salivary gland lymphoma).
 Hashimoto’s thyroiditis (thyroid lymphoma).

Question 21

Highly aggressive B-cell malignancy.

Answer 21

Burkitt Lymphoma

Question 22

t(8;14) translocation → c-myc activation

Answer 22

Burkitt Lymphoma

Question 23

“Starry sky” histology.

Answer 23

Burkitt Lymphoma

Question 24

Strongly linked to Epstein-Barr virus (EBV).

Answer 24

Burkitt Lymphoma:

Question 25

There are 3 forms of Burkitt Lymphoma

Answer 25

 Endemic (African): Facial/mandibular mass.  Sporadic: Abdominal involvement.  Immunodeficiency-associated (HIV).

Question 26

B cell NHL

Answer 26

Diffuse Large B-Cell Lymphoma (DLBCL) Follicular Lymphoma Mantle Cell Lymphoma Marginal Zone Lymphoma (MZL) Burkitt Lymphoma

Question 27

T-Cell NHLs

Answer 27

Adult T-Cell Leukemia/Lymphoma (ATLL) Cutaneous T-Cell Lymphomas (CTCL)

Question 28

Presents with lymphocytosis, skin lesions, and lytic bone lesions with hypercalcemia

Answer 28

Adult T-Cell Leukemia/Lymphoma (ATLL)

Question 29

Caused by HTLV-1 virus

Answer 29

Adult T-Cell Leukemia/Lymphoma (ATLL)

Question 30

Adult T-Cell Leukemia/Lymphoma (ATLL) is ………… prognosis.

Answer 30

Poor prognosis (rapidly fatal in months)

Question 31

Sezary syndrome

Answer 31

 Diffuse skin involvement (erythroderma).  Circulating Sezary cells (malignant T-cells with "cerebriform" nuclei).

Question 32

Diagnosis of lymphoma relies on

Answer 32

biopsy, immunophenotyping, and genetic studies.