Lymphoma

Question 1

Divisions of lymphoma

Answer 1

Hodgkins and non-hodgkins

Question 2

Divisions of non-hodgkins lympoma

Answer 2

Follicular lymphoma
Mantle cell lymphoma
Marignal zone lymphoma
Burkitt lymphoma
Diffuse large B cell lymphoma

Question 3

What cells proliferate in follicular lymphoma?

Answer 3

small b cells

Question 4

Pathophys of follicular lymphoma?

Answer 4

proliferatino of small B cells (CD20+) form follicle-like nodules
Translocation results in overexpression of Bcl2 and loss of apoptosis

Question 5

Which translocation is present in follicular lymphoma?

Answer 5

t(14:18) - Bcl2 is translocated to location of it heavy chain locus result in overexpression and prevention of cell death

Question 6

Treatment of follicular cell lymphoma

Answer 6

reserved for patients with symptoms

Rituximab (anti-CD20 antibody)

Question 7

How to dinstinguish between follicular cell lymphoma and reactive follicular hyperplasia?

Answer 7

Follicular cell lymphoma has disruption of normal lymph architecture, lack of tangible body macrophages in germinal center, bcl2 overexpression and monoclonality

Question 8

What proliferates in mantle cell lymphoma?

Answer 8

Small b cells (CD20+)

Question 9

Which area of the lymph node expands in mantle zone lymphoma?

Answer 9

Mantle zone

Question 10

Which translocation is present in mantle cell lymphoma?

Answer 10

t(11:14)
- cylcin D1 on chromosome 11 translocation to it heavy chain locus of chromosome 14 leading to overexpression of cyclin D1

Question 11

What does the t(11:14) seen in mantle cell lymphoma result in?

Answer 11

Overexpression of Cyclin D1 and progression from G1 to S phase

Question 12

What is marginal zone lymphoma a proliferation of?

Answer 12

small b cells (cd20+)

Question 13

Which zone is expanded in marginal zone lymphoma?

Answer 13

Marginal zone

Question 14

What is marginal zone lymphoma associated with?

Answer 14

Chronic inflammatory states including Hashimoto thyroiditis, Sjorgren, H pylori gastritis

Question 15

what type of lymphoma is MALToma?

Answer 15

marginal zone lymphoma of mucosal sites

Question 16

which translocation may be seen in marginal zone lymphoma?

Answer 16

t(11;18)

Question 17

What non hodgkins lymphomas have overexpression of small B cells?

Answer 17

follicular lymphoma
Mantle cell lymphoma
Marginal zone lymphoma

Question 18

Which non hodgkins lymphoma has overexpression of intermediate-b cells?

Answer 18

Burkets lymphoma

Question 19

which cells proliferate in burkitts lymphoma?

Answer 19

intermediate-sized b cells (cd20+)

Question 20

what is burkitt lymphoma associated with?

Answer 20

EBV

Question 21

classic presentation of burkitt lymphoma

Answer 21

extranodal mass in child or young adult

Question 22

What are the two forms of burkitt lymphoma?

Answer 22

African form - involves jaw

Sporadic form - involves abdomen

Question 23

What translocation drives burkitt lymphoma?

Answer 23

t(8;14)

c-myc gene is translocated to igheavy chain locus on chromosome 14 resulting in overexpression of c-myc oncogene

Question 24

What will burkitts lymphoma look like histologically?

Answer 24

high mitotic index and ‘starry sky’ appearance

Question 25

what cells proliferate in diffuse large b-cell lymphoma?

Answer 25

large B cells (CD20+)

Question 26

histological appearance of large b-cell lymphoma

Answer 26

diffuse growth in sheets

Question 27

Hodgkins lymphoma has which type of cell?

Answer 27

Reed-sternberg cells

Question 28

What are reed-sternberg cells?

Answer 28

Cell type seen in hodgkins lympoma | they are large B cells with multilobed nuclei and prominent nucleoli 'Owl eyed'

Question 29

Which markers are reed-sternberg cells + for?

Answer 29

CD15 and CD30

Question 30

Pathophys of hodgkins lymphoma

Answer 30

reed-sternberg cells secrete cytokines which draws in other cell types May result in B cell symptoms (fever, chills, weight loss, night sweats) May lead to fibrosis

Question 31

What are the subdivisions of Hodgkins lymphoma?

Answer 31

Mixed-cellularity hodgkins lymphoma Lymphocyte-depleted hodgkins lymphoma Nodular sclerosis Lymphocyte-rich hodgkins lymphoma

Question 32

Which type of hodgkins lymphoma is the most common?

Answer 32

Nodular sclerosis (70%)

Question 33

Nodular sclerosis hodgkins lymphoma presentation?

Answer 33

enlarging cervical or mediastinal lymph node in a young adult female

Question 34

Nodular sclerosis hodgkins lymphoma histology?

Answer 34

Bands of sclerosis with reed-sternberg cells in lacunar spaces

Question 35

Which subtype of hodgkins lymphoma has the best prognosis ?

Answer 35

Lymphocyte-rich

Question 36

Which subtype of hodgkins lymphoma is the most aggressive and which populations does it effect?

Answer 36

Lymphocyte-depleted | seen in elderly and HIV positive individuals

Question 37

Which cell type is abundant in mixed-cellularity hodgkins lymphoma?

Answer 37

eosinphils drivin by IL-5 produced by RS cells