Malignancies of lymphoid cells Flashcards by Rakesh Durai

ALL

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Most common childhood cancer

B cell ALL

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Poor prognostic factors in ALL

t(9;22)

High leukocyte count

Symptomatic CNS disease

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Most common lymphoid leukemia

Chronic lymphoid leukemia

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Non hodgkin Lymphomas with female preponderance

Follicular lymphoma

Marginal Zone B cell lymphoma of MALT type

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NHLs common in children

Precursor T cell lymphoblastic lymphoma (40%)

Burkitt lymphoma (30%)

Diffuse large B cell lymphoma (25%)

Peripheral T cell non hodgkin lymphoma (5%)

Anaplastic large T/Null cell lymphoma

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International prognostic index for NHL

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B symptoms are common in which NHLs

Anaplastic large T/null cell lymphoma

Peripheral T cell non hodgkin lymphoma

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NHLs which doesnot involve bone marrow commonly

Anaplastic large T/Null cell lymphoma

MALT

DLBCL

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NHLs with good prognosis

NHL

% surviving 5 years

Anaplastic large T/Null cell lymphoma

77%

MALT

74%

Follicular

72%

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CLL

Smudge or basketcells

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Cytogenetic abnormalities in CLL

trisomy 12

abnormalities in chromosome 13

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Diagnosis of typical B cell CLL is made when the number of circulating lymphocytes is more than

4000/µL

These are monoclonal B cells expressing CD5

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CD5 positive NHLs

Mantle cell lymphoma

B cell CLL

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Tissue manifestation of waldenstrom macroglobulinemia

Lymphoplasmacytic lymphoma

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Lymphomas similar to SLL

Mantle cell lymphoma

Nodal marginal zone B cell lymphoma

lymphoplasmacytic lymphoma

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The diagnosis of typical B cell CLL should be considered in any patient with

Autoimmune hemolytic anemia

Autoimmune thrombocytopenia

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Poor prognostic markers in CLL

CD38

ZAP 70

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Lumbar puncture is needed in which NHLs

Lymphoblastic

burkitt

DLBCL

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Treatment for CLL/SLL

Oral Chlorambucil

IV Fludarabine(more active)

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Drug equally efficacious as fludarabine in CLL

Bendamustine

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MALT lymphomas

Site

Disease

Stomach

H.Pylori

Thyroid

Hashimoto thyroiditis

Salivary gland

Sjogren

Ocular

Chlamydia psitacci conjunctivitis

Skin

Borrelia

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Translocation in MALT lymphoma

t(11;18)

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Determining factor in progression of MALT lymphoma to DLBCL

t(11;18) negativity

BCL 6 mutations

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translocation in mantle cell lymphoma

t(11;14)

Overexpression of _____________ leads to mantle cell lymphoma

BCL1/CYCLIN D1

Difference btw mantle cell lymphoma and SLL

Mantle cell lymphoma has a slightly indented nucleus

GI involvement of mantle cell lymphoma

Lymphomatosis polyposis of large intestine

Mantle cell lymphoma patients with GI involvement usually have involvement of

waldeyer ring

Treatment of mantle cell lymphoma

Hyper CVAD Cyclophosphamide Vincristine doxorubicin dexamethasone cytarabine methotrexate

Translocation in follicular lymphoma

t(14;18)

Abnormal expression of ___________ protein is seen in follicular lymphoma

BCL2

Small cleaved cells large cells arranged in follicular pattern follicular lymphoma

Follicular lymphoma must be differentiated from

Reactive follicular hyperplasia

Most common presentation of follicular lymphoma

new painless lymphadenopathy

Transformation of follicular lymphoma to DLBCL is heralded by

Rapidly enlarging nodes B symptoms

Most common type of NHL

DLBCL

Transformation of CLL to DLBCL

Richter syndrome

Primary mediastinal DLBCL

Common in females Younger median age(37 years)

Most common extranodal sites of DLBCL

Gi tract Bone marrow

Treatment of DLBCL

R-CHOP

Which is better in relapsed DLBCL? Autologus BMT or salvage chemotherapy

Autologus BMT

Medium sized lymphocytes Frequent mitotic figures Burkitt Lymphoma

Translocations in burkitt lymphoma

t(8;14) t(2;8) lambda t(8;22) kappa

Clinical forms of burkitt

Endemic Sporadic Immunodeficiency associated

Difference between burkitt lymphoma and DLBCL

Extremely high proliferative fraction in burkitt lymphoma

Burkitt lymphoma commonly metastasises to

CNS

Treatment of burkitt lymphoma must begin within

48h of diagnosis

Treatment of burkitt lymphoma

Combination regimen with high dose chemotherapy Prophylactic therapy to CNS

Hairy cell leukemia typically presents with

Pancytopenia

Staining in Hairy cell leukemia

Tartrate resistant acid phosphatase

Who are affected by hairy cell leukemia?

Older males

Diseases associated with hairy cell leukemia

MAC infection Vasculitic syndromes

Rx of hairy cell leukemia

Interferon alpha pentostatin CLADRIBINE

Lymphoma associated with Hepatits C

Lymphoplasmacytic lymphoma

Other name for nodal marginal zone lymphoma

Monocytoid B cell lymphoma

Presentation of Precursor T cell lymphoblastic lymhoma

Young Men Mediastinal mass Pleural effusion CNS mets

Stages of mycosis fungoids

Patch►Plaque►Tumor

Sezary syndrome

Mycoses fungoids with erythroderma and circulating tumor cells

Treatment of mycosis fungoides

Early stage: Total skin electron beam radiation Later stages: Topical glucocorticoids Topical Nitrogen mustard PUVA Phototherapy Extracorporeal photopheresis Retinoids Electron beam radiation Antibodies Interferon Histone Deacytelase inhibitors

Adult Tcell lymphoma/Leukemia is caused by

HTLV

Mode of transmission of HTLV1

Placental breast feeding Blood transfusion Sexual transmission

Latency for different diseases due to HTLV infection

T cell lymphoma: 55 years Tropical spastic paraparesis: 1-3 years

Peripheral blood picture in T cell lymphoma

Flower cells

Flower cells T cell leukemia

CD in T cell lymphoma

CD2,CD3,CD4,CD5,CD25

Treatment of T cell Lymphoma

Interferon Zidovudine Arsenic trioxide

Bone marrow involvement in Adult T cell lymphoma/Leukemia

Usually not involved Anemia and thrombocytopenia are uncommon

lung lesions in Adult T cell leukemia are due to

Tumor infiltration Infection

Markers of anaplastic large T/null cell lymphoma

CD30(Ki antigen) ALK protein t(2;5)

ALK inhibitor

Crizotinib

Aggressive lymphoma with good prognosis

anaplastic large T/null cell lymphoma

Presentation of angioimmunoblastic T cell lymphoma

Generalised lymphadenopathy Fever Skin rash Weight loss Polyclonal hypergammaglobulinemia

Synonyms for extranodal T/NK cell lymphoma of nasal type

Angiocentric lymphoma Lethal midline granuloma

Lymphoma that occurs in untreated gluten sensitive enteropathy patients

Enteropathy type intestinal T cell lymphoma

Hemophagocytic syndrome is common in which lymphomas

Extranodal T/NK cell lymphoma of nasal type Subcutaneous panniculitis-like T cell lymphoma

Presentation of hodgkin lymphoma

Painless lymphadenopathy of neck,supraclavicular area and axilla mediastinal adenopathy

Hodgkin presenting with subdiaphragmatic involvement is seen in

older males

Fever pattern in hodgkin

Pel ebstein fever

Unusual manifestations of hodgkin disease

Severe unexplained itching Erythema nodosum Ichthyosiform atrophy paraneoplastic cerebellar degeneration nephrotic syndrome autoimmune hemolytic anemia thrombocytopenia pain in nodes on alcohol consumption Hypercalcemia

In whom hodgkin presents as FUO?

Older patients with mixed cellularity hodgkin in abdominal site

Most common subtype of hodgkin in US

Nodular sclerosing

Hodgkin subtypes seen in PLHA

Mixed cellularity lymphocyte depleted

DD for hodgkin disease

Inflammation Phenytoin NHL Mononucleosis Nonlymphomatous malignancies

Hodgkin disease-mixed cellularity

In hodgkin PET and gallium scans are useful for

documenting remission

Chemotherapy regimens in Hodgkin

ABVD MOPP Stanford V BEACOPP

ABVD

doxorubicin, bleomycin, vinblastine, and dacarbazine

MOPP

mechlorethamine, vincristine, procarbazine, and prednisone

Stanford V

A mustard derivative such as Cyclophosphamide, Mechlorethamine or Ifosfamide Doxorubicin Vinblastine Vincristine Bleomycin Etoposide Prednisone

BEACOPP

Bleomycin Etoposide Doxorubicin Cyclophosphamide Vincristine Procarbazine Prednisone

Late Rx side effects in hodgkin

Leukemia(common in MOPP) Breast cancer,Lung cancer(Thoracic radiotherapy) Stroke(cervical radiation) CAD(Thoracic radiotherapy) Hypothyroidism Lhermitte syndrome Infertility

Immunophenotype of nodular lymphocyte predominant hodgkin disease

CD45+ EMA+(Epithelial membrane antigen) CD15- CD30-

Causes of reactive lymphoid hyperplasia

Phenytoin,Carbamazepine RA SLE CMV,EBV Cat scratch disease

Presentation of disseminated castleman

Lymphadenopathy anemia polyclonal hypergammaglobulinemia

Manifestations of disseminated castleman is due to

IL-6

Rosai dorfman disease

Sinus histiocytosis with massive lymphadenopathy AIHA

Lymphoma that can lead to intestinal perforation

Enteropathy type intestinal T cell lymphoma

Malignancies of lymphoid cells Flashcards

(98 cards)