Malignant Lymphomas and Hodgkin's Disease Flashcards Preview

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Flashcards in Malignant Lymphomas and Hodgkin's Disease Deck (20):

Describe the features of Precursor B lymphoblastic leukemia/lymphoma.

-particularly occur in childhood
-TdT positive
-related to B cell ALL


Describe the features of B small lymphocytic lymphoma/B cell CLL.

-Diffuse, uniform, small lymphocytes
-long survival, but difficult to cure by chemotx
-tissue equiv of CLL, often involves multiple nodes, spleen
-prolymphocytic varieties, include larger cells and may be more agressive


Describe the features of Lymphoplasmacytic Lymphoma.

-similar to small lymphocytic lymphomas but shows plasmacytoid differentiation. slow growing
-IgM monoclonal spike, may have hyper viscosity: Waldenstrom's Macroglobulinemia
-pay have t(9;14) Pax 5 gene-b cell specific activating protein


Describe the features of Mantle Cell Lymphoma

-mantle zone cells (periphery of follicles)
-t(11;14), bcl-1 genes for cyclin D1, upregulated, promotes G1 to S transition in cell cycle


Describe the features of follicular center cell (FCC) lymphomas.

-one of most common forms of B cell lymphoma
-forms follicle like nodules
-t(14;18) translocation, with increased bcl2 protein, inhibits apoptosis
-B cell markers +CD10
-the more large cells, the more aggressive
Grade 1: small cell type--very few large cells
-mainly small lymphocytes with nuclei showing deep cleaves
-most have follicular pattern
-marrow involvement is detectable in over 70% at presentation
-few cells in S phase so cure difficult
Grade 2/3 mixed small and large cell types
-may progress to diffuse large cell lymphomas


Describe the features of marginal zone lymphoma.

-called MALToma in GI tract (MALT=mucosa associated lymphoid tissue)
-some MALTomas are on the borderlands of hyperplasias and respond to antibiotic tx, means that proliferation is antigen driven.
-contain many plasma cells and blur with lymphoplasmacytic lymphoma


Describe the features of plasma cell (multiple myeloma).

-in bone marrow, multiple lytic lesions, usually not in nodes
-typically shows monoclonal Ig spike in serum
-plasma cell is the end stage fully differentiated effector B cell


Describe the features of large B cell lymphoma. (DLBCL)

-includes large B cell immunoblastic large cells containing prominent nucleoli, and abundant cytoplasm. Prognosis untreated is poor, may respond well to chemo tx
-some show t(14;18)
-some show bcl-6 gene defects
-common, about 30% of adult lymphomas


Describe the features of Burkitt lymphoma

-agressive, one of most common lymphomas of children
-endemic in africa and new guinea, assoc with malaria & EBV
-t(8;14), myc oncogene
-Starry night appearance


Describe the features of precursor T- T lymphoblastic leukemia/lymphoma.

-children and young adults, esp males
-present often as mediastinal mass, then becomes leukemic
-diffuse proliferation of primitive cells resembling embryonic T lymphoblasts
-have high mitotic rate, aggressive
-related to T cell ALL
-Express TdT and T cell markers


Describe peripheral T cell lymphoma

-various appearances; probably more than one disease type, CD3 phenotype useful in diagnosis
-may resemble diffuse large B cell lymphoma, from which they must be distinguished via CD3 v. CD20


Describe cutaneous T cell lymphomas, including mycosis fungicides.

-small cells with folded nuclei
-frequently composed of cells with T helper CD4
-related to leukemia like condn Sezary syndrome


Describe Adult T cell lymphoma/leukemia

-japan, africa, caribbean, HTLV1 related


Describe anapestic large cell lymphoma- ALCL

-CD30+ cells
-t(2,5) translocation, npm/alk gene
-cutaneous variant, less aggressive than nodal form


What are the general pathologic features of Hodgkin lymphoma?

-Reed Sternberg cells: owl face
-also have large mononuclear cells
-RS cells mixed with lymphocyte,s plasma cells, histiocytes, eosinophils, neutrophils, fibroblasts "reactive"
-if assoc with B symptoms (due to RS secreting cytokines): night sweats, fever, wt loss: poor prognosis
-markers: CD15+ and CD30+


Describe lymphocyte predominant Hodgkin lymphoma.

-many lymphocytes and only a few RS cells
-usually in nodular form
-contains polypoid variants of RS cell with lobulated nuclei
-markers: CD45 and CD20


Describe Classical hodgkin lymphoma: nodular sclerosing Hodgkin lymphoma.

-broad bands of collagen circumscribing nodules of neoplastic tissue
-large RS cell variants are characteristic
-usually presents as early stage disease and has a slow progression
-young women are particularly affected and mediastinal involvement is common


Describe Classical hodgkin lymphoma: lymphocyte rich HL.

numerous lymphocytes, few RS cells


Describe Classical hodgkin lymphoma: mixed cellularity (MC) HL.

intermediate histologic appearance with many lymphocytes, plasma cells, eosinophils, and RS cells
-prognosis is intermediate


Describe Classical hodgkin lymphoma: lymphocyte-depleted (LD) HL

-very many reed-sternberg cells, few lymphocytes
-has worst prognosis and typically presents as stage III or IV disease
-very rare