Non Hodgkin Lymphoma

Question 1

Basics of Leukemia

Answer 1

Malignancy of hematopoietic cells
Starts in bone marrow (can spread to blood, nodes)
Myeloid or Lymphoid
Acte or Chronic

Question 2

Basics of Lymphoma

Answer 2

Malignancy of hematopoietic cells
Starts in lymph nodes (can spread to marrow, blood)
Lymphoid only
Hodgkin or Non Hodgkin

Question 3

What is the most common cause of lymphadenopathy?

Answer 3

benign reaction to infection

Question 4

Most common cause of malignant lymphadenopathy?

Answer 4

Metastatic carcinoma

Question 5

Where are most follicles located?

Answer 5

In cortex, under the capsule (lymphocytes with germinal centers)

Question 6

Where does cell differentiation and maturation occur

Answer 6

Germinal center and mantle zone

Question 7

Follicular hyperplasia

Answer 7

B cell response to immune stimulus
Tingible macrophages
Large irregular follicles

Question 8

Tingible macrophages in Lymphoma…

Answer 8

NONE

Question 9

Interfollicular hyperplasia

Answer 9

Expanded area between follicles
Mixture of cells
Partial effacement (normal architecture obliterated)
T cell response to some type of stimuli.

Question 10

Non Hodgkin Lymphoma

Answer 10

Malignant proliferation of lymphoid cells (blast or mature cells) in lymph nodes
Skips around
Mostly B cells

Question 11

Non Hodgkin vs Hodgkin

Answer 11

Non Hodgkin tends to skip around more, has a worse prognosis because it is unpredicable

Question 12

Symptoms of NHL

Answer 12

painless, firm lymphadenopathy
extranodal manifestations
B symptoms

Question 13

What are B symptoms

Answer 13

Weight loss
Night Sweats
Fever

Question 14

A

Answer 14

no B symptoms

Question 15

Low Grade NHL

Answer 15

Older patients
Indolent (not a lot of mitosis)
Small, mature cells
Non destructive

Question 16

High Grade NHL

Answer 16

Children
Aggressive
Big ugly cells
Destructive

Question 17

Types of Low Grade (4)

Answer 17

1. Small lymphocytic lymphoma
2. Malt lymphoma
3. Follicular lymphoma
4. mycosis fungoides

Question 18

Types of High Grade (3)

Answer 18

1. Large Cell lymphoma
2. Lymphoblastic lymphoma
3. Burkitt Lymphoma

Question 19

Small Lymphocytic Lymphoma

Answer 19

CLL
small mature lymphocytes
B cell, CD5+

Question 20

What is Richter’s Transformation?

Answer 20

Change from low grade lymphoma/leukemia to a high grade process - cells get bigger and become more aggressive

Question 21

Marginal Zone Lymphoma

Answer 21

Actually a bunch of lymphomas
Marginal zone pattern
MALT lymphoma

Question 22

What is MALT Lymphoma associated with?

Answer 22

H. Pylori

If catch early, antibiotic and goes away

Question 23

Mantle Cell Lymphoma

Answer 23

Mantle zone pattern
Small angulated lymphocytes
T (11;14) cyclin D and IgH
Aggressive

Question 24

Mantle Cell translocation?

Answer 24

T(11;14)

Question 25

Follicular Lymphoma

Answer 25

Follicular pattern (later diffuse) Small cleaved cell (1), mixed (2) or large cell (3) T (14;18) IgH and Bcl-2 Butt cells

Question 26

Butt cells

Answer 26

Follicular lymphoma

Question 27

Follicular lymphoma translocation?

Answer 27

T (14;18)

Question 28

Stage I

Answer 28

Single Node

Question 29

Stage II

Answer 29

Two or more nodes on the same side of the diaphragm

Question 30

Stage III

Answer 30

Lymph nodes on both sides of the diaphragm

Question 31

Stage IV

Answer 31

Diffuse extranodal involvement

Question 32

A

Answer 32

No additional symptoms

Question 33

B

Answer 33

weight loss, night sweats, fever

Question 34

Mycosis Fungoides/Sezary Syndrome

Answer 34

``` Skins lesions (MF), present as flat lesions like eczema Starts as patch - then plaque - nodule Blood involvement (SS) Cerebriform lymphocytes T cell immunophenotype ```

Question 35

Cerebriform lymphocytes

Answer 35

Mycosis Fungoides / Sezary Syndrome

Question 36

Diffuse Large Cell Lymphoma

Answer 36

Large B cells Extranodal involvement Grows rapidly Bad prognosis

Question 37

Lymphoblastic Lymphoma

Answer 37

Two types: B and T Lymphoblasts in diffuse pattern same thing as ALL

Question 38

How does lymphoblastic lymphoma present?

Answer 38

Teenage Male Mediastinal Mass (Thymus) T-lymphoblastic

Question 39

Burkitt Lymphoma presentation

Answer 39

Child with fast growing extranodal mass

Question 40

Burkitt Lymphoma pattern?

Answer 40

Starry sky | FAST GROWING

Question 41

Burkitt Lymphoma translocation

Answer 41

T (8;14) cmyc and IgH

Question 42

Adult T cell Leukemia/Lymphoma

Answer 42

Japan/Caribbean basin HTLV-1 Skin lesions, hypercalcemia Aggressive