Non-Hodgkin Lymphomas Flashcards Preview

SBL Exam 1 WBCs, Spleen, and Thymus > Non-Hodgkin Lymphomas > Flashcards

Flashcards in Non-Hodgkin Lymphomas Deck (28)
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1

What is the clinical staging of lymphomas?

Ann Arbor Classification

Stage I: single LN region (I) or single extralymphatic site (IE)

Stage II: two or more LN regions on same side of diaphragm (II) or localized extralymphatic site (IIE)

Stage III: LN regions on both sides of diaphragm (III) w/ or w/o localized extralymphatic site (IIIE)

Stage IV: multiple, diffuse extralymphatic sites w/ or w/o lymphatic involvement

2

What is the most common and most deadly plasma cell cancer?

multiple myeloma

3

What is follicular lymphoma? (cell type and key features)

-germinal center B cell lymphoma (non-Hodgkin)

-t(14:18) involivng Ig heavy chain and antiapoptotic BCL2 (normally absent in germinal centers)

-nodular masses in lymphnodes

-normal B cell markers

 

4

What is the common presentation of follicular lymphoma?

-middle aged adults

-painless, generalized lymphadenopathy

5

What are potential complications of follicular lymphoma?

-transformation to large B-cell lymphoma

6

What is the course/prognosis of CLL/SLL?

-indolent course but uncurable

-survival median of 7-9 years

-palliative chemotherapy

7

What is the most common form of non-Hodgkin lymphoma?

diffuse large B cell lymphoma

8

What is diffuse large B cell lymphoma? (cell type and key features)

-large (4-5x normal) mature B cells

-non-Hodgkin lymphoma

-normal B cell markers

-occurs spontaneously or from transformation of other cancers

9

What is the common presentation of diffuse large B cell lymphoma?

-occurs in all ages; more common in adults (median age 60)

-rapidly enlarging lymph node

10

What is the course/prognosis of diffuse large B cell lymphoma?

aggressive course

 

Prognosis:

-rapidly fatal without treatment

-remission: 60-80%

-cure: 40-50%

11

What is Burkitt lymphoma? (cell type and key features)

-germinal B cell

-associated with EBV infection

-t(8:14) involivng oncogene c-myc and Ig heavy chain

-"starry sky" appearance (sky = cancer cells, stars = occasional macrophage phagocytizing apoptotic cancer cells)

-normal B cell markers

12

What are the different presentations of Burkitt lymphoma?

Common to both:

-child/young adult

-extranodal mass

 

African:

-lesion on jaw

Sporadic:

-lesion in abdomen

13

What is the course/prognosis of Burkitt lymphoma?

Aggressive course

 

Prognosis:

-most younger individuals cured; worsens with older age1

14

What is lymphoplasmacytic lymphoma?

Also called Waldenström macroglobulinemia

-plasma cell cancer

-excess production of monoclonal IgM -> serum hyperviscosity

-MyD88 association

15

What is the common presentation of lymphoplasmacytic lymphoma?

-nonspecific

-lymphadenopathy

-anemia

-*vision problems

-*neurologic effects (HA,, dizziness, stupor)

-*bleeding

-*cryoglobulinemia (Raynaud phenomenon)

 

*associated with increased serum viscosity/high IgM

16

What is the course/prognosis of lymphoplamacytic lymphoma?

Indolent course

 

plasmaphoresis to remove IgM improves symptoms

 

incurable, meidan survivial is 4 years

17

Compare lymphblastocytic lymphoma to CLL and MM.

CLL:

-similar in presentation (asymptomatic, present in LNs, )

-CLL does not have hyperviscosity sydrome

 

MM:

-MM produces IgG/A instead of bulkier IgM, hence no hyperviscosity in MM

-MM has bone lesions

18

What is mantle cell lymphoma?

-naive B cell lymphoma

-t(11;14) involving cyclin-D1 and IgH promoting G1/S transition

-CD5+, CD23-, CD19, CD20 (CD23- distinguished from CLL)

19

What is the course/prognosis of mantle cell lymphoma?

moderately aggressive course

 

poor prognosis; median survival 3-4 years

no cure

20

What is the common presentation of mantle cell lymphoma?

-Older men 

-painless lymphadenopathy

21

What is marginal zone lymphoma?

-heterogenous B cell lymphoma

-extranodal sites in chronic inflammatorys states (salivary glands in Sjögrens, thyroid in Hashimoto thyroiditis, and stomach with H. pylori infection

 

22

What is the course/prognosis of marginal zone lymphomas?

early stages can be reveresed by removing chronic inflammatory state (ie. treating H. pylori)

 

Later stages, tumor have mutations that allow them to survive without the chronic inflammatory state

23

What is extranodal NK/T-cell lymphoma?

- cancer of NK cells

-CD3-, TCR-, CD16+, CD56+

-EBV infection

24

What is the common presentation of extranodal NK/T-cell lymphoma?

-adults

-destructive extranodal masses, most commonly nasopharyngeal

25

What is the course/prognosis of extranodal NK/T-cell lymphoma?

aggressive course

 

poor prognosis

26

What is anaplastic large-cell lymphoma?

-cancer of CD8 T cells

-ALK+ (not normally present in lymphocytes)

-CD30+ (also found on Reed-Sternberg cells)

-large "hallmark" cells with horseshoe nuclei

-cluster around venules/lymphoid sinuses mimicing metastatic carinoma

27

What is the common presentation of anaplastic large-cell lymphoma?

-children and young adults (unusual for T cell neoplasms)

-lymphadenopathy

28

What is the course/prognosis of anaplastic large-cell lymphoma?

aggressive course

 

very good prognosis; 75-80% cure (unusual for T cell neoplasms)