Non Hodgkin's Lymphoma

Question 1

Non-Hodgkin’s Lymphomas involve what types of cells, in order of occurrence?

Answer 1

B cells most often, minority are T cells

Question 2

Describe the lymph node involvement of NHL

Answer 2

typically involves multiple nodes

non-contiguous spread

Question 3

B cell NHLs will all involve the translocation of what gene on what chromosome?

Answer 3

Ig heavy chain, on chromosome 14

Since Ig heavy chain is highly expressed in B cells, any gene that switches places with it will thus be highly expressed itself

Question 4

Describe bcl2’s lymphoma association, its chromosome #, and its normal function

Answer 4

bcl2 is associated with Follicular lymphoma
its on chromosome 18
bcl2 stabilizes the mitochondrial membrane, preventing release of cytochrome c. This inhibits apoptosis. We don’t want that during + and - selection of lymphocytes!!

Question 5

What region of the lymph node does mantle cell lymphoma involve?

Answer 5

the region immediately surrounding the follicle (forms a ring around it)
cells will be CD20+ and CD5+

Question 6

Name the translocation and protein associated with mantle cell lymphoma?

Answer 6

t(11;14)
cyclin D1
this protein moves the cell cycle from G1 into S phase

Question 7

Burkitt’s lymphoma involves Ig heavy chain switching spots with what gene?

Answer 7

c-myc (on chromosome 8)

c-myc is a transcription factor that induces cellular growth

Question 8

What are the characteristics of the virus most heavily associated with Burkitt Lymphoma?

Answer 8

Epstein Barr Virus (EBV)
part of the Herpesviruses (all of which are DS DNA, enveloped, and associated with latency)
latency in B cells
transmitted via secretions/saliva
causes BL and heterophile + mononucleosis

Question 9

Describe the histological findings of Burkitt Lymphoma

Answer 9

starry sky appearance

sheets of lymphocytes (sky) with interspersed macrophages (starry)

Question 10

What pic will they always show with Burkitt?

Answer 10

a black kid with a giant ball on his jaw

Question 11

What are the 2 non-B cell NHL cases?

Answer 11

T cell lymphoma, mycosis fungoides (both CD4+)

Question 12

What are the characteristics of the causative agent of Adult T cell lymphoma?

Answer 12

HTLV-1
in the retrovirus family with HIV!
SS + linear RNA, enveloped
icosahedral

Question 13

What is the typical presentation with an adult T cell lymphoma?

Answer 13

Person from Japan/Caribbean/West Africa with
cutaneous lesions
also lytic bone lesions and hyperCalcemia

Question 14

Mycosis fungoides presents in what way?

Answer 14

cutaneous patches/nodules

filled with Th cells (CD4+)

Question 15

How does mycosis fungoides progress to Sezary syndrome?

Answer 15

dissemination into blood

leads to characteristic “cerebriform nuclei”, as well as Pautrier microabscesses (exfoliative)