Pathology of Lymphoma Flashcards Preview

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Flashcards in Pathology of Lymphoma Deck (76):
1

What are the two major distinction between lymphomas?

B cell origin
T cell origin

2

What are the malignancies that come from the germinal center of a lymph node?

Follicular lymphoma
Burkitt lymphoma
Large cell lymphoma

3

What are the lymphomas that arise from the mantle zone of lymph nodes?

Naive B cell
Mantle cell lymphoma

4

What are the lymphomas that arise from the marginal zone of the lymph node?

Memory B cell
CLL/SLL
Marginal zone lymphoma

5

What are the clinical symptoms of follicular lymphoma? (3)

-Widespread lymphadenopathy
-Splenomegaly
-BM

6

What are the two cells that compose follicle germinal center lymphomas?

Centroblasts and centrocytes

7

What is the characteristic of low grade follicular lymphoma? High grade?

Low = mostly centrocyte
High = greater than 15 centroblasts/hpf

8

What are the gross histological findings of follicular lymphoma?

High grade infiltration of lymph nodes s/t there is no discernable structure

9

What is the difference between centroblasts and centrocytes?

Centrocytes are smaller with more condensed nuclei

Centroblasts have a lot more cytoplasm

10

What are the four CD markers for follicular lymphoma?

CD19
CD20
CD10
Bcl-2

11

What are the two markers that are absent in follicular lymphoma?

CD5
CD3

12

What are the markers for T cells? (3)

CD3
CD4
CD8

13

What is the function of Bcl-2?

Anti-apoptotic protein

14

Who gets mantle cell lymphoma?

50-60 year old males

15

What are the symptoms of mantle cell lymphoma?

Generalized lymphadenopathy

HSM

16

What organs are affected in mantle cell lymphoma?

Spleen
Liver
Small bowel

17

What are the characteristic lab findings with mantle cell lymphoma?

Lymphocytosis

18

If there is small bowel involvement with mantle cell lymphoma, what is this called?

Lymphomatoid polyposis

19

What are the cell markers for mantle cell lymphoma?

CD19
CD20
CD5
Cyclin D1

20

What are the negative markers for mantle cell lymphoma?

CD23
CD3

21

What is cyclin D1?

Anti Apoptotic molecule that is characteristic of mantle cell lymphomas

22

What is endemic burkitt lymphoma?

EBV viral infection in young africans

23

What is sporadic burkitt lymphoma?

Worldwide childhood infection

24

True or false: only the sporadic type of Burkitt lymphoma has CNS involvement

False--all types

25

What is the presentation for endemic burkitt lymphoma?

Jaw enlargement, ovaries, kidney involvement

26

What are the symptoms of sporadic Burkitt lymphoma?

Abdominal masses in the ileo-cecal region

27

What are the symptoms of Immunodeficient Burkitt lymphoma?

Nodal localization and involvement of BM is frequent

28

"Starry sky pattern" on histology = ?

Burkitt's lymphoma

29

What are the histological findings of Burkitt's lymphoma?

Diffuse **monomorphic** infiltrate of intermediate sized round to slightly irregular lymphoid cells with multiple peripherally place nucleoli

30

What does tigible mean?

Stainable

31

What are the tingible bodies in histological samples of Burkitt's lymphoma?

Macrophages in germinal centers

32

What are the CD markers for Burkitt's lymphoma? What is distinguishes it from follicular lymphoma?

CD10
CD19
CD20

NEGATIVE for bcl-2

33

CD10+CD19+CD20+blc-2 =?

Follicular lymphoma

34

CD10+CD19+CD20 = ?

Burkitt's lymphoma

35

CD19 + CD20 + CD5 + Cyclin D1 = ?

Mantle cell lymphoma

36

What is the prognosis for Burkitt lymphoma?

Responds well to therapy (90% cure with low stage)

37

True or false: aggressive Burkitt lymphoma is a medical emergency

True

38

What is the viral cause of adult T cell leukemia/lymphoma?

HTLV-1 (HUman T-cell Leukemia virus type 1)

39

Where is adult T cell leukemia/lymphoma endemic?

Central africa
Caribbean
Southwestern japan

40

True or false: T cell leukemia/lymphoma is only found in adults

True

41

What is the latency period of HTLV1?

Long

42

What is the common presentation of adult T cell lymphoma? (3 physical findings + 2 lab findings)

Lymphadenopathy
Skin lesions
HSM
Lymphocytosis
Hypercalcemia

43

What are the histological features of adult T cell leukemia/lymphoma?

Immature = smooth, even chromatin

Mature = multilobed nuclei

44

What type of T cell is found in adult T cell lymphoma?

CD4+ cells

45

What is the virus that is found in Adult T cell leukemia?

HTLV-1

46

Flower cells = ?

Adult T cell leukemia

47

What is the prognosis for adult T cell leukemia/lymphoma?

Rapidly progressive, death within 1 year despite chemo

48

What is the new therapy for Adult T cell lymphoma?

anti-CD52 (Alemtuzumab)

49

True or false: adult T cell leukemia/lymphoma with primarily skin involvement is more aggressive

False--more indolent

50

What organ is always involved in mycosis fungoides/Sezary syndrome?

Skin

51

What is the cell type that is involved in mycosis fungoides/Sezary syndrome?

Cd4+ T cells

52

What is the prognosis for mycosis fungoides/Sezary syndrome?

Indolent disease

53

What are the histological characteristics of mycosis fungoides/Sezary syndrome?

Folded nuclear membrane

54

What are the three stages of mycosis fungoides/sezary syndrome?

Premycotic patch
Plaque (with epidermal involvement)
Tumor phase (dermis involvement)

55

What are the very late stages of mycosis fungoides/sezary syndrome?

BM
Lymph nodes

56

Sezary syndrome presents with 2 simultaneous manifestations. What are they?

Leukemia
Generalized exfoliative erythroderma

57

Leukemia+Generalized exfoliative erythroderma = ?

SS

58

What are the two major immature T cell lymphoid neoplasms/lymphomas?

T lymphoblastic leukemia

Anaplastic large T cell lymphoma

59

What are the two clinical manifestations of T lymphoblastic leukemia/lymphoma?

85% as lymphoma with anterior mediastinal lymph nodes

15% as leukemia ( T-ALL)

60

What is the presentation of T cell ALL?

Abrupt onset with depression of normal marrow, fatigue, infx, bleeding etc.

Mediastinal mass

61

What are the CNS ssx of T cell ALL?

HA
vomiting
nerve palsy d/t meningeal spread

62

What are the histological characteristics of T-ALL?

Sheets of blasts in lymph node, soft tissue, or bone marrow

63

What are the cell markers for T-ALL? (4)

CD34
TdT
CD1a
CD3 (cytoplasmic)

64

TdT cell marker = ?

T-ALL

65

CD34 + TdT + CD1a = ?

T-ALL

66

Which has a worse prognosis: B-ALL or T-ALL?

T-ALL

67

What are the three factors that determine the prognosis of T-ALL?

1. Under 2 yo
2. Philadelphia chr
3. WBC >100

68

Who usually gets anaplastic large cell lymphoma?

Young males

69

What are the cell markers for Anaplastic large T cell lymphoma

CD30
ALK-1

70

Is anaplastic large cell lymphoma hodgkin's or non-hodgkin's?

Non

71

What sites are involved in anaplastic large cell lymphoma?

LN
Extranodal sites
Mediastinal disease

72

Which age group has ALK-1 positive anaplastic large cell lymphoma? Negative? Which has a good prognosis, and which has a poor prognosis?

Positive = children/young adults, good prognosis

Negative = edler adults, bad prognosis

73

What are the histological characteristics of anaplastic large cell lymphoma?

pleomorphic with characteristic "hallmark" cells

74

What are the four characteristics of hallmark cells in large cell lymphoma?

1. medium size
2. Abundant cytoplasm
3. Kidney shaped nuclei
4. Paranuclear eosinophilic region

75

What is large granular lymphocytic leukemia?

T cell/NK cell type
Associated with RA

76

What are extranodal NK/T cell lymphoma, nasal type?

EBV associated tumor cells invade small vessels causing extensive ischemic necrosis