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Pathology of Lymphoma Flashcards

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1
Q

What are the two major distinction between lymphomas?

A

B cell origin

T cell origin

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2
Q

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

A

Follicular lymphoma
Burkitt lymphoma
Large cell lymphoma

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3
Q

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

A

Naive B cell

Mantle cell lymphoma

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4
Q

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

A

Memory B cell
CLL/SLL
Marginal zone lymphoma

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5
Q

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

A
  • Widespread lymphadenopathy
  • Splenomegaly
  • BM
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6
Q

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

A

Centroblasts and centrocytes

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7
Q

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

A 
Low = mostly centrocyte 
High = greater than 15 centroblasts/hpf
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8
Q

What are the gross histological findings of follicular lymphoma?

A

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

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9
Q

What is the difference between centroblasts and centrocytes?

A

Centrocytes are smaller with more condensed nuclei

Centroblasts have a lot more cytoplasm

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10
Q

What are the four CD markers for follicular lymphoma?

A

CD19
CD20
CD10
Bcl-2

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11
Q

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

A

CD5

CD3

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12
Q

What are the markers for T cells? (3)

A

CD3
CD4
CD8

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13
Q

What is the function of Bcl-2?

A

Anti-apoptotic protein

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14
Q

Who gets mantle cell lymphoma?

A

50-60 year old males

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15
Q

What are the symptoms of mantle cell lymphoma?

A

Generalized lymphadenopathy

HSM

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16
Q

What organs are affected in mantle cell lymphoma?

A

Spleen
Liver
Small bowel

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17
Q

What are the characteristic lab findings with mantle cell lymphoma?

A

Lymphocytosis

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18
Q

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

A

Lymphomatoid polyposis

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19
Q

What are the cell markers for mantle cell lymphoma?

A

CD19
CD20
CD5
Cyclin D1

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20
Q

What are the negative markers for mantle cell lymphoma?

A

CD23

CD3

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21
Q

What is cyclin D1?

A

Anti Apoptotic molecule that is characteristic of mantle cell lymphomas

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22
Q

What is endemic burkitt lymphoma?

A

EBV viral infection in young africans

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23
Q

What is sporadic burkitt lymphoma?

A

Worldwide childhood infection

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24
Q

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

A

False–all types

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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

Hematology (32 decks)

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