Presentations - Ch. 13 Flashcards Preview

Heme/Lymph 2 > Presentations - Ch. 13 > Flashcards

Flashcards in Presentations - Ch. 13 Deck (47):
1

Enlarged, painful lymph nodes that may be fluctuant, overlying skin is red

Acute nonspecific lymphadenitits - bacterial infection

2

Enlarged, nontender inguinal and/or axillary lymph nodes that grow slowly over time, organized collections of immune cells in nonlymphoid organs (tertiary lymphoid organs)

Chronic nonspecific lymphadenitits - chronic H. pylori gastritis or RA B-cell follicles in synovium

3

Child, abrupt onset, fatigue, fever, bleeding, bone pain, lymphadenopathy, organomegaly, meningitis symptoms (stiff neck, vomiting, etc.)

Explain symptoms

B-ALL (leukemia)

Fatigue = anemia
Fever = neutropenic infections
Bleeding = thrombocytopenia
Bone pain = marrow expansion
Organomegaly and neuro symptoms = neoplastic infiltration

4

Adolescent male, thymic mass, superior vena cava syndrome, Horner's syndrome

T-ALL (lymphoma)

5

Adolescent/young adult, masses in the mandible and abdominal viscera

Endemic (EBV-associated) Burkitt lymphoma

6

Older adult, rapidly growing masses within LN, liver, spleen, Waldeyer ring (throat) and/or extranodal sites (GI, skin, bone, brain)

DLBCL

7

Adult, chronic inflammatory disease, extranodal mass, indolent

Extranodal marginal zone lymphoma

8

Middle age, generalized painless lymphadenopathy, marrow involvement, indolent, expanded white pulp follicles in spleen

Follicular lymphoma

9

Middle aged white male, pancytopenia, massive splenomegaly, atypical Mycobacterium infections

Hairy cell leukemia

10

Older male, disseminated disease, moderately aggressive

Mantle cell lymphoma

11

Older adult, lytic bone lesions, pathologic fractures, hypercalcemia, renal failure, neurologic manifestations, recurrent bacterial infections

Multiple myeloma

12

Isolated plasma cell mass in bone, extraosseous lesions in lungs, oronasopharynx, or nasal sinuses

Solitary plasmacytoma

13

Older adult, asymptomatic at diagnosis, then nonspecific symptoms (easily fatigued, weight loss), generalized lymphadenopathy, hepatosplenomegaly, periportal lymphocytic infiltrate in liver

CLL/SLL

14

Adult, rapidly progressive, skin lesions, generalized lymphadenopathy, hepatosplenomegaly, lymphocytosis, hypercalcemia

What else can accompany this?

Adult T cell leukemia/lymphoma - Endemic to Japan, West Africa, Caribbean

Progressive demyelinating disease

15

Older adult, generalized lymphadenopathy, eosinophilia, pruritis, fever, weight loss

Peripheral T-cell lymphoma, unspecified

16

Children/young adult, LN and soft tissue disease

Anaplastic large-cell lymphoma

17

Adult, destructive extranodal mass (esp. sinonasal, testis, or skin), ischemic necrosis, EBV

Extranodal NK/T-cell lymphoma

18

Adult, changing cutaneous patches, plaques, nodules, or generalized redness

Mycosis fungoides/Sezary syndrome

19

Adult, lymphocytosis, splenomegaly, neutropenia and anemia, maybe autoimmune (rheumatologic) disease

Large granular lymphocytic leukemia

20

Small monoclonal Ig spike

CLL/SLL

21

Hypogammaglobulinemia, multiple bacterial infections

CLL/SLL

22

10% to 15% of CLL/SLL patients may develop ___ or ___ due to autoantibodies

Hemolytic anemia or thrombocytopenia

23

HIV+, EBV+ neoplastic B cells, rapidly growing mass(es)

Immunodeficiency-associated large B-cell lymphoma (DLBCL subtype)

24

HIV+, KSHV/HHV-8, malignant pleural or ascitic effusion, cells w/ clonal IgH rearrangements, no B or T cell surface markers

Primary effusion lymphoma (DLBCL subtype)

25

Children/young male, mass in ileocecum or peritoneum

Sporadic (American) Burkitt Lymphoma

26

Older adult, asymptomatic, moderately large monoclonal Ig population in the blood (but less than 3 gm/dL)

Monoclonal gammopathy of undetermined significance (MGUS)

27

Asymptomatic, monoclonal Ig population in blood greater than 3 gm/dL, plasma cells are 10% to 30% of marrow cellularity

Smoldering myeloma (between MGUS and MM)

28

50s or 60s, many plasma cells in bone marrow, monoclonal IgM in blood, hyperviscosity

Lymphoplasmacytic lymphoma

29

Nonspecific symptoms, lymphadenopathy, hepatosplenomegaly, anemia, maybe autoimmune hemolysis via cold agglutinins

Lymphoplasmacytic lymphoma

30

Visual impairment, neurologic problems, bleeding, symptoms in cold temperatures

Hyperviscosity syndrome - due to excess IgM secretion

31

Salivary gland disease or thyroid gland disease or chronic gastritis

Marginal zone lymphoma - MALToma type

32

Rheumatoid arthritis, splenomegaly, neutropenia

Felty syndrome - due to Large granular lymphocytic leukemia

33

Young adult male or older male, painless lymphadenopathy, cutaneous anergy, systemic symptoms, advanced tumor stage

Mixed-Cellularity HL

34

Young adult, mediastinal mass, early tumor stage, lacunar cells

Nodular sclerosis HL

35

Older adult or HIV+ or poor country, systemic symptoms, late tumor stage, poor prognosis

Lymphocyte depletion HL

36

Young male, cervical or axillary lymphadenopathy, excellent prognosis

Lymphocyte predominance HL

37

Older adult, anemia, thrombocytopenia, neutropenia, much hemorrhaging, fever, fatigue, recurrent opportunistic infections (Pseudomonas, fungi, commensals)

AML

38

Older adult, maybe asymptomatic, maybe weakness, infections, hemorrhages

MDS

39

Middle age, slow onset, anemia and thrombocytopenia symptoms, dragging sensation in abdomen or LUQ pain, later myeloid blasts in the blood and marrow

CML

40

Late middle age adult, slow onset, plethora, cyanosis, headache, dizziness, HTN, GI symptoms, intense pruritis, peptic ulceration, hyperuricemia

Major risk for what?

Polycythemia vera

DVT, stroke, MI, bowel infarction, or minor hemorrhages

41

Older adult, elevated platelet count, thrombosis (DVT, venous thromboses, MI), hemorrhage

Essential thrombocytopenia

42

Throbbing and burning of hands and feet

Erythromelalgia - due to small arteriole occlusion in PCV or ET

43

Older adult, progressive anemia and splenomegaly, fullness in LUQ, nonspecific symptoms

Primary myelofibrosis - ealry

44

Under 2 yo, cutaneous lesions over front and back of trunk and scalp, hepatosplenomegaly, lymphadenopathy, pulmonary lesions, bone lesions

Multifocal multisystem Langerhans cell histiocytosis (L-S disease)

45

Child or older adult, eosinophilic infiltration of skull, ribs, or femur that may extend into soft tissue, diabetes insipidus

Histiocytosis X (Eosinophilic granuloma Langerhans cell histiocytosis)

46

Skull bone defects, diabetes insipidus, eyeball protrusion

Hand-Schuller-Christian triad -- Eosinophilic granuloma

47

Adult, smoker, pulmonary lesion of macrophages

Pulmonary Langerhans cell histiocytosis