WBC Part 4

Question 1

what is the most common non-hodgkin lymphoma

Answer 1

diffuse large B-cell lymphoma (DLBCL)

Question 2

diffuse large B-cell lymphoma is what kind of lymphoma (high or low grade)

Answer 2

high grade

aggressive if not treated

Question 3

what clinical features can one see with diffuse B-Cell lymphoma

Answer 3

rapidly enlarging, symtmoatic mass at nodal or extra nodal sites
B-symptoms
late adulthood

Question 4

what would one expect to see on a blood smear of a patient with diffuse large B-cell lymphoma

Answer 4

convoluted nuclear contours, 1-3 nucleoli, mitotically active

Question 5

how does diffuse b cell lymphoma arise

Answer 5

sporadically or from transformation of a low-grade lymphoma (like follicular lymphoma)

Question 6

what is the grade of burkitts lymphoma

Answer 6

high grade (the highest non-hodgkin lymphoma)

Question 7

what are the subtypes of Burkitt’s lymphoma

Answer 7

Endemic EBV associated (malaria belt of Africa)
Sporadic (mainly children in US)
immunodeficiency associated

Question 8

what is the main way children in the US get Burkitt’s lymphoma

Answer 8

sporadic

Question 9

Burkitt’s Lymphoma is associated with what translocation and oncogene

Answer 9

t(8;14) - cMYC
also t(2;8) or t(8;22)

Question 10

the sporadic form of Burkitt’s lymphoma is associated with what clinically

Answer 10

abdominal mass in ileocecum or pelvis

Question 11

the endemic (African) form of Burkitt’s lymphoma is associated with what clinically

Answer 11

mass on the jaw (mandible) or orbit

Question 12

a “starry sky” on a blood smear is significant in what cancer and what is actually being shown

Answer 12

Burkitts lymphoma

it is tingible macrophages eating dead cells interspersed b/w sheets of lymphocytes

Question 13

what is tumor lysis syndrome

Answer 13

rapid cellular proliferation and turnover
tumor cell death releases calcium, uric acid, and potassiums
medical emergency

Question 14

what morphologic things would one see in Burkitt’s lymphoma

Answer 14

diffuse infiltrate of medium sized cells with round nuclear contours
basophilic cytoplasm with cytoplasmic vacuoles
high mitotic activity
“starry sky”

Question 15

what flow cytometry results would one expect in Burkitt’s lymphoma

Answer 15

CD19, CD20, CD10

BCL6

Question 16

how does one determine monoclonality of a mature T-cell neoplasm

Answer 16

aberrant T cell immunophenotype (flow cytometry)

PCR to identify monoclonal rearrangements of TCR locus

Question 17

define Peripheral T-cell lymphoma not otherwise specified (PTCL NOS)

Answer 17

heterogeneous group of T cell lymphomas that do not meet criteria for a different entity

Question 18

the T cell counterpart of diffuse large B-cell lymphoma

Answer 18

Peripheral T-cell lymphoma not otherwise specified (PTCL NOS)

Question 19

what are the clinical features of Peripheral T-cell lymphoma not otherwise specified (PTCL NOS)

Answer 19

generalized lymphadenopathy
eosinophilia
pruritits, fever, weight loss

Question 20

what is a double hit lymphoma

Answer 20

diffuse large b cell lymphoma with both transactions bcl-2/igH and myc/IgH

Question 21

tumor lysis syndrom is seen in what cancer

Answer 21

burkitt’s lymphoma

Question 22

a proliferation index of nearly 100% is indicative of what

Answer 22

Burkitt’s lymphoma

Question 23

Anaplastic large cell lymphoma (ALCL) is defined by what

Answer 23

ALK gene mutation

Question 24

ALK fusion proteins behave as what

Answer 24

tyrosine kinases

Question 25

what are the hallmark cells seen in a blood smear of anapestic large cell lymphoma (ALCL)

Answer 25

large anaplastic appearing cells with horseshoe or wreath shaped nuclei often sinusoidal pattern

Question 26

what flow cytometry results would one expect in anapestic large cell lymphoma (ALCL)

Answer 26

CD30+ EMA+ ALK+

Question 27

Adult T cell leukemia/ lymphoma (ATCL) is defined by what

Answer 27

CD4+ T cells infected with retrovirus HTLV 1 (human T-cell leukemia virus)

Question 28

what places would one be more likely to find Adult T cell leukemia/ lymphoma (ATCL)

Answer 28

HTLV-1 is endemic in Caribbean basin, Japan, W. Africa

Question 29

what flow cytometry results would one expect in Adult T cell leukemia/ lymphoma (ATCL)

Answer 29

CD4+ | HTLV-1 +

Question 30

what morphological features are associated with Adult T cell leukemia/ lymphoma (ATCL)

Answer 30

flower/cloverleaf cells

Question 31

what do patients with Adult T cell leukemia/ lymphoma (ATCL) present with

Answer 31

``` generalized adenopathy skin lesions HSM peripheral blood lymphocytosis hypercalcemia ```

Question 32

Mycosis Fungoides/Sezary syndrome are defined by what

Answer 32

CD4+ t cells usually MF: skin issues SS: leukemic

Question 33

Mycosis fungoides presents clinically with what

Answer 33

3 stages: patch, plaque, tumor

Question 34

Sezary Syndrome presents clinically with what

Answer 34

generalized exfoliative erythroderma plus leukemia | disease spread to involve nodes and BM

Question 35

Mycosis Fungoides/Sezary syndrome have what neoplastic cell features

Answer 35

cerebriform nuclear contours

Question 36

what is a sezary cell

Answer 36

Mycosis Fungoides/Sezary syndrome neoplastic cell in blood

Question 37

Large granular lymphocytic leukemia (LGLL) has what two different types

Answer 37

T-cell type = indolent | NK cell type = aggressive

Question 38

Fetty syndrome (Rh arthritis, splenomegaly, and neutropenia) may have what as the underlying cause

Answer 38

Large granular lymphocytic leukemia (LGLL)

Question 39

Extranodal NK/T-cell Lymphoma is defined by what clinically

Answer 39

"lethal midline granuloma" | most commonly presents as a destructive midline mass

Question 40

What occurs in Extranodal NK/T-cell Lymphoma

Answer 40

small and large or predominately large neoplastic cells invade vessels leading to expensive necrosis