Week 4 Friday

Question 1

Mantle cell lymphoma

Answer 1

t(11,14) translocation (heavy chain)

Low grade NHL

Question 2

Follicular lymphoma

Answer 2

t(14,18)
back to back follicles
Grade 1-3 (3 bad)
Low grade NHL
Can spread to other tissues as white dots (which are follicules)
hang out next to trabecular

Question 3

Follicular lymphoma blood smear:

Answer 3

Little cells with slit
“Butt cells”
Low grade NHL

Question 4

Marginal zone lymphoma

Answer 4

low grade NHL
Malt lymphoma
Associated with w helicobacter pylori

Question 5

mycosis fungoides / sezary syndrome

Answer 5

low grade NHL
skin lesions
blood involvement
*cerebriform lymphocytes (look like brains)
*t-cell immunophenotype

Question 6

sezary syndrome

Answer 6

end resuld of mycosis fungoides low grade NHL

Question 7

pautrier microabscess

Answer 7

found in mycosis fungoides. in the skin.

Question 8

Benign lymph node enlargement

Answer 8

most common
caused by infection
soft when palpating
can be painful

Question 9

Malignant lymphadenopathy

Answer 9

most common cause is metastatic carcinoma
Hard when palpating
Painless

Question 10

diffuse large cell lymphoma

Answer 10

large B cells
extranodal involvement, large cells that grows fast
bad prognosis
High grade NHL

Question 11

lymphoblastic lymphoma

Answer 11

type types: t and b
lymphoblasts diffuse pattern
Same as ALL
often seen in teenage MALE with mediastinal mass
High grade NHL

Question 12

Burkitt lymphoma

Answer 12

Children, extranodal mass
STARRY SKY PATTERN
african type (jaw) and non african type (abdomen)
t(8;14) (same as burkitt leukemia)

Question 13

Starry sky pattern

Answer 13

Found in burkitt lymphoma

white dots are tingle body macrophages

Question 14

Adult t-cell leukemia/lymphoma

Answer 14

japan/caribbean basin
HTLV-1 (virus)
skin lesions, hypercalcemia
very aggressive

Question 15

tingle body macrophage

Answer 15

non malignant macrophage just eating up all debris from high turnover. See them in germinal centers or any tumor that grows fast

Question 16

T cell lymphomas?

Answer 16

Adults t-cell leukemia and mycosis fungoides

Question 17

Burkitt leukemia microscope:

Answer 17

starry sky patterns. Cells have clear dots (vacoules)

Question 18

Hodgkins vs NHL

Answer 18

Hodgkins is contigous spread
NHL is very sporadic and most are B cells
Hodgkins nodules are larger on liver and spleen

Question 19

Hodgkins lymphoma must know:

Answer 19

younger patients, good prognosis
Even spread
Five subtypes
Reed-sternberg cell

Question 20

Reed sternberg cell

Answer 20

Very large cell with 2/nuclei that are as big as lymphocytes “owl eyes”
Hodgkins lymphoma!
Malignant part of the disease. Release cytokines to recruit cells, but recruited cells are not malignant

Question 21

Hodgkins lymphoma subtypes

Answer 21

Nodular lymphocyte predominance

Classical:
nodular sclerosis
lymphocyte rich
mixed cellularity
lymphocyte depletion

Question 22

Nodular lp hodgkin lymphoma

Answer 22

good prognosis
usually asymptomitc and young male with cervical lymphadenopathy

Bcell origin with POPCORN cells

Question 23

nodular sclerosis hodgkin lymphoma

*

Answer 23

good prognosis
most common of classicaly subtype
LACUNAR cell
Fibrotic bands that seperate nodules

Question 24

mixed cellularity hodgkin lymphoma

Answer 24

Bad prognosis

Classic reed-sternberg cells with mixed background of cells

Question 25

lymphocyte rich HL

Answer 25

uncommon | popcorn cells

Question 26

Treatment for HL

Answer 26

Surgery, chemo, radiation Prognosis depends on STAGE Danger: second malignancies

Question 27

Small lymphocytic lymphoma

Answer 27

``` Low grade NHL small mature lymphocytes Same as CLL Bcell lesions w/CD5 Long course Richter transformation ```

Question 28

Richter Transformation

Answer 28

Sound in SLL/CLL

Question 29

Low grade NHL

Answer 29

older patients incurable small mature cells non-destructive

Question 30

High grade NHL

Answer 30

children aggressive big ugle cells destructive

Question 31

Symptoms of NHL

Answer 31

Painless firm lymphadenopathy Extranodal manifestations B symptoms make it worse: weight loss, night sweats, fever

Question 32

Follicular hyperplasia

Answer 32

large, irregular follices mixture of cells in germ centers tingible body macrophages B-cell response to some immune stimulus

Question 33

Interfollicular hyperplasia

Answer 33

Expanded between follicles mixture of cells Partial effacement T-cell response to some immune stimullus!!

Question 34

Chronic lymphoproliferative disorders musk know:

Answer 34

Many disorders: CLL most important ONLY in adults Long course

Question 35

CLL must know

Answer 35

small, mature lympocytes B-cell, with CD5+ (normally on only tcell) TdT Negative Long course HYPOGAMMAGLOBULINEMIA

Question 36

Pathophysiology of CLL

Answer 36

bcl-2 gene rearrangement bcl-2 prevents apoptosis Gets stuck next to gene that turns it on at all times Treat conservative. death usually from infection

Question 37

Hairy cell leukemia CLD

Answer 37

Hairy cells Splenomegaly WITHOUT LYMPHADENOPATHY pancytopenia TRAP+ STAIN

Question 38

Hairy cell leukemia bone marrow aspiration

Answer 38

HARD to pull out bone marrow. Bone marrow stuck together with fibrosis

Question 39

Hairy cell leukemia chem and immunophenotype. Labs?

Answer 39

TRAP + Positive for B-cell antigen, CD25 AND CD11C Negative for CD5 Always MONOCYTOPENIA

Question 40

Prolymphocytic leukemia CDL

Answer 40

splenomegaly WITHOUT LYMPADENOPATHY rare and aggressive Nucleoli show through on blood smear

Question 41

Large granulated lymphocyte leukemia must know:

Answer 41

Large granulated lymphocytes T CELL Neutropenia with long survival