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Flashcards in White Blood Cell Disorders 2 Deck (33)
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1
Q

follicular lymphomas arise from ______

A

germinal center B cells

2
Q

what is the characteristic immunophenoytpe for follicular lymphoma

A

CD19, CD20, CD10+

3
Q

what is the characteristic translocation of follicular lymphoma

A

t(14,18)

14: Ig heavy chain
18: Bcl2 (anti-apoptotic)

4
Q

what other organs can be affected in follicular lymphoma?

A

spleen will show prominent nodules that represent white pulp follicles that are expanded by follicular lymphoma cells (similar pattern seen with SLL, mantle cell and marginal zone lymphoma)

5
Q

________ is used to stain for follicular lymphoma

A

BCL2 stain:

in reactive follicles, the BCL2 is present in mantle zone cells but NOT in follicular center B cells
in follicular lymphoma, there is strong BCL2 staining in germinal center

6
Q

follicular lymphoma can transform into a more aggressive lymphoma, most commonly _____

A

DLBL

7
Q

_________ lymphoma can present as an extra nodal mass (GI, skin, etc) but also can present in LN’s as a single enlarging mass

A

DLBL (diffuse large B cell lymphoma)

8
Q

flow cytometry shows: CD19, CD20, CD10+; what is your diagnosis

A

follicular lymphoma

9
Q

at diagnosis of DLBL, what stage do you usually find it at? With or without BM involvement

A

Stage I/II with negative BM

compare to follicular lymphoma: Stage IV w/ positive BM

10
Q

describe the manifestation of DLBL on the spleen

A

a single large mass; other B cell lymphomas usually produces small nodules all over the spleen as expansion of the white pulp

11
Q

______ is the most common adult leukemia

A

CLL (chronic lymphocytic leukemia)

12
Q

“smudge” cells and small mature looking lymphocytes on peripheral blood smear is seen in what B cell neoplasm

A

CLL

13
Q

what immune phenotype by flow cytometry of someone with SLL/CLL

A
  • CD19, CD20, CD5, CD23, CD43 +
14
Q

what are the most common causes of death in someone with SLL/CLL

A
  • infections/bleeding due to progressive pancytopenia

- tranformation to a more aggressive neoplasm with larger cells

15
Q

what are some normal mucosa associated lymphoid tissue?

A
  • adenoids and tonsils
  • Peyer’s patches

these are places you would NOT see MALTomas

16
Q

other than the stomach, what are other common sites of marginal zone lymphoma

A
  • salivary and thyroid gland on top of autoimmune inflammation
17
Q

__________ lymphoma remains localized for long periods of time and often recurs or spreads to other mucosal sites

A

marginal zone lymphoma

18
Q

EBV infection is associated with which lymphoma?

A

Burkitt Lymphoma (African)

19
Q

“starry sky” pattern is seen in ______ and is explained by:

A

Burkitt lymphoma; diffuse infiltrate of medium sized cells with high mitotic rate and apoptosis → many macrophages to clean up dead cells

20
Q

what is the characteristic immunohistochemistry pattern of Burkitt lymphoma

A
  • CD19, CD20, CD10, surface Ig

similar to follicular lymphoma

21
Q

describe the translocation (gene and chromosome) of Burkitt lymphoma

A

t(8,14) > t (2,8) > t (8,22)

c-myc oncogene on chromosome 8 is translocated to either Ig heavy or light chain loci

22
Q

Bukitt lymphomas presents as extra nodal mass at what preferred sites?

A
  • mandible

- abdominal viscera: kidneys, ovaries, adrenal glands

23
Q

who as better prognosis of treating burkitt lymphoma with high dose chemotherapy: kids or adults

A

kids

24
Q

translocation of what gene is seen in Burkitt lymphoma

A

c- myc oncogene

25
Q

middle aged males that present with pancytopenia and splenomegaly is a common presentation of B cell neoplasm?

A

Hairy cell leukemia

26
Q

describe the spleen’s appearance in someone with hairy cell leukemia

A
  • beefy red appearance due to red pulp infiltration
27
Q

what is the characteristic immunophenotype of hairy cell leukemia

A
  • CD20, CD11c, CD25, CD103+
28
Q

TRAP stain is used to visualize what neoplasm?

A

hairy cell leukemia

29
Q

What are plasma cell neoplasms?

A

these are B cell neoplasms with some plasma cell differentiation that secrete monoclonal immunoglobulins

30
Q

what are the findings in the blood and urine in plasma cell neoplasms

A

blood: M component (monoclonal Ig)
urine: Bence Jones proteins (monoclonal light chains of kappa or lambda)

31
Q

what are the bone marrow findings in hairy cell leukemia?

A

fried egg appearance; dry tap (also seen in aplastic anemia)

32
Q

which monoclonal immunoglobulin is secreted by multiple myeloma which is a plasma cell neoplasm

A

IgG

33
Q

presentation of follicular lymphoma

A

waxing and waning of painless lymphadenopathy