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46 Cards in this Set
- Front
- Back
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What is the mode of tumor spread
-In NHL -In HL |
NHL - noncontiguous
HL - contiguous |
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What is the cellular composition
-In NHL -In HL |
NHL - Primarily tumor cells
HL - few tumor cells, primarily reactive cells |
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What is the tumor cell phenotype in NHL? HL?
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NHL = B or T
HL = indeterminate |
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How common is Extranodal involvement in NHL? HL?
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NHL = common
HL = uncommon |
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How does prognosis differ for NHL vs HL?
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NHL = variable
HL = usually curable |
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What are the 2 main classes of Hodgkins lymphoma?
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1. Classical HL
2. Lymphocyte predominant HL |
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What are the 2 most common Hodgkin lymphomas that people most often get?
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-Classical HL with nodular sclerosis
-Classical HL with mixed cellularity |
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What are the 4 main general features of Classical HL?
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-Lymph node based disease
-Contiguous spread -Bimodal age distribution -HIghly curable with modern chemotherapeutic regimens |
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Where does classical HL RARELY spread?
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-To waldeyer's ring (tonsils)
-To extranodal sites -To mesenteric nodes |
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What are the most abundant cells in classical HL?
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Non-neoplastic reactive elements
-Lymphs (T) -histiocytes -eos -plasma cells |
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Why are there abundant reactive cells in classical HL?
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Because though relatively few, the neoplastic cells that are present secrete cytokines which recruit the reactive cells.
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What are the CLASSIC cells seen in Hodgkin lymphoma?
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Reed-sternberg cells
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What are 3 types of Reed-sternberg cells?
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-Classic (bi/multinucleated)
-Mononuclear variants -Lacunar cells |
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How does the cytoplasm of Reed sternberg cells appear?
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Glassy, eosinophilic, and with inclusion-like nucleoli.
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What is the hallmark immunophenotypic feature of the cells in Hodgkins lymphoma?
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They are NULL - lack both B and Tcell markers, and also lack the leukocyte common Ag CD45
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What immunophenotypic markers can be found on HL cells?
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-CD30
-CD15 |
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So what type of cells ARE the cells of origin in Classical Hodgkin lymphoma?
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Post-germinal center Bcells
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What are the 2 major things wrong with the post-germinal center Bcells in classical HL?
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1. Lack normal Bcell functionality
2. Apoptosis mechanisms are defective |
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What is BY FAR THE MOST IMPORTANT prognostic factor in Classical HL?
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Ann Arbor Stage!
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So ann arbor staging is used for:
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Both NHL and HL
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What is a prognostic factor in Nodular Sclerosis HL?
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Bulky mediastinal mass
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In what RACE is Classical HL worse?
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Blacks
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What cell type in NS HL is a poor prognostic factor?
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Eosinophilia
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What proportion of classical HL is made up by Nodular Sclerosis HL?
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2/3
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What gender may NS HL be more predominant in? What age?
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Females
-Younger patients ~28 yrs old |
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Where are the lymph nodes that tend to be involved in NS HL?
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-Cervical
-Supraclavicular -Mediastinal |
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At what Ann Arbor stage are the majority of patients with NS HL?
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Low - 1 or 2
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In Nodular sclerosis HL:
-What % have B symptoms -What % have BM involvement What % are EBV+ |
40% - B sx
<5% - BM involvement 20-30% EBV+ |
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Why is it called Nodular sclerosis HL?
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Because there are cellular nodules delineated by fibrous bands
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What is the cellular composition of the nodules in NS HL? (3 types)
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Heterogenous
-Lacunar cells -Few classic RS cells -Reactive cell background |
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In what age/sex of patients is Mixed Cellularity HL predominant?
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-Older
-Males |
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How does the disease stage of Mixed cellularity HL compare to Nodular Sclerosis HL?
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Higher stage
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What is common in MC HL? What is uncommon?
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Common = B symptoms
Uncommon = Mediastinal mass |
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In which type of classical HL is there more BM involvement and EBV+?
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Mixed cellularity HL
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In which type of classical HL is there fibrous bands and nodules?
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Only in NS HL
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In which type of classical HL are Lacunar cells prominent?
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NS HL
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What is the non classical HL?
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Lymphocyte-Predominant HL
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What % of hodgkins lymphomas of Lymphocyte-predominant?
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Only 5%
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What is the predominant sex and age of patients with LP HL?
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Male
35 |
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What is the predominant stage of disease in LP HL?
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Low stage
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What is the progression and prognosis of Lymphocyte predominant HL?
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-Indolent progression
-Excellent prognosis |
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What is the hallmark morphology of LP HL?
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Nodular proliferation without sclerosis
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What do the nodules in LP HL consist of? (4 cell types)
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-Small lymphocytes
-Histiocytes -Dendritic cells -Neoplastic cells |
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What cell types are LACKING in nodular lymphocyte-predominant HL, in contrast to classical HL?
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-No eosinophils
-No plasma cells |
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What type are the reactive cells in Classical HL? In NLPHL?
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Classical = reactive Tcells
NLPHL = reactive Bcells |
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What are the 3 types of possible neoplastic cells in NLPHL?
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-Lymphocytes
-Histiocytes -Popcorn cells |
