B&l: 12. Fischler : Non-Hodgkins Lymphoma

Front 1

In a lymph node, where are T and B cells located respectively

Back 1

Parafollicular cortex: T cells

Follicular: B cell

Front 2

nodes: tender, enlarged (cellular infiltration)
prominence of large reactive germinal centers

this describes what?

Back 2

Acute Nonspecific Lymphadenitis

Front 3

this is a chronic nonspecific lymphadenitis, and is due to activation of humoral immune responses.

It can be seen in RA, toxoplasmosis, and early HIV

Back 3

Follicular hyperplasia

remember humoral = B cells

Front 4

this is a chronic nonspecific lymphadenitis, and is due to stimulation to the T-cell-mediated immune response

Examples include: infectious mononucleosis, acute viral infections

Back 4

Paracortical lymphoid hyperplasia

Front 5

this is a chronic nonspecific lymphadenitis, and is due to an increase in the number and size of cells that line the lymphatic sinusoids (nonspecific)

this is seen in: lymph node draining cancers

Back 5

Sinus histiocytosis (reticular hyperplasia)

Front 6

What is the difference between leukemia and lymphoma?

**

Back 6

Leukemia: widespread in the blood, bone marrow is involved

Lymphoma: more discrete masses, palpable

Front 7

what is a common cause of white cell neoplasia?

**

Back 7

Chromosomal translocations

Front 8

Leukocyte common antigen, is common on all leukocytes and is known as CD___

Back 8

45

Front 9

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD1

Back 9

T Cell

Front 10

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD3

Back 10

T Cell

Front 11

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD5

Back 11

T Cell

Front 12

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD4

Back 12

T Cell

Front 13

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD8

Back 13

T Cell

Front 14

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD10(CALLA)

Back 14

B Cell

Front 15

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD19

Back 15

B Cell

Front 16

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD 20

Back 16

B Cell

Front 17

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD21

Back 17

B Cell

Front 18

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD23

Back 18

B Cell

Front 19

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD79a

Back 19

B Cell

Front 20

Please list what kind of cell the following is associated with (T/B/Primary Stem Cell)

CD34

Back 20

Primarily Stem Cell and Progenitor Cell Associated

Front 21

85 to 90% of lymphoid neoplasms are of

Back 21

B-Cell origin

Front 22

What is the most common malignancy of children and adolescents? what do the neoplasms consist of?


***TEST

Back 22

Acute Lymphoblastic Leukemia / Lymphoma (ALL)

are neoplasms consisting of immature B (pre-B) or T (pre-T) lymphoblasts. (note: most are pre-B)

Front 23

A while 3 year old male is brought to your office for a suspected neoplasm. You know that neoplasms of this age group are more likely due to ____ whereas in adolescence, it is due to _____

**

Back 23

3 years: B-ALL

Adolescence: T-ALL
-also more likely to see masses in thymus mediastinum

Front 24

in Lymphoblastic leukemia >95% of cases are positive for what?

****TEST

Back 24

TdT (terminal deoxynucleotidyl-transferase)

specialized DNA polymerase, expressed only by pre-B and pre-T lymphoblasts that are seen in ALL (remember this was most common in kids)

Front 25

Positive TdT should make you think

**TEST

Back 25

ALL

specialized DNA polymerase, expressed only by pre-B and pre-T lymphoblasts that are seen in ALL

Front 26

pt comes in with acute onset of Fatigue, fever, bleeding
Anemia, absence of mature leukocytes, thrombocytopenia
Bone pain
Generalized lymphadenopathy, hepatomegaly, splenomegaly
Headache, vomiting, nerve palsies

what should you be thinking?

Back 26

Acute Lymphoblastic leukemia (ALL)

Front 27

This involvement can be seen in males who have ALL

*

Back 27

testicular

Front 28

What is the prognosis for children with ALL?

What factors are associated with a worse prognosis? 4**** TEST

Back 28

Normally: 95% have complete remission with aggressive chemo

Factors that worsen prognosis:
1. < 2 years of age, association of infantile ALL with translocations of the MLL gene.
2. Presentation in adulthood or adolescence.
3. Peripheral blood blast counts greater than 100,000
4. The presence of particular cytogenetic aberrations, such as the Philadelphia chromosome t(9;22).

Front 29

What is the most common leukemia of adults in the western world?

***TEST

Back 29

Chronic Lymphocytic Leukemia (CLL)

Front 30

What is the difference btw Chronic Lymphocytic Leukemia (CLL) / Small Lymphocytic Lymphoma (SLL)

Back 30

Differ only in the degree of peripheral blood lymphocytosis
In CLL the absolute lymphocyte count is > 4000/mm3

Front 31

Lymph node: architecture is diffusely effaced by small lymphocytes; round to sl. irregular nuclei, condensed chromatin, scant cytoplasm.
Proliferation centers (loose aggregates of larger activated lymphocytes)

this is the morphology of?

Back 31

CLL/SLL