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32 Cards in this Set
- Front
- Back
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low grade lymphomas natural history, cure rate
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many years, incurable
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High grade lymphoma natural history, cure rate
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quick, curable (>80%)
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Paracortex indicates what?
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reactive lymph node (often partnering with T cells)
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3 roles within the follicular zones
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Ig class switching
somatic hypermutation affinity maturation |
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What can lead to errors in follicular zones?
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double strand cuts during Ig rearrangement
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Why are lymphoma classifications so difficult?
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similar presentation
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Clinical implications of lymphoma bio
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all clonal diseases
risk factors -inc lymphocyte processing (age) -Immune dysregulation (lupus) -viruses |
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Where can lymphoma occur?
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any where there are lymphocytes
(lymph nodes, bone marrow, spleen, mucosa (MALT), solid organs (less common) |
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Highest lymphoma risk for HIV
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Hodgkin's disease
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Key to Burkitt's lymphoma
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grows fast
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What is the chromosome with Burkitt's lymphoma?
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myc (8:14), (2,8), (8,22)
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What does myc do?
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transcription factor, drives proliferation and directly transactivates LDH
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Association of Burkitt's with disease
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plasmodium falciparum
HIV |
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Lymphoblastic lymphomas are what kind of diseases?
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T cell disease
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Grade of diffuse large cell lymphoma
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medium
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3 disease presentations of diffuse large B-cell
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activated, germinal B cell type, mediastinal B cell type
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Which is a better prognosis, germinal or activated B-cell?
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germinal B cell type
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Gene for diffuse large B-cell lymphoma
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BCL-6 (turns genes off) not consistent cytogenetic change
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Describe presentation of small cleaved cell lymphoma
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asymptomatic lymph node
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Gene with follicular (small cleaved cell) lymphoma
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Bcl2 (left on, prevents cell death), translocation (14:18)
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SLL expresses what?
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CD5, acts like low grade lymphoma
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4 areas of Hodgkin's lymphoma
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lymphocyte predominance (older)
mixed cellularity lymphocyte depleted nodular sclerosis |
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Hodkin's disease spread, compare to non-Hodgkins
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tends to spread to adjacent nodes, non-Hodgkin's produces skip lesions
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How often does HD have a residual mass?
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2/3
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When to suspect lymphoma
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symptoms due to lymph node growth (low grade)
systemic symptoms (anemia, fatigue) |
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Lymph node sizes
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<1cm ok
1-2cm maybe >2cm not good |
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3 B symptoms?
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Fevers >38 degrees
drenching night sweats weight loss (>10% over 6 mo) |
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Stage III grading
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lymphoma above and below diaphragm
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Stage IV grading
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liver/bone marrow involving
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Staging information needed?
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bone marrow biopsy
history |
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components of determining prognosis
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> normal LDH
age >60 stage III or IV >1 extranodal site performance status >2 |
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Thing to consider tx
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end goal (SLL/CCL get palliation)
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