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77 Cards in this Set
- Front
- Back
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Gene expression driving CLL
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Abnormal CD5 expression on CD20+ B-cells
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Gene mutation driving CML
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bcr-abl fusion gene (anti-apoptotic + Tyr-kinase)
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What mutation causes bcr-abl fusion protein?
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t(9;22) Philadelphia chromosome
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What % of marrow cells must be blasts to classify ACUTE diseas?
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20%
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Age of majority of AML cases
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elderly; 80% of adult leukemias are AML
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Where are Auer rods found?
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in cytoplasm of blast cells of AML
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Gene mutation causing APL
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t(15;17) --> RAR-alpha + PML fusion gene
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Treatment for APL
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ATRA and chemo, arsenic trioxide
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Age of majority of ALL cases
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children, usually <6yo
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Gene mutations driving ALL
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- bcr-abl fusion protein
- 11q23 MLL gene |
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site of NEGATIVE central selection of T-cells
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thymus medulla
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site of POSITIVE central selection of T-cells
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thymus cortex
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location in lymph node for formation of germinal centres
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cortex
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location in lymph node for antigen stimulation
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paracortex
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antibodies in PRIMARY immune response
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IgM
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antibodies in SECONDARY immune response
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IgA
IgG |
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role of T-cells in primary immune response
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none; T-cell independent
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role of T-cells in secondary immune response
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activation of B-cells, Ig class switching
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what is in the white pulp of the spleen? |
lymphoid nodules |
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what is in the red pulp of the spleen?
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sinusoids filled with blood
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locations of MALT
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- Waldeyer ring: naso/oropharynx, tonsils, adenoids
- Peyer's patches: ileum, appendix in GI tract |
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CD45+ cells
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leukocytes; non-specific marker
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CD20+ cells
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mature B-cells; highly specific
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CD19+ cells
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B-cells; highly specific
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bcl6 marker
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B-cells in germinal centre
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CD10+ cells
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lymphoblastic B-cells in germinal centre
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CD2+ cells
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T-cells; highly specific
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CD3+ cells
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T-cells; highly specific
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CD4+ cells
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helper T-cells (Th1, Th2, Th17, etc)
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CD8+ cells
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cytotoxic T-cells
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CD5+ cells
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mostly T-cells
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bcl2 marker
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anti-apoptotic
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CD15+, CD30+
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Hodgkin's lymphoma (cHL)
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CD34+ cells
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stem cells
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CD38+/CD138+
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plasma B-cells (no other B-cell markers!)
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Ki67 marker
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proliferation
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TdT+
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lymphoblastic precursors
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CD23+
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follicular dendritic cells
CLL/SLL marker |
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acute, non-specific reactive lymphadenitis
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bacterial infection causing neutrophilia
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chronic, non-specific reactive lymphadenitis
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follicular hyperplasia (B-cells)
paracortical/diffuse (T-cells) sinus histiocytes |
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causes of follicular hyperplasia
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rheumatoid arthritis
toxoplasmosis early HIV |
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causes of paracortical/diffuse lymphadenitis
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viral
drugs dermatopathic |
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chronic, specific reactive lymphadenitis
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granulomatous disease +/- abscesses
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chronic, granulomatous lymphadenitis NO ABSCESSES
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mycobacteria
fungi sarcoidosis |
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chronic, granulomatous lymphadenitis WITH ABSCESSES
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cat scratch disease (B. henselae bacteria)
tularemia |
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"popcorn cells" with exploded nuclei found in...
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nodular-predominant Hodgkins lymphoma
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Reed-Sternberg "owl eyes" cells found in...
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classic Hodgkins lymphoma
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Majority of B-lymphoblastic NHL manifest as...
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ALL (acute lymphoblastic LEUKEMIA)
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Majority of T-lymphoblastic NHL manifest as... |
LBL (lymphoblastic LYMPHOMA) |
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Clinical signs of LBL
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- mediastinal mass --> effusions
(since T-cell associated, in thymus) |
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clinical signs of ALL
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- bleeding gums, bone pain
(since B-cell associated, and leukemic = blood phase) |
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Histology of LBL/ALL cells (3 Ms!)
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- monomorphic
- monotonous -medium-sized |
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LDH marker
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sign of high cell turnover in leukemia/lymphoma (released when cells die)
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CLL/SLL cell morphology
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SMALL cells (duh), round/irregular shape
some larger prolymphocytes in nodes |
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origin of CLL/SLL
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-naive B-cells (poorer prognosis)
-post-GC B-cells (better prognosis) |
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origin of follicular lymphoma
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germinal centre B-cells
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genetic mutation in follicular lymphoma
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t(14;18) --> bcl2 anti-apoptotic protein + Ig heavy chain fusion protein
(prevents cells with lower affinity Abs from being destroyed) |
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Follicular lymphoma grade 1
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0-5 centroblasts per high-power field
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Follicular lymphoma grade 2
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6-16 centroblasts per high-power field
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follicular lymphoma grade 3a
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>15 centroblasts per high-power field, some normal centrocytes remaining
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follicular lymphoma grade 3b
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>15 centroblasts per high-power field, with no remaining centrocytes
(MORE AGGRESSIVE) |
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DLBCL extranodal involvement sites
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GI tract
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DLBCL morphology
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Diffuse
Large size (3-4x normal) |
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LBL markers
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TdT+ (since precursor cells)
CD3+ (since T-cells) +/- CD4, +/- CD8 expression varying based on stage of development |
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CLL/SLL markers
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KEY: CD23+ (follicular dendritic cells) also: CD5+ (abnormal expression in CLL) CD20+ (since B-cell) |
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DLBCL markers
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elevated LDH (indicates high turnover, since rapidly progressing disease)
elevated Ki67 (proliferation) CD20+ (since B-cell) |
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plasma cell/multiple myeloma pathogenesis |
(osteoclast activation by cytokines --> bone resorption --> lytic lesions & fractures) |
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plasma cell/multiple myeloma markers
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CD138+ (plasma cell marker)
monoclonal lambda/kappa light chain one heavy chain predominates |
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mycosis fungoides pathogenesis
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plaque --> patch --> tumour
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Leukemic "cousin" of Mycosis Fungoides
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Sezary syndrome
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Mycosis fungoides markers
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CD3+
CD4+ CD8- (T helper cell markers) |
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nodular predominant Hodgkins lymphoma markers
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CD20+
CD45+ bcl6 |
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classical Hodgkins lymphoma markers
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CD15+
CD30+ |
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NHL treatment (besides kicking the Sens' ass)
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CHOP-R:
-cyclophosphamide -hydroxydaunorubicin (adriamycin) -oncovin (vincristine) -prednisone -rituximab |
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classic Hodgkins lymphoma treatment
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ABVD:
-adriamycin -bleomycin -vinblastine -dacarbazide (or MOPP) |
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anti-CD20 monoclonal antibody therapy
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rituximab
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anti-CD30 monoclonal antibody therapy
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brentuximab
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