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51 Cards in this Set
- Front
- Back
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Which type of lymphoma is associated with HTLV-1?
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Adult T-cell leukemia/lymphoma
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<b>Type of lymphoma</b>
Diffuse infiltrate of cells with multilobated nuclei (cloverleaf/flower cells) Thick nuclear membranes and coarse chromatin Reed-Sternberg like cells Cutaneous infiltrates are dermal or epidermotropic Pautrier’s microabscesses (resembling mycosis fungoides) |
Adult T-cell leukemia/lymphoma
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Immunophenotype of adult T-cell leukemia/lymphoma
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CD2, CD3, CD4, CD5, CD25 POS
Rarely CD30+ but ALK- CD7, CD8 NEG |
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Type of lymphoma:
Interfollicular zones Nodal sinuses Large cells Abundant cytoplasm Horseshoe, wreath-like, MULTIPLE nuclei Perinuclear eosinophilic region Brisk mitotic activity |
Anaplastic large cell lymphoma
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Staining pattern of anaplastic large cell lymphoma:
CD3 CD30 CD45 CD61 CD2 or CD4 CD25 factor VIII |
Positive
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Staining pattern of anaplastic large cell lymphoma:
ALK CD43 EMA |
Variable
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Staining pattern of anaplastic large cell lymphoma:
B cell markers CD13 |
Rare
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Staining pattern of anaplastic large cell lymphoma:
CD15 CD20 CD79a CK bcl2 PAX5 |
Negative
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Locus of ALK
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Chromosome 2
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Describe: Lymphohistiocytic variant of anaplastic large cell lymphoma
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Numerous histiocytes and small lymphocytes
Neoplastic cells tend to cluster around blood vessels Positive stains: CD30, ALK |
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Type of lymphoma:
Peri- and intravascular infiltrates Destruction of surrounding parenchyma Favors sinonasal area and skin |
Angiocentric T-cell lymphoma
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Type of lymphoma:
Effaced lymph nodes Preservation of sinuses (incl subcaps) Prominent arborizing endothelial venules Thickened PAS+ venule walls Venules surrounded by CD21+ FDC Burnt out germinal centers Aggregates of polymorphic large cells Clear/pale cytoplasm |
Angioimmunoblastic T-cell lymphoma
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Type of lymphoma:
Diffuse monotonous infiltrate Of lymphoblast-like cells Skin cases usually involve entire dermis Don’t involve epidermis No coagulative necrosis No angiocentric infiltrate Stains for CD56, CD43, HLA-DR |
NK Blastic Lymphoma
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Rare, aggressive lymphoma:
Assoc with gluten-sensitive enteropathy Typically affects stomach, jejunum, colon Ulcerated mucosa with abundant IELs Stains for CD3, CD7, CD103, TIA-1, perforin, granzyme B Variable CD8 Neg CD 4, 5, 56 |
Enteropathy-type T-cell lymphoma
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DDX of rheumatoid lymphadenopathy?
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Other inflammatory disorders (Sjogren's
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Disorder? Florid follicular hyperplasia Interfollicular plasmacytosis Epithelioid granulomata Thick fibrotic capsule Perivascular plasma cells Possible arteritis and phlebitis
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Syphilis (luetic lymphadenitis)
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Disorder? Florid follicular hyperplasia Marked interfollicular plasmacytosis Plasma cells within follicles Clusters of neutrophils in the sinuses
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Rheumatoid arthritis
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Disorder? Regressively transformed germinal centers Depletion of lymphocytes from paracortex
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Late stage HIV
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List follicular hyperplasias
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Reactive foll. hyperplasia Toxo CMV HIV syphilis Rheumatoid arthritis Progressive transformation of germinal centers Castleman's disease (hyaline vascular type and plasma cell type)
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List necrotizing granulomatous lymphadenitides
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Cat scratch disease Lymphogranuloma venereum Tularemia yersinia Tuberculosis Fungal infection
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List necrotizing nongranulomatous lymphadenitides
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Kikuchi-Fujimoto disease Systemic lupus erythematosus
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List paracortical hyperplasias
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Infectious mononucleosis Atypical immunoblastic reaction Dermatopathic lymphadenopathy
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List spindle cell lesions of lymph node
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Bacillary angiomatosis Kaposi's sarcoma Palisaded myofibroblastoma Inflammatory pseudotumor of lymph node Follicular dendritic cell sarcoma Interdigitating dendritic cell sarcoma
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Most common site of toxoplasmosis-associated lymphadenopathy?
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Posterior cervical lymph node chain
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What's the 'toxo triad?'
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Florid follicular hyperplasia Monocytoid B-cell hyperplasia expanding and surrounding sinuses Paracortical epithelioid histiocyte clusters that encroach on germinal centers
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In addition to florid follicular hyperplasia and monocytoid B-cell hyperplasia expanding sinuses which other feature can be seen in CMV lymphadenopathy?
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Immunoblastic proliferation (may appear atypical) Also characteristic inclusions in the hyperplastic B-cell areas
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Disorder? Florid reactive lymphoid hyperplasia with absent mantle zones and follicle lysis of germinal centers (germinal centers disrupted by hemorrhage disrupted FDC network and increased T-cells) Monocytoid B-cell hyperplasia expanding sinuses Epithelioid histiocyte clusters Increased plasma cells and polykaryocytes (large multinucleated giant cells) in interfollicular zones
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Early stage HIV
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DDX of rheumatoid lymphadenopathy?
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Other inflammatory disorders (Sjogren's Felty's Still's) HIV infection Syphilis Castleman's disease (plasma cell type)
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Arbitrary cut-off for % blasts in marrow to diagnose lymphoblastic lymphoma
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25%
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Prognosis in ALL: hyperdiploidy > 50 chromosomes
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Better
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Prognosis in ALL: t(12;21)(p13;q22)
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Better
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Prognosis in ALL:
t(1;19) |
Poorer
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Prognosis in ALL:
t(9;22) |
Poorer
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Prognosis in ALL:
t(4;11)(q21;q23) |
Poorer
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Prognosis in ALL:
Hypodiploidy |
Poorer
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Prognosis in ALL:
Lack of CD10, CD34, or CD24 |
Poorer
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Prognosis in ALL:
CD13 or CD33 positive |
Poorer
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Type of lymphoma:
Effacement of nodal architecture Invasion of perinodal fat Paracortical involvement with occasional sparing of reactive follicles Starry-sky pattern with frequent mitosis Monotonous population of medium-sized cells with scant cytoplasm, fine chromatin |
Lymphoblastic lympoma
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IHC of lymphoblastic lymphoma:
CD34, CD43, TdT |
Positive
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IHC of lymphoblastic lymphoma:
sIg |
Negative
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DDX of pre-B lymphoblastic lymphoma:
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Blastoid variant of mantle cell lymphoma (TdT and CD34 NEG, sIg POS)
Myeloid sarcoma (CD13, CD33, MPO, CD58, lysozyme POS) Burkitt lymphoma (sIg POS, CD34 and TdT NEG) |
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Rapidly enlarging mediastinal mass +/- lymphadenopathy, SVC syndrome, pericardial/pleural effusions. Starry-sky pattern histologically.
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Pre-T lymphoblastic lymphoma
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IHC of pre-T lymphoblastic lymphoma?
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CD2, CD3 (cytoplasmic), CD5, CD7, TdT. Neg for immunoglobulin. Subset: CD1, CD4, CD8
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DDX of pre-T lymphoblastic lymphoma:
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B-LBL
Mature B-cell lymphoma Mature T-cell lymphoma (Heterogeneous population lacking blastic cytology) Myeloid sarcoma (more eosinophilic cytoplasm) |
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History of waxing and waning lymphadenopathy, 10K/mL circulating lymphocytes
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CLL
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Poor prognostic factors in CLL
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+12, del(17p), del(11q), CD38+, ZAP70+
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Better prognosis in CLL
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del(13q)
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Positive IHC in CLL
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CD19, CD20, CD79a, CD23, CD5, CD43, sIg (weak)
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Negative IHC in CLL
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CD10 and cyclin D1
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Lymphoma resembling SLL but numerous residual follicles seen
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Interfollicular small lymphocytic lymphoma
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DDX SLL
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LPL,
MCL (cleaved nuclei, no proliferation centers, CD23-, cyclin D1+), FL (CD5-, CD43-, CD23-, CD10+), Marginal zone lymphoma (CD5-, CD23-, no prolif centers) T-cell PLL B-cell PLL |
