Lymphomas Olsow

Front 1

Lymphoid neoplasms with widespread involvement of bone marrow. Tumor cells are usually found in peripheral blood

Back 1

Leukemia

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Discrete tumor masses arising from lymph nodes. Presentations often blur definitions

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Lymphoma

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T/F: Tumor cells are not seen in blood in leukemia

Back 3

False. Tumor cells are usually found in peripheral blood

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T/F: Lymphomas are discrete tumor masses arising from the thymus

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False. Discrete tumor masses arising from lymph nodes

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T/F: Leukemia often presents with blurred definitions

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False. Lymphoma often presents with blurred definitions

Front 6

T/F: Leukemia has a widespread involvement of bone marrow

Back 6

True

Front 7

What kind of neoplasms are the leukemias

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Lymphoid neoplasms

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T/F: Leukemia is the same as leukemoid reaction

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False

Front 9

Increased WBC count with left shift (80% bands) and increased leukocyte alkaline phosphatase, usually due to infection

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Leukemoid reaction

Front 10

T/F: Decrease of leukocyte alkaline phosphatase in leukemoid reaction

Back 10

False. increase

Front 11

T/F increased WBC count in leukemoid reaction

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True

Front 12

7 characteristics of Hodgkin's lymphoma

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1. Presence of Reed-Sternberg cells
2. Localized, single group of nodes
3. Mediastinal lymphadenopathy
4. 50% of cases associated with EBV
5. Bimodal distribution - young and old
6. More common in men except for nodular sclerosing type
7. Good prognosis = Increased lymphocytes and decreased RS cells

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T/F: Extranodal sites are common in HL

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False. Rare

Front 14

The strongest predictor of prognosis in HL

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Stage

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T/F: HL spreads diffusely

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False. Has a contiguous spread

Front 16

3 constitutional signs/symptoms of HL

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Low-grade fever, weight loss and night sweats

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The virus associated with HL

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EBV

Front 18

The type of HL not common in men

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Nodular sclerosing type

Front 19

5 characteristics of Non-Hodgkin's lymphoma

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1. Multiple peripheral nodes
2. Majority involve B cells
3. Peak incidence for certain subtypes at 20-40 yrs
4. Extranodal involvement is common
5. Noncontiguous spread

Front 20

T/F: HL is associated with HIV and immunosuppression

Back 20

False. HIV and immunosuppression are associated with NHL

Front 21

T/F: Single, peripheral nodes in NHL

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False. Multiple peripheral nodes

Front 22

T/F: Extranodal involvement is rare in NHL

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False. Common

Front 23

T/F: The majority of NHL involve T cells

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False. The majority involve B cells (except those of lymphoblastic T cell origing)

Front 24

T/F: Leukemoid reaction is usually due to neoplasms

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False. Usually due to infections

Front 25

T/F: NHL has more constitutional signs/symptoms

Back 25

False. Fewer

Front 26

T/F: NHL also has bimodal distribution

Back 26

False. Peak incidence of certain subtypes at 20-40yrs

Front 27

4 characteristics of Reed-Sternberg cells

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1. Tumor giant cell seen in HL
2. Binucleate or bilobed with the 2 halves as mirror images
3. CD-15 and CD-30 positive
4. B cell origin

Front 28

T/F: RS cells are sufficient for the diagnosis of HL

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False. Necessary but not sufficient

Front 29

T/F. Variants of RS cells include lacunar cells in nodular sclerosing variant

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True

Front 30

The 4 types of HL

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1. Nodular sclerosing
2. Mixed cellularity
3. Lymphocyte predominant
4. Lymphocyte depleted

Front 31

The 2 types of HL with excellent prognosis and why?

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1. Nodular sclerosing
2. Lymphocyte predominant
They more lymphocytes than RS cells

Front 32

Most common type of HL

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Nodular sclerosing (65-75%)

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5 characteristics of nodular sclerosing type of HL

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1. Most common
2. Lacunar cells
3. Collagen banding
4. Women more than men
5. Primarily young adults

Front 34

The type of HL with the poorest prognosis

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Lymphocyte depleted

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The of HL with an intermediate prognosis

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Mixed cellularity

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T/F: Collagen bands are seen in the mixed cellularity type of HL

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False. Collagen bands are seen only in the nodular sclerosing type

Front 37

The type of HL commonly seen in males < 35 yrs old

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Lymphocyte predominant

Front 38

T/F: Numerous RS cells are seen in the mixed cellularity type of HL

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True

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The type of HL seen in older males with disseminated disease

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Lymphocyte depleted

Front 40

T/F: The nodular sclerosing type of HL is more common in men

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False. Women>men

Front 41

T/F: The nodular sclerosing type of HL is seen primarily in middle-aged people

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False. Primarily seen in young adults

Front 42

Lacunar cells are seen in which type HL

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nodular sclerosing

Front 43

NHL is divided into 2 large groups

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1. Neoplasms of mature B cells
2. Neoplasms of mature T cells

Front 44

The 4 types of neoplasms(NHL) of mature B cells

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1. Burkitt's lymphoma
2. Diffuse large B-cell lymphoma
3. Mantle cell lymphoma
4. Follicular lymphoma

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T/F: Burkitt's lymphoma is seen in old people

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False. Seen in adolescents and young adults

Front 46

t(8;14) c-myc gene moves next to heavy-chain Ig gene (14)

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Burkitt's lymphoma

Front 47

The histological appearance of burkitt's lymphoma

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"Starry-sky" appearance

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Description of "starry-sky" appearance

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Sheets of lymphocytes with interspersed macrophages

Front 49

The NHL associated with EBV

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Burkitt's lymphoma

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The 2 forms of Burkitt's lymphoma

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1. Endemic
2. Sporadic

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Location of lesion in endemic form of Burkitt's

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Jaw

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Location of lesion in the sporadic form of Burkitt's

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Pelvis and abdomen

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The most common NHL

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Diffuse large B-cell lymphoma

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T/F: Diffuse large B-cell lymphoma may be mature T cell in origin

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True. In about 20%

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Diffuse large B-cell lymphoma usually affects which age group

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Usually older adults, but 20% in children

Front 56

The type of NHL that typically affects older males

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Mantle cell lymphoma

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The NHL with t(11;14) genetics

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Mantle cell lymphoma

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T/F: Mantle cell lymphoma has a very good prognosis

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False. Poor prognosis

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T/F: Mantle cell lymphoma has no CD association

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False. CD5+

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The NHL that has an indolent course and difficult to cure

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Follicular lymphoma

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T/F: Follicular lymphoma affects children

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False. Adults

Front 62

The NHL associated with bcl-2 expression

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Follicular lymphoma

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What is the effect of bcl-2 expression in follicular lymphoma

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bcl-2 inhibits apoptosis

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The NHL associated with t(14;18) genetics

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Follicular lymphoma

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The 2 neoplasms of mature T cells

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1. Adult T-cell lymphoma
2. Mycosis fungoides/Sezary syndrome

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Adult T-cell lymphoma is seen in which age group

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Adults

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Mycosis fungoides/Sezary syndrome is seen in which age group

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Adults

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Adult T-cell lymphoma is caused by

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Human T-lymphotropic virus 1 (HTLV-1)

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T/F: Adult T-cell lymphoma is a mild disease

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False. Aggressive

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The type of lesion seen in Adult T-cell lymphoma

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Cutaneous lesions

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Adult T-cell lymphoma often affects populations in these 3 areas of the world

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Japan, West Africa and the Caribbean

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The type of lesion seen in Mycosis fungoides/Sezary syndrome

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Cutaneous patches or nodules

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Mycosis fungoides/Sezary syndrome affects which age group

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Adults

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In which type NHL is CD4+ seen

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Mycosis fungoides/Sezary syndrome

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T/F: The course of mycosis fungoides/Sezary syndrome is mild

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False. Indolent

Front 76

Monoclonal plasma cell cancer

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Multiple myeloma

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The term used in the histological description of MM

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"Fried-egg" appearance

Front 78

T/F: Multiple myeloma arises in lymph nodes

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False. Arises in the bone marrow

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MM produces large amounts of these 2 immunoglobulins in what %

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1. IgG (55%)
2. IgA (25%)

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Which age group is affected by MM

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The elderly (>40 - 50 yrs)

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The most common primary tumor arising within bone in the elderly (>40 -50yrs)

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Multiple myeloma

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Multiple myeloma is associated with these 6 issues

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1. Increased susceptibility to infection
2. Primary amyloidosis (AL)
3. Punched out lytic bone lesions on x-ray
4. M spike on protein electrophoresis
5. Ig light chains in Urine (Bence Jones protein)
6. Rouleaux formation

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T/F. MM is associated with secondary amyloidosis

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False. Primary amyloidosis

Front 84

What are Bence Jones proteins?

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Ig light chains in urine of patients with MM

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Describe the bone lesions seen in X ray of MM

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Punched out lytic lesions

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T/F Patients with MM have decreased susceptibility to infections

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False. Increased susceptibility.

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Multiple myeloma should be distinguished from which condition?

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Waldenstroms macroglobulinemia

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One similarity between MM and Waldenstrom's macroglobulinemia

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M spike on electrophoresis

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2 differences between MM and Waldenstrom's macroglobulinemia

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1. Hyperviscosity symptoms WM
2. No lytic bone lesions WM

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4 symptoms of MM

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1. Hypercalcemia
2. Renal insufficiency
3. Anemia
4. Bone lytic lesions/back pain

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Monoclonal plasma cell expansion without the symptoms of MM

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Monoclonal gammopathy of undetermined significance (MGUS)

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What is (MGUS) monoclonal gammopathy of undetermined significance

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Monoclonal plasma cell expansion without the symptoms of multiple myeloma