Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
30 Cards in this Set
- Front
- Back
|
What are small B cell NHLs?
|
Tumors of mature B cells
|
|
|
What are the 3 types of SBC NHLs?
|
1. Follicular Lymphoma
2. CLL/SLL 3. Marginal Zone Lymphoma |
|
|
What is the most common NHL?
|
Follicular Lymphoma
|
|
|
What are the 3 main clinical features of Follicular Lymphoma?
|
1. Lymphadenopathy
2. BM involvement (usually goes undeteced until late, stage IV, disease) 3. Spleen/Liver involvment |
|
|
What are "cleaved" lymphocytes with prominent nuclear clefts characteristic of?
|
Follicular Lymphomas - "small cleaved" low grade germinal center B cells = centrocytes.
Seen in Peripheral Blood Smear in FL |
|
|
How aggressive are follicular lymphomas?
|
usually low grade, median survival of 7-9 years
|
|
|
What is the major danger with follicular lymphomas?
|
They can transforms to aggressive Large B Cell Lymphoma (<1 year survival)
|
|
|
Where in the lymph node do the malignant B cells in follicular lymphomas come from?
|
Germinal Center
|
|
|
What appearence does a follicular lymphoma tumor usually have?
|
Nodular Appearance
|
|
|
What are the microscopic characteristics of Follicular Lymphoma follicle?
|
- Crowded
- Lack Polarity - Lack Macrophages - Lack mantle Zone |
|
|
Grading of follicular lymphomas depends on what 2 factors?
|
1. Cytology - more centroblasts (as opposed to small, cleaved centrocytes) makes tumor more aggressive
2. Growth Pattern - More diffuse makes tumor more aggressive |
|
|
What is the grading scale for follicular lymphomas?
|
Grade 1: 1-5 centroblasts
Grade 2: 6-15 centroblasts Grade 3: >15 centroblasts |
|
|
What is the unique pattern of growth in the Bone Marrow seen in follicular lymphomas?
|
Grows along trabecular bone, in "paratrabecular" pattern
|
|
|
What is the major immunophenotype difference between follicular lymphoma cells and normal germinal center B cells?
|
Follicular Lymphoma express BCL2, normal B cells in germinal center do not
BCL2+ is clear sign of neoplasm |
|
|
What is the cytogenetic hallmark of Follicular Lymphoma?
What does this cause? |
t(14;18)
-Translocation between heavy chain locus on 14 and BCL2 locus on 18. - causes overexpression of BCL2 |
|
|
What is the proliferation rate in follicular lymphomas?
|
LOW (no Ki67 expression seen)
|
|
|
What does CLL/SLL stand for?
|
CLL = chronic lymphocytic leukemia
SLL = small lymphocytic leukemia |
|
|
What are the clinical features of CLL/SLL?
|
- Generalized lymphadenopathy
- BM Involvement in virtually all cases - Spleen/Liver involvement - peripheral blood involvement (hemolytic anemia) |
|
|
Is the exact site of origin for CLL/SLL known?
|
NO
|
|
|
What are the 3 classic morphological (architecture) features of CLL/SLL?
|
1. Diffuse Effacement of architecture
2. Proliferation Centers 3. Prolymphocytes / Paraimmunoblasts |
|
|
What are the 2 classical findings on a blood smear of a Pt with CLL/SLL?
|
1. Lymphocytosis (many small mature lymphocytes)
2. Smudge Cells (disrupted lymphocytes) |
|
|
What pattern of growth is usually seen with CLL/SLL in the bone marrow?
|
- Interstitial aggregates usually observed
- Often in Nodular pattern |
|
|
What is the marker unique to CLL/SLL?
|
CD5+
Note: CD5 is a T cell marker but is inappropriately expressed by B cells of CLL |
|
|
What are the 2 categories (basically 2 different diseases) of CLL/SLL?
Which one has the better prognosis? |
1. Naive Form: contains rearranged by unmutated immunoglobin genes
2. Post-GC form: rearranged and somatically hypermutated IG genes that have traversed GC Post-GC form has MUCH better prognosis |
|
|
What are the clinical features of a MALT lymphoma?
|
Unique: Associated with chronic inflammation (ie caused by a mucosal site specific infectious agent)
|
|
|
Is there a distinct immunophenotypic marker for marginal zone lymphomas?
|
NO
|
|
|
What is the cytogenetic hallmark of MALTs?
|
t(11:18)
|
|
|
What kind of bone marrow involvement is seen in Marginal Zone Lymphomas?
|
Interstitial
|
|
|
What are the 3 types of marginal zone lymphomas?
|
1. Extranodal (MALT)
2. Nodal 3. Splenic |
|
|
What is the immunophenotype of Marginal Zone Lymphomas?
|
CD5-, CD10-
|
