Overview Of Hematopoietic Neoplasms/non-Hodgkin Lymphoma

Front 1

In a leukemia, the neoplastic cells are mainly in the ___ and ____?
As opposed to lymphoma, where the cells are in the ____ and ____?

Back 1

blood & bone marrow

lymph nodes & tissues

You CAN'T differentiate btwn a leukemia and lymphoma clinically (by symptoms alone).

Front 2

How do you differentiate btwn an indolent and aggresive neoplasm?

Back 2

Use marker studies

CANNOT MAKE DISTINCTION FORM MORPHOLOGY ALONE

Front 3

What is an example of an indolent myeloid neoplasm?

an aggressive one?

Back 3

a myeloproliferative disorder such as chronic myelogenous leukemia (CML)

Acute Myeloid Leukemia

Front 4

What is an example of an indolent lymphoid neoplasm?

an aggressive one?

Back 4

low grade lymphoma

high grade lymphoma

Front 5

What is a plasma cell tumor called?

Back 5

Multiple Myeloma

Front 6

What is a neoplasm of the pro-B cells involved (less differentitated)?

Back 6

Acute LymphoBLASTIC Leukemia

Front 7

When classifying a neoplasm, calling it a Precursor means what?
a Peripheral cell?

Back 7

primitive cell -- more aggresive

more mature cell --more indolent

Front 8

Lymphocyte distribution (T/B):
1)in blood?
2)in BM?
3)in lymph nodes?
4)in spleen?
5)in GI tract lymph tissue?
6)in thymus?
7)in skin?

Back 8

1)T cells
2)B cells
3)T cells
4)equal T and B cells
5)B cells
6)T cells
7)T cells, dendritic cells, and NK cells

Front 9

When measuring a lymph node, what is the cut off for a lympadenopathy?

Back 9

> 2 cm

Front 10

Lymph Node Structure:
1)Where are T cells found?
2)B cells?
3)Macrophages and histiocytes?

Back 10

1)parafollicular cortex
2)lymphoid follicles
3)sinuses

Front 11

If a tumor metastasizes to a LN, where does it usually get stuck?

Back 11

subcapsular area

Front 12

What are centrocytes and centroblasts? Where are they found?

Back 12

B cells in different stages of activation, found in lymphoid follicles

Front 13

MCC of acute nonspecific lymphadenitis?

Back 13

viral infection

Front 14

What is the morphology of chronic follicular hyperplasia?
Cause?

Back 14

follicles more prominent

RA, syphillis, giant lymph node hyperplasia (GLNH=Castleman’s disease)

Front 15

What is the morphology of chronic paracortical hyperplasia?
Cause?

Back 15

T cells more prominent (in between follicles)

viral illness such as infectious mononucleosis (EBV), postvaccinial lymphadenitis

Front 16

What is the morphology of chronic sinus histiocytosis?
Cause?

Back 16

very prominent macrophage activity, sinuses

tumors, lymphangiography, storage disease etc.

Front 17

What are non-caseating granulomas seen w/?

Back 17

sarcoidosis

Front 18

____ lymphomas are more common in Western Hemisphere.
____ lymphomas are more common in Eastern Hemisphere.

Back 18

B-cell

T-cell

Front 19

What is an agent that has been associated w/ lymphoma (Non-hodgkin's lymphoma (NHL))?

Back 19

H. pylori

Front 20

What role does immunosuppression have on lymphoma?

Back 20

predispose to lymphoma by altering immune regulation

Front 21

What NHL is most frequent in the Western Hemisphere?

Back 21

Follicular lymphoma, followed by Diffuse Large B cell

Front 22

Highest age group to get lymphoma?

Back 22

40-70

Front 23

Which lymphoma is much more common in children?

Back 23

Lymphoblastic Lymphoma

Front 24

Which leukemia is only seen after age 60?

Back 24

Chronic Lymphocytic Leukemia

Front 25

What is meant by a LOW GRADE lymphoma?

Back 25

favorable, indolent, long natural survival

Treatment: palliative rather than curative

Front 26

What is meant by a INTERMEDIATE GRADE lymphoma?

Back 26

aggressive disease w/ short survival (<3 years)
more aggresive treatment

Front 27

What do we currently use for grading a lymphoma?

Back 27

immunochemistry, NOT CELL SIZE

Front 28

Morphology of B-cell Small Lymphocytic or Chronic Lymphocytic Leukemia (CLL)?

Back 28

diffuse architecture, small monotonous cells, Smudge cells

Front 29

Immunophenotype of B-cell Small Lymphocytic or Chronic Lymphocytic Leukemia (CLL)?

Back 29

*****CD5+****, CD19+, CD20+, CD21+, CD23+, plus a surface immunoglobulin

CD5 is actually a T-cell marker, therefore it is an example of an ABERRANT MARKER, seen in lymphomas

Front 30

Clinical features of B-cell Small Lymphocytic or Chronic Lymphocytic Leukemia (CLL)?

Back 30

indolent, mostly asymptomatic

15-30% transform into High Grade Large Cell Lymphoma --- RICHTOR'S SYNDROME

Front 31

Immunophenotype for Follicular Lymphoma (FL)?

Back 31

CD20+ (B cell marker), CD10+ (follicular center cell marker), *****************CD5 and CD3 both NEGATIVE*******, kappa and lambda chain

Front 32

What genetic marker is very specific for FL?

Back 32

translocation (14:18)

Front 33

What lymphoma has the highest prevalence in the BM?

Back 33

FL

indolent

Front 34

What does Mantle Cell Lymphoma resemble?

Back 34

B-Cell small CLL, but is very aggressive

Front 35

Immunophenotype for MCL?

Back 35

CD20+, CD19+, CD5+, **********CD23 NEGATIVE********, this is how you differentiate btwn CLL

Kappa or Lambda +, CYCLIN D+

Front 36

Where is there high prevalence of MCL?

genetic characterisics?

Back 36

BM

translocation(11:14)

Front 37

Characteristics of Large Cell Lymphoma?

Back 37

large, aggressive, mitotically active cells

Front 38

Immunophenotype of B-cell type LCL?

Back 38

CD19+, CD20+, CD22+, CD10+/-, and kappa or lambda +

Front 39

Molecular phenotype of LCL?

Back 39

t(14:18)
t(3:22) as well

Front 40

Most aggressive lymphoma?

Back 40

Burkitt's lymphoma

Front 41

What is the unique translocation seen in BL?

Back 41

t(8:14), where C-Myc is overexpressed

Front 42

Immunophenotype of BL?

Back 42

B cell phenotype, CD19+, CD20+, CD22+

Front 43

The African form of BL is?

Back 43

endemic form, more often associated EBV, also associated w/ maxilla and mandible

Front 44

The American form of BL is?

Back 44

sporadic form, mostly found in abdomen, peritoneum, and ovaries

Front 45

How do you differentiate the more immature Precursor B or T lymphoblastic Leukemia/Lymphoma?

Back 45

tDt positive

Front 46

What is Mycosis Fungoides?

Back 46

very indolent skin condition

lymphoma at interface of dermis and epidermis

may see abscesses known as Pautrier's Abscesses

almost all cells are T cells

Front 47

Typical location of lymphoma in adults?
children?

Back 47

node based

extra nodal

Front 48

Typical growth of lymphoma in adults?
children?

Back 48

indolent growth

high grade tumor w/ rapid, aggressive tumor

Front 49

Typical growth pattern of lymphoma in adults?
children?

Back 49

follicular pattern, cytology - pleomorphic

diffuse pattern, cytology - monomorphic

Front 50

Adult lymphomas tend to secrete?

Back 50

paraprotein