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20 Cards in this Set
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- Back
- 3rd side (hint)
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Middle aged, 40-60
Painless, generalized lymphadenopathy Germinal center B cells CD19, CD20, CD10+ t(14;18) |
Follicular Lymphoma (FL)
Prognosis? |
Indolent but incurable.
40% transform to Diffuse Large B-Cell Lymphoma, death within 1 year. |
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Median age 60, but wide range
B-Symptoms common (fever, weight loss, night sweats) Diffuse, large (4-5x normal) cells |
Diffuse Large B-Cell Lymphoma
Prognosis? |
Fatal if untreated.
Chemo 75% remission, 35% cured. |
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>50 years old
lymphocytosis later, cytopenia smudge cells in PB diffuse effacement of nodal architecture, with homogeneous small round lymphocytes CD19, CD20, CD23, CD5 |
Chronic Lymphocytic Leukemia (CLL)
Small Lymphocytic Lymphoma Prognosis? |
Indolent, incurable
Survival 4-6 years pancytopenia -> infections, bleeding transform to Prolymphocytic leukemia (20%) transform to Diffuse Large B-cell Lymphoma (10%) |
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mature looking lymphocytes in stomach
H.pylori infection |
extranodal Marginal Zone Lymphoma (MALToma)
Prognosis? |
Cured by killing H. pylori
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starry sky pattern cells
EBV |
Burkitt Lymphoma
African (endemic) presentation? Sporadic presentation? |
Endemic: Mandible
Sporadic: Iliocecal |
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c-myc oncogene on chromosome 8
CD19, CD20, CD10, surface Ig t(8;14) |
Burkitt Lymphoma
Prognosis? Virus? |
Extraordinarily aggressive
Usually cured with high dose chemo. EBV |
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middle aged male
pancytopenia, splenomegaly PB: pale blue cytoplasm with thread or bleb-like extensions BM: dry tap Spleen: beefy red appearance CD11c, CD20, CD25, CD103 |
Hairy Cell Leukemia
Prognosis? |
Easily cured.
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>50 years old, male
bone pain cytopenia organomegaly renal insufficiency secondary to hypercalcemia, Bence Jones proteins, amyloid deposition |
Multiple Myeloma
Prognosis? |
Untreated, death in 1 year.
Alkylating chemo - 3 years. if <50 yo, bone marrow transplant - 10 years |
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Multiple Myeloma
Diagnostic Criteria |
M-protein in serum or urine
Bone marrow clonal plasma cells or plasmacytoma Organ or Tissue Impairment - what is CRAB? |
Calcemia (hyper)
Renal Insufficiency Anemia Bone Lesions |
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Painless rubbery large lymph nodes
Pain in lymph nodes post EtOH Fever, night sweats, weight loss Reed-Sternberg cells |
Hodgkins Lymphoma (HL)
What is Ann Arbor staging? |
I single lymph node (LN) region
II 2 or more LN regions on same side of diaphragm III LN regions on both sides of diaphragm, which could include spleen IV Multiple / disseminated involvement of 1 or more extralymphatic organs or tissues (including bone marrow) |
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Reed-Sternberg (RS) cells
CD15, CD30 |
Hodgkin's Lymphoma
Classical type what are subtypes? |
Nodular sclerosis 65%
Mixed cellularity 25% Lympocyte depleted <5% Lymphocyte rich - very uncommon |
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Reed-Sternberg (RS) cells
CD20, CD45 |
Hodgkin's Lymphoma
Variant type what is the subtype? |
Lymphocyte predominant 5%
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young adult
Enlarged mediastinal lymph nodes. Histo: Lymph node has large nodules surrounded by thick fibrous collagen bands. Reed-Sternberg (RS) cells |
Classical Hodgkin's
Nodular Sclerosis |
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Reed-Sternberg (RS) cells
EBV Biphasic - young adults & adults > 55 |
Classical Hodgkin's
Mixed Cellularity |
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Reed-Sternberg (RS) cells
EBV RS cells are bizarre Elderly or HIV+ |
Classical Hodgkin's
Lymphocyte Depleted |
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<35 yo
Cervical or axillary nodes Reed-Sternberg (RS) cells EBV negative RS cells are "popcorn" cells |
Variant Hodgkin's Lymphoma
Lymphocyte predominant Prognois? |
Indolent but tend to recur.
<5% transform to non-Hodgkin's large B-cell lymphoma |
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Hodgkin's Lymphoma
Treatment and Prognosis |
Stage is most important prognostic indicator.
5 year survival: Stage I-II: 90% Stage IV: 60-70% What is side effect of therapy? |
Long term survivors get secondary cancers (AML, LungCA) due to drugs.
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Abrupt and severe onset -> Flu that won't stop.
Cytopenia Enlargement of LNs, liver, spleen Thymic enlargement TdT+, CD2, CD7 NOTCH1 mutation |
Precursor T-cell
Acute Lymphoblastic leukemia/lymphoma Prognosis? |
No prediction.
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Abrupt and severe onset -> Flu that won't stop.
Cytopenia Enlargement of LNs, liver, spleen Testicular enlargement CNS involvement TdT+, CD19 |
Precursor B-cell
Acute Lymphoblastic leukemia/lymphoma |
Good Prognosis:
Age: 2-10 years WBC in PB: low Pre-B type hyperploidy (>50 chromosomes) t(12;21) All others die within months. |
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What are the good and bad translocations in ALL?
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Good: t(12;21)
Bad: t(9;22) |
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