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21 Cards in this Set

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Hodgkins lymphoma types
In order from good to bad prognosis:
(1) Lymphocyte rich (males <35y)
(2) Nodular sclerosing (F>M, lacunar cells)
(3) Mixed cellularity
(4) Lymphocyte depleted
Hodgkins
Reed Sternberg (CD15, CD30+ B cells)
B symptoms
Cervical/mediastinal lymphadenopathy
Contiguous spread
Age 15-35
More lymphs and fewer RS -> better prognosis
B symptoms
Drenching night sweats
10%+ weight loss
low-grade fever
Myelodysplastic syndrome
Ineffective erythropoesis
Spectrum up to AML w/ >20% blasts
Elderly
Post-chemo
ALL
Kids peak at age 4 if pre-B
pre-T ALL> teen boys w/ mediastinal mass
CNS and testis spread reqs prophylaxis
Worse prognosis if adult or Ph+
AML
Adults
Auer rods
Granules
Infiltrates gums
APML
M3 AML
Prominent Auer rods
t(15;17) > PML-RAR fusion
ATRA
Risk of DIC due to Auer rod release on tx
CML
Myeloproliferative disorder
Basophilia
Bcr-Abl/Philadelphia chromosome/t(9;22)
Imatinib
Splenomegaly
Progresses to AML OR ALL blast crisis
CLL/SLL
Smudge cells
Elderly
Warm autoimmune hemolytic anemia
Indolent but incurable
Effaced LN architecture by sheets of tumor cells
Polycythemia vera
Myeloproliferative disorder
Low epo > DDx secondary polycythemia
Jak2
Pruritis, plethoric
Hyperviscosity
Clotting
Aspirin & phlebotomy
Myelofibrosis
Myeloproliferative disorder
Replaces marrow with fibrosis
Myelphtisic smear
Ann Arbor staging
Better than histology in predicting HL prognosis

I: one node
II: two nodes, same side of diaphragm
III: two nodes, opposite sides of diaphragm
IV: mets
A: no B symptoms
B: B symptoms
Non-Hodkin's lymphomas
In general:
-Non-contiguous spread
-Extranodal involvement
-Assoc w/ HIV & immunodeficiency
Follicular lymphoma
Follicles in LNs w/cleaved nuclei
t(14;18) > bcl-2 (antiapoptosis) driven by Ig heavy chain promoter
Painless waxing & waning lymphadenopath
Indolent but incurable
Diffuse large lymphoma
Mostly mature B-cells
Single large mass
B0symptoms
Adults > kids
Aggressive but curable at early stages
Marginal zone lymphoma (MALToma)
Chronic inflam in extranodal lymphoid tissue
-H. pylori
-Sjogren's
-Hashimoto's thyroiditis
Remove stim early enough before full transformation to cure lymphoma
Burkitt lymphoma
Endemic/African form: large jaw bump
Sporadic/American form: abd/pelvic nodes
Aggressive
EBV > t(8;14) > c-myc overexpression
Mantle cell lymphoma
t(11;14) > bcl-1 overexpression
Multiple myeloma
Plasma cell monoclonal prolif
-M spike of monoclonal IgG or IgA immunoglobulin
-Amyloidosis
-Bence-Jones proteins > renal insufficiency
-Lytic bone lesions > hypercalcemia, bone pain, and pathologic fractures
-Hyperviscosity > Rouleaux formation
Waldenstrom macroglobulinemia
M spike of IgM rather than IgG or IgA. No lytic bone lesions. Get hyperviscosity symptoms instead.
-Old men
-Slowly progressive
Monocolonal gammopathy of unknown significance (MGUS)
Old people w/ M spike and no symptoms.