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21 Cards in this Set
- Front
- Back
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Hodgkins lymphoma types
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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 |
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Hodgkins
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Reed Sternberg (CD15, CD30+ B cells)
B symptoms Cervical/mediastinal lymphadenopathy Contiguous spread Age 15-35 More lymphs and fewer RS -> better prognosis |
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B symptoms
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Drenching night sweats
10%+ weight loss low-grade fever |
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Myelodysplastic syndrome
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Ineffective erythropoesis
Spectrum up to AML w/ >20% blasts Elderly Post-chemo |
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ALL
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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+ |
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AML
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Adults
Auer rods Granules Infiltrates gums |
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APML
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M3 AML
Prominent Auer rods t(15;17) > PML-RAR fusion ATRA Risk of DIC due to Auer rod release on tx |
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CML
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Myeloproliferative disorder
Basophilia Bcr-Abl/Philadelphia chromosome/t(9;22) Imatinib Splenomegaly Progresses to AML OR ALL blast crisis |
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CLL/SLL
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Smudge cells
Elderly Warm autoimmune hemolytic anemia Indolent but incurable Effaced LN architecture by sheets of tumor cells |
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Polycythemia vera
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Myeloproliferative disorder
Low epo > DDx secondary polycythemia Jak2 Pruritis, plethoric Hyperviscosity Clotting Aspirin & phlebotomy |
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Myelofibrosis
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Myeloproliferative disorder
Replaces marrow with fibrosis Myelphtisic smear |
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Ann Arbor staging
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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 |
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Non-Hodkin's lymphomas
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In general:
-Non-contiguous spread -Extranodal involvement -Assoc w/ HIV & immunodeficiency |
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Follicular lymphoma
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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 |
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Diffuse large lymphoma
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Mostly mature B-cells
Single large mass B0symptoms Adults > kids Aggressive but curable at early stages |
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Marginal zone lymphoma (MALToma)
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Chronic inflam in extranodal lymphoid tissue
-H. pylori -Sjogren's -Hashimoto's thyroiditis Remove stim early enough before full transformation to cure lymphoma |
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Burkitt lymphoma
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Endemic/African form: large jaw bump
Sporadic/American form: abd/pelvic nodes Aggressive EBV > t(8;14) > c-myc overexpression |
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Mantle cell lymphoma
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t(11;14) > bcl-1 overexpression
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Multiple myeloma
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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 |
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Waldenstrom macroglobulinemia
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M spike of IgM rather than IgG or IgA. No lytic bone lesions. Get hyperviscosity symptoms instead.
-Old men -Slowly progressive |
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Monocolonal gammopathy of unknown significance (MGUS)
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Old people w/ M spike and no symptoms.
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