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49 Cards in this Set

  • Front
  • Back
Where are B cells typically found in lymph nodes?
Cortex
Cortex
Where are T cells typically found in lymph nodes?
Paracortex
Paracortex
Where do lymphomas originate from in the lymph nodes?
The germinal centers
The germinal centers
Where do mantle cell lymphomas originate from?
the mantle zone
the mantle zone
What is a cause of marginal zone expansion in lymph nodes?
Hyperplastic syndromes
Marginal zone lymphomas
Hyperplastic syndromes
Marginal zone lymphomas
What is a primary follicle?
A follicle without a germinal center
What are the most common types of B-cell non-Hodgkins lymphoma?
1. Diffuse large B cell lymphoma
2. Follicular lymphoma
What are the most common types of Hodgkin lymphomas?
Classic hodgkin lymphoma
What are the different types of B-cell non-Hodgkin lymphomas?
Chronic lymphocytic leukemia/small lymphocytic lymphoma
Follicular lymphoma
Mantle cell lymphoma
Diffuse large B-cell lymphoma
Marginal zone lymphoma
What are the aggressive lymphomas?
Mantle cell lymphoma
DLBCL
Burkett lymphoma
What are the more indolent lymphomas?
CLL/SLL
Marginal zone
Follicular
What does it mean when referring to a B-cell lymphoma that is restricted?
Monoclonal expression of a kappa;lambda light chain as determined by flow cytometry

This is abnormal!
What are good markers for B cells?
CD20
What are good markers for T cells? What do you have to confirm?
CD2, 3, 5, 7

You need to see that they're expressed at the same level to confirm that there's not a T cell lymphoma
What does CLL/SLL look like?
Nuclei that are odd looking
Too many T cells
Nuclei that are odd looking
Too many T cells
How do you confirm a diagnois of CLL/SLL?
Flow cytometry
Biopsy
What's diagnostic for CLL/SLL in a lymph node?
Proliferation centers!

lots and lots of the CLL/SLL cells all growing in one place
Proliferation centers!

lots and lots of the CLL/SLL cells all growing in one place
What immunohistochemistry stains are used to diagnose CLL/SLL?
CD20
CD5

CD5 is aberrantly expressed...normally it's a T cell marker!
What do you see in flow cytometry for CLL/SLL?
Dim CD20
Dim immunoglobulin
+CD23
Where can mantle cell lymphomas present?
Nodes
Inside the intestine as polyps
Spleen
What is the appearance of the cells in mantle cell lymphomas?
More angular
Lots of them
Irregular nuclear patterns
More angular
Lots of them
Irregular nuclear patterns
What marker is specific for mantle cell lymphoma?
Cyclin D1
What are the immunohistochemial findings in mantle cell lymphoma?
+CD20
+CD5
+cyclin D1
What do you find in flow cytometry for mantle cell lymphoma?
Moderate to bright CD20
Moderate to bright light chain
What do you find on FISH for mantle cell lymphoma?
t(11;14) CCND1/IgH
What does a lymph node look like in follicular lymphoma?
Nodularity!
Lack of normal node structure
Nodularity!
Lack of normal node structure
What is the appearance of the cells in follicular lymphoma?
Small cells

Small cells with clefts: centrocytes
Hollowed out nuclei with multiple nucleoli: centroblasts (grading)
Dispersed chromatin with a central nucleoli: FDC (follicular dendritic cells)
Small cells

Small cells with clefts: centrocytes
Hollowed out nuclei with multiple nucleoli: centroblasts (grading)
Dispersed chromatin with a central nucleoli: FDC (follicular dendritic cells)
What makes a follicular lymphoma higher grade?
More centroblasts per high powered field.
What are the findings in immunohistochemistry for follicular lymphomas?
CD20
Germinal center markers:
CD10
BCL6
What do you find on FISH in follicular lymphoma?
t(14,18): immunoglobulin heavy with the BCL2
What's the zoomed out appearance of marginal zone lymphoma?
Monocytoid: it looks more white than normal

Colonization of the germinal centers
Monocytoid: it looks more white than normal

Colonization of the germinal centers
What is a Dutcher body? What condition is it found in?
Intranuclear inclusions of IgGs

It's found in marginal zone lymphomas
Intranuclear inclusions of IgGs

It's found in marginal zone lymphomas
What are the subtypes of marginal zone lymphomas?
Extranodal MALT: stomach, conjuctiva, salivary gland

Nodal marginal zone lymphoma

Splenic marginal zone lymphoma
What is a common cause of gastric MALTs?
H. pylori infection
What do you see in marginal lymphomas?
Lymphoepithelial lesions: the lymphocytes are invading the epithelium!
Lymphoepithelial lesions: the lymphocytes are invading the epithelium!
What's the problem with the diagnosis of marginal zone lymphomas?
They don' have any specific immunohistochemical markers

You can only use CD20 to confirm it's a B-cell; it's a diagnosis of exclusion
What's the appearance of the cells in a diffuse large B-cell lymphoma?
Big!
Dark/hyperchromatic
Atypical looking!
Big!
Dark/hyperchromatic
Atypical looking!
What do you find in large b cell lymphoma more than in other types?
Necrosis.
What immunohistochemistries do you do for large B cell lymphomas?
CD20: see if it's a B cell
10: see if it came from a germinal center
What's the progression of a Burkitt lymphoma?
Fast; it's an aggressive mass
How does a Burkitt lymphoma typically present?
Terminal mass in the ileum of a child
What are the types of hodgkin lymphoma?
Classical hodgkin lymphoma
Nodular lymphocyte predominant hodgkin lymphoma
What are the subtypes of classical hodgkin lymphoma subtypes?
Nodular sclerosis
Mixed celluarity (inflammatory cells)
Lymphocyte rich (lymphocytes all over the place)
Lymphocyte depleted (rare!)
Nodular sclerosis
Mixed celluarity (inflammatory cells)
Lymphocyte rich (lymphocytes all over the place)
Lymphocyte depleted (rare!)
How does nodular sclerois typically present?
Mediastinal mass in a young person
What are the type of neoplastic cells in the nocular sclerosis subtype of hodgkin lymphoma?
Reed-sternberg cells/variants
What is the typical appearance of Reed-Sternberg cells?
Lots of free space
Binucleate
Prominent nuclei

They look like owl eyes!
Lots of free space
Binucleate
Prominent nuclei

They look like owl eyes!
What type of cells are reed-sternberg cells?
B cells
What do you almost always see in Hodgkin lymphomas?
Inflammatory background
What is the immunophenotype for Hodgkin lymphoma?
CD30
CD15