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Non Hodgkin T Cell Lymphomas
Exam 3 Pathology Details
26
Medical
Graduate
10/07/2010

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Term
Majority of T-Lineage Lymphomas belong to what class?
Definition
Alpha-Beta (95%)
Term
t (2;5) chromosomal translocation is associated with what disease?
Definition
Anaplastic Large Cell Lymphoma
Term
What is the usual of a T-lineage lymphoma compared to a B-lineage lymphoma?
Definition
There is a poorer prognosis, and the cancer is typically more aggressive
Term
What is the most common cutanaous T-cell lymphoma?
Definition
Mycosis Fungoides
Term
What is it about the morphology of Mycosis Fungoides that confirms definitively that MF is the right answer?
Definition
Small-to-medium sized T cells with cerebriform nuclei
Term
Name 2 out of 3 skin characteristics found in mycosis fungoides
Definition

1. Epidermotropic T-cell infiltrates

2. Pautrier Microabscesses

3. T cells with cerebriform nuclei

Term
Does mycosis fungoides ever present with lymphadenopathy? If so, how would it be caused?
Definition
Lymphadenopathy is possible in MF. Pieces of skin plaques can deposit in the lymph nodes, provoking an immune response and subsequent enlargement of the nodes
Term
What is the cell of origin for mycosis fungoides?
Definition
CD4+ T helper cell
Term
What is the diagnostic triad for Sezary syndrome?
Definition

1. Generalized erythroderma

2. Lymphadenopathy

3. Circulating tumor cells in blood

Term
What happens to the bone marrow in Sezary syndrome?
Definition
The bone marrow is spared, and the spread of Sezary cells usually occurs into the interstitial space, not the bone marrow
Term
What markers are positive in an immunophenotype for Sezary syndrome?
Definition
CD 2, 3, 4, and 5
Term
What is the prognosis for Sezary syndrome?
Definition
It is incurable, and the median survival is 5 years. Patients usually succumb to opportunistic infections
Term
In individuals with Adult T-cell Leukemia/Lymphoma, what is the only way they could have gotten it?
Definition
Those individuals were infected by the human T-cell leukemia retrovirus type-1 (HTLV-1)
Term
In which geographic locations is Adult T-cell leukemia/lymphoma endemic to?
Definition
Japan, Central Africa, and the Caribbean nations
Term
What cells are classically observed in Adult T-cell leukemia?
Definition
flower cells- cells with multilobated nuclei
Term
Name the clinical variants of ATL that are commonly found
Definition
Acute, Lymphomatous, Chronic, and Smoldering
Term
What are some common clinical findings in acute ATL?
Definition

hypercalcemia with bone lesions

skin rash

hepatosplenomegaly

marked leukemic phase (increase in WBC with eosinophils)

constitutional symptoms

Term
In which variants of ATL is the median survival greater than 2 years?
Definition
Chronic and Smoldering variants
Term
In the Smoldering variant of ATL, what two diseases are commonly present, and what classical characteristic of acute ATL is not present?
Definition
Skin and Lung diseases are common, but hypercalcemia is not featured
Term
In addition the usual T-cell markers present, what additional CD is present in ATL?
Definition
CD25
Term
What cells are classically featured in Anaplastic Large-Cell Lymphoma (ALK positive)?
Definition
hallmark cells with horeshoe-shaped nuclei and voluminous cytoplasm
Term
The rearrangement of the ALK gene in Anaplastic disease has the effect of doing what?
Definition
ALK rearrangement leads to constitutive activation of tyroskine kinases that trigger the JAK/STAT pathway
Term
What age group is commonly affected in Anaplastic disease?
Definition
People under 30
Term
In the primary systemic type of Anaplastic Large-Cell lymphoma, what are some common clinical indications?
Definition
There is enlargement of the lymph nodes, but the bone marrow is typically unaffected. There is involvement of extranodal sites, but there is little mediastinal mass formation.
Term
Besides the usual T-cell antigens, what other marker is found in Anaplastic leukemia that is also found in Hodgkin's Lymphoma?
Definition
CD30
Term
What is the prognosis for Anaplastic Leukemia?
Definition
Unlike the other aggressive peripheral T-cell neoplasms, the five-year survival rate is 80%/ soft tissue involvement and children being the ones affected are factors that contribute to the favorable survival odds.
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