Term
| What are the features of chronic nonspecific lymphadenitis? |
|
Definition
| follicular hyperplasia, paracortical hyperplasia, sinus histiocytosis |
|
|
Term
| Name the Non-hodgkin B cell lymphomas? |
|
Definition
| chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), mantle cell lymphoma, marginal zone lymphoma, follicular lymphoma, plasmacytoma/plasma cell myeloma, diffuse large B0cell lymphoma, burkitt lymphoma |
|
|
Term
| Name the T cell non hodgkin's lymphoma? |
|
Definition
| anaplastic large cell lymphoma, cutaneous T cell lymphoma, extranodal NK/T-cell lymphoma, peripheral T cell lymphoma (unclassified) |
|
|
Term
| Name the two Hodgkin's lymphomas. |
|
Definition
| nodular lymphocyte predominant hodgkin lymphoma; classic HL (nodular sclerosis, mixed cellularity, lymphocyte-rich, lymphocyte-depleted) |
|
|
Term
| What is the B cell area of the lymph node? |
|
Definition
|
|
Term
| What is the t cell area of the normal lymph node? |
|
Definition
|
|
Term
| Where is the plasma cell area of a normal lymph node? |
|
Definition
|
|
Term
| Where in a normal lymph node are histiocytes found? |
|
Definition
|
|
Term
| What is a typical lymph node size? |
|
Definition
|
|
Term
| A fluctuant rubbery node is typical of... |
|
Definition
|
|
Term
| "shotty" nodes that feel like buckshot under the skin are typical of... |
|
Definition
| children with viral illnesses |
|
|
Term
| What is matted lymphadenopathy? |
|
Definition
| nodes feel connected and can move as a unit or be fixed in place. May be benign (TB, sarcoid) or malignant (lymphoma or mets) |
|
|
Term
| In what location does LAD have the highest risk of metastatic malignancy? |
|
Definition
| supraclavicular (90% for pts over 40, 25% in pts under 40) |
|
|
Term
| Where is cat scratch disease LAD usually located? |
|
Definition
|
|
Term
| What are the MC sites of nonspecific acute lymphadenitis? |
|
Definition
cervical= oral cavity infections
inguinal= infections of extremities |
|
|
Term
| A generalized lymphadenopathy can be due to what kind of situation? |
|
Definition
| child with systemic viral infection |
|
|
Term
| What is the physical exam findings of nonspecific acute lymphadenitis? |
|
Definition
| nodes are tender, fluctuant, and the over lying skin is reddened |
|
|
Term
| What is the histological appearance of nonspecific acute lymphadenitis? |
|
Definition
| follicular hyperplasia with neutrophils around the follicles and within the sinuses |
|
|
Term
| What are the clinical characteristics of cat scratch lymphadenitis? |
|
Definition
| axillary or cervical lymphadenopathy, history of exposure to cats/scratches on arms |
|
|
Term
| What is the histology of cat scratch lymphadenitis? |
|
Definition
stellate microabscesses, necrotizing granulomas
bartonella henselae (gram negative bacillus) seen on warthin-starry stain |
|
|
Term
| What types of diseases cause folllicular hyperplasia? |
|
Definition
| early HIV, RA, toxoplasma |
|
|
Term
| What are the features of follicular hyperplasia associated with crhonic nonspecific lymphadenitis? |
|
Definition
| preservation of LN architectures, polarized mantle zone, well defined germinal centers that vary in size and shape, and tingible body macrophages |
|
|
Term
| What causes paracortical hyperplasia? |
|
Definition
| immunologic reaction to drugs (dilantin), acute viral infection (IM), poast vaccination |
|
|
Term
| What are the characteristics of paracortical hyperplasia? |
|
Definition
| T-cell activation, T cells encroach and efface germinal centers, hypertrophy of sinusoidal and vascular endothelial cells |
|
|
Term
| What causes sinus histiocytosis? |
|
Definition
| lymphatic sinuses distended with histiocytes; seen in lymph nodes draining carcinoma (e.g. breast) |
|
|
Term
|
Definition
| proliferation in the bone marrow and usually the peripheral blood. Can be acute (immature/blasts) or chronic (mature) |
|
|
Term
| What are the different types of leukemia? |
|
Definition
| granulocytic, monocytic, erythrocytic, lymphocytic |
|
|
Term
|
Definition
| proliferation of lymphoid cells in discrete tissue masses usually not seen in peripheral blood |
|
|
Term
| Are lymphomas malignant or benign? |
|
Definition
| all malignant but behavior can range from indolent to aggressive |
|
|
Term
| What percent of lymphoid neoplasms are B cell origin? |
|
Definition
|
|
Term
| T/F All lymphoid neoplasms are monoclonal proliferations. |
|
Definition
| true, they are all derived from a single transformed cell |
|
|
Term
| T/F You need histologic examination of lymphoid neoplasms in order to diagnose them. |
|
Definition
|
|
Term
| How do you diagnose lymphomas? |
|
Definition
| microscopic recognition of the dominant cell type supplemented by immunologic and cytogenetic/molecular techniques |
|
|
Term
| How do you treat lymphomas/determine the prognosis? |
|
Definition
| based upon the dominnat cell type (and its inherent biological behavior), extend of spread (stage), and underlying health of the patient |
|
|
Term
| T/F Indolent lymphomas can further mutate and transform to aggressive types. |
|
Definition
|
|
Term
| What are the characteristics of hodgkin's lymphoma? |
|
Definition
| localized to a single axial group of nodes, oderly spread by contiguity, mesenteric nodes and waldeyer ring rarely involved, extranodal involvement uncommon |
|
|
Term
| What are the characteristics of nonhodgkin lymphoma? |
|
Definition
| more frequent involvement of multiple peripheral nodes, noncontiguous spread, waldeyer ring and mesenteric nodes commonly involved, extranodal involvement common |
|
|
Term
| Name some supplemental/ancillary techniques to diagnose lymphoma/leukemia? |
|
Definition
| flow cytometry immunophenotyping, immunohistochemistry on tissue sections, cytogenetics |
|
|
Term
| How do you perform flow cytometry/immunophenotyping? |
|
Definition
| cells flow through a smal quartz capillary tube at a constant velocity and are illuminated by 1 or more focused light sources. Forward scatter measures cross sectional area/size. Side scatter measures complexity/granularity |
|
|
Term
| How is B cell clonality determined via flow cytometry immunophenotyping? |
|
Definition
| light chain restriction (kappa versus lambda) |
|
|
Term
| What enzyme is used in immunohistochemistry? |
|
Definition
| immunoperoxidase based staining |
|
|
Term
|
Definition
| CD19, 20, 23, 79a and surface immunoglobulins |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What translocation is associated with mantle cell lymphoma? |
|
Definition
|
|
Term
| What translocation is associated with follicular lymphoma? |
|
Definition
|
|
Term
| What translocation is associated with burkitt lymphoma? |
|
Definition
|
|
Term
| What translocation is associated with anaplastic large cell lymphoma? |
|
Definition
|
|
Term
| Name some examples of small cell, mature B cell neoplasms? |
|
Definition
| chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), mantle cell lymphoma, follicular lymphoma, marginal zone lymphoma |
|
|
Term
| Name an example of a plasma cell mature b cell neoplasm? |
|
Definition
| plasmacytoma, plasma cell myeloma |
|
|
Term
| Name an example of a large cell mature b cell neoplasm. |
|
Definition
| diffuse large b cell lymphoma |
|
|
Term
| Name an example of a medium cell mature b cell neoplasm. |
|
Definition
|
|
Term
| WHat is a precursor b cell neoplasm? |
|
Definition
| precursor b lymphoblastic leukemia/lymphoma |
|
|
Term
| What is chronic lymphocytic leukemia/small lymphocytic lymphoma? |
|
Definition
| neoplasm of monomorphic small, round B lymphocytes in the peripheral blood, bone marrow and lymph nodes |
|
|
Term
| What's the differenct between chronic lymphocytic leukemia and small lymphocytic lymphoma? |
|
Definition
| SLL is restricted to tissue, non-leukemic; CLL invovles bone marrow and peripheral blood |
|
|
Term
| How many lymphocytes are in the peripheral blood when you have CLL? |
|
Definition
|
|
Term
| What is the most common leukemia in the western world? |
|
Definition
| crhonic lymphocytic luekemia |
|
|
Term
| What percent of NHL is SLL? |
|
Definition
|
|
Term
| What is the age and gender preference of CLL/SLL? |
|
Definition
most common >50 yoa (median is 60)
M:F::2:1 |
|
|
Term
| What are the symptoms and prognosis of CLL and SLL? |
|
Definition
| frequently asymptomatic and median survival is 7 years |
|
|
Term
| What is the immunophenotype of CLL and SLL? |
|
Definition
| coexpresion of CD19 or CD20 (b cell marker) with CD5 (t cell marker). Positive CD23 |
|
|
Term
| What is the appearance of mantle cell lymphoma cells? |
|
Definition
| resemble normal mantle layer cells: small, slightly irregular nuclei with a nodular architecture. |
|
|
Term
| What is the immunohistochemistry of mnatle cell lymphomas? |
|
Definition
CD19+, CD20+, CD5+, Cyclin D1+
CD23- |
|
|
Term
| Describe the pathology behind the translocation of mantle cell lymphoma? |
|
Definition
| juxtaposes cyclin D1 gene on chromosome 11 next to immunoglobulin heavy chain gene on chrmosome 14. This causes over-expression of cyclin D1 a protein that promotes proliferation |
|
|
Term
| How do you treat/what is the prognosis of mantle cell lymphoma? |
|
Definition
|
|
Term
| What is the most common NHL in the US? |
|
Definition
| follicular lymphoma (45%) |
|
|
Term
| What is the age/gender preference of follicular lymphoma? |
|
Definition
|
|
Term
| How do follicular lymphomas present? |
|
Definition
| painless, generalized LDN |
|
|
Term
| What percent of follicular lymphomas invovle the bone marrow? |
|
Definition
| 85% (paratrabecular, high stage) |
|
|
Term
| What is the prognosis of follicular lymphoma? |
|
Definition
| indolent course but incurable; 7-9 year life expectancy |
|
|
Term
| Do follicular lymphomas transform to aggressive lymphomas? |
|
Definition
| yes 30-50% do; frequently diffuse large B cell |
|
|
Term
| What is the histology of follicular lymphoma? |
|
Definition
| nodular growth pattern; neoplastic cells resemble normal germinal center B cells |
|
|
Term
| What is follicular lymphoma a tumor of? |
|
Definition
| centrocytes (small cleaved cells), and centroblasts (large cells with open chromatin and prominent multiple nucleoli |
|
|
Term
| What are the CD markers of follicular lymphoma? |
|
Definition
CD19+, 20+, 10+ (CALLA), Bcl2+
CD5- |
|
|
Term
| Describe the translocation involved in follicular lymphoma? |
|
Definition
| t(14:18) leads to an over expression of Bcl2 which is an anti-apoptotic protein. FL stain positively for Bcl2 and reactive follicles are negative |
|
|
Term
| What is the cell origin of marginal zone lymphoma? |
|
Definition
|
|
Term
| What are the different types of marginal zone lymphomas? |
|
Definition
| may be nodal, extranodal (MALT); splenic |
|
|
Term
| Infections cause what types of marginal zone lymphomas? |
|
Definition
| gastric (malt), (helicobacter pylori) |
|
|
Term
| What kinds of autoimmune diseases are associated with marginal zone lymphoma? |
|
Definition
| thyroid (hashimoto's), salivary glands (Sjorgren's) |
|
|
Term
| What is the prognosis/course of marginal zone lymphomas? |
|
Definition
| usually localized, indolent; can get generalized late in course of disease, may regress if inciting agent is eradicated |
|
|
Term
| What is the histology of marginal zone lymphomas? |
|
Definition
| small cells with variable mixture nuclear shapes (round, irregular, cleaved) |
|
|
Term
| What are the markers for marginal zone lymphoma? |
|
Definition
| CD19+, CD20+, CD5-, CD10- |
|
|
Term
| Small B cell lymphomas all have which CD markers in common? |
|
Definition
|
|
Term
| What is a tumor that has CD19+, CD20+, CD3-, CD5+, CD23+, CD10-? |
|
Definition
|
|
Term
| What kind of tumor is CD19+, CD20+, CD3-, CD5+, CD23-, CD10-, Cyclin D1+? |
|
Definition
|
|
Term
| What kind of tumor has CD19+, CD20+, CD3-, CD5-, CD23-, CD10+, Bcl2+? |
|
Definition
|
|
Term
| What kind of tumor is CD19+, CD20+, CD3-, CD5-, CD23-, CD10-? |
|
Definition
|
|
Term
| What is diffuse large b cell lymphoma? |
|
Definition
| fastr growing tumor composed of large B cells that presents as a rapidly enlarging mass at nodal or extranodal sites and can be rapidly fatal if untreated |
|
|
Term
| What is the age/gender preference for diffuse large B cell lymphoma? |
|
Definition
| male predominance; median age is 60 yrs |
|
|
Term
| What percent of NHLs are diffuse large b cell lyphomas? |
|
Definition
|
|
Term
| What is the prognosis of diffuse large b cell lymphoma? |
|
Definition
| rapidly fatal if untreated. 60-80% remission with aggressive chemo. 50% potentially "cured" |
|
|
Term
| What percent of diffuse large b cell lymphomas have extranodal involvement? |
|
Definition
|
|
Term
| AntiCD20 (rituximab) is used for what lymphoma/leukemia? |
|
Definition
| diffuse large b cell lymphoma |
|
|
Term
| HIV related diffuse large b cell lymphoma is usually... |
|
Definition
|
|
Term
| T/F Burkitt lymphoma is an indolent neoplasm. |
|
Definition
|
|
Term
| Burkitt lymphoma often presents in _______ sites. |
|
Definition
|
|
Term
| What age/gender is common for burkitt lymphoma? |
|
Definition
| children/young adults; M:F::2-3:1 |
|
|
Term
| What are the three different forms of burkitt lymphoma? |
|
Definition
| endemic, sporadic (non endemic), HIV related |
|
|
Term
| What are the characteristics of endemic burkitt's lymphoma? |
|
Definition
| africa, jaw, abdominal viscera, all EBV+ |
|
|
Term
| What are the characteristics of sporadic (nonendemic) burkitt's lymphoma? |
|
Definition
| extranodal, abdominal mass, ileocecum, most EBV negative |
|
|
Term
| What are the characteristics of HIV-related burkitt's lymphoma? |
|
Definition
| usually eaerlier than large B cell lymphoma, most eBV+ |
|
|
Term
| What is the histology of Burkitt lymphoma? |
|
Definition
| diffuse infiltrate of monomporphic medium sized B cells with basophilic cytoplasm and round nuclei with 2-5 nucleoli. Also has many interspersed histiocytes ("starry sky" pattern) with many mitotic figures and apoptotic bodies |
|
|
Term
| What are the markers for burkitt lymphoma? |
|
Definition
| CD10+, CD20+, Bcl6+, Bcl2-, TdT- |
|
|
Term
| What is the proliferaiton index of burkitt's lymphoma? |
|
Definition
|
|
Term
| Describe the pathology of the translocation behind burkitt's lymphoma. |
|
Definition
| juxtaposes c-myc (ch. 8) with IgH (cg. 14) cuasing over expression of cmyc which is a pro-proliferative/anti-apoptotic protein |
|
|
Term
| Plasma cell neoplasms account for what percent of all hematologic malignancies? |
|
Definition
|
|
Term
| What are the different types of plasma cell neoplasms? |
|
Definition
| plasma cell myeloma (multiple myeloma), plasmacytoma, monoclonal immunoglobin deposition diseases (amyloidosis), heavy chain disease |
|
|
Term
| What is the most common lymphoid malignancy in blacks? |
|
Definition
|
|
Term
| What is the age/gender of Multiple myeloma? |
|
Definition
|
|
Term
| What is the prognosis of multiple myeloma? |
|
Definition
| usually incurable; median survival rate is 3 years |
|
|
Term
| What are the CD markers of multiple myeloma? |
|
Definition
| CD38+, CD79a+, CD138+, usually CD56+ |
|
|
Term
| What parts of the skeleton are typically involved in MM? |
|
Definition
| vertebrae, ribs, skull, pelvis, femur, clavicle, and scapula |
|
|
Term
| What are the clinical features of MM? |
|
Definition
C= hypercalcemia
R= renal failure; recurrent infections
A= anemia
B= bone lesions, "punched out", vertebral collapse, bone pain, pathologic fx |
|
|
Term
| T/F MM is usually associated with hepatosplenomegally and lymphoadenopathy? |
|
Definition
|
|
Term
| What is the #1 cause of death for MM patients? |
|
Definition
|
|
Term
| What do you call proteins in the urine as a result of MM? |
|
Definition
|
|
Term
| Which plasmacytomas usually progreses to MM? |
|
Definition
| solitary plasmacytoma of bone |
|
|
Term
| Describe the features of plasmacytomas and give two examples of plasmacytomas? |
|
Definition
| solitary lesions of bone or soft tissue that are plasma cell tumors and can be controlled locally by radiation therapy 1) solitary plasmacytoma of bone 2)extraosseus plasmacytoma |
|
|
Term
| What are examples of precursor T cell neoplasms? |
|
Definition
| precursor T lymphoblastic leukemia/lymphoma; blastic NK cell lymphoma |
|
|
Term
| What percent of NHL are mature T cell neoplasms? |
|
Definition
|
|
Term
| Which lymphoma is more common in asia? |
|
Definition
|
|
Term
| What are the CD markers of mature T cell neoplasms? |
|
Definition
|
|
Term
| What are the immunologic markers of T cell clonality? |
|
Definition
| there are none: the loss of normally expressed antigens implies T cell clonality. Loss of CD5 and CD7 is most common |
|
|
Term
| What are the two types of anaplastic large cell lymphomas? |
|
Definition
| ALK positive and ALK negative |
|
|
Term
| What is the age range of ALCL, ALK+? |
|
Definition
| 3% of adult NHLs and 10-30% of childhood lymphomas |
|
|
Term
| Where are ALCL, ALK+ tumors? |
|
Definition
| both lymph nodes and extranodal sites |
|
|
Term
| What are the symptoms of ALCL, ALK+? |
|
Definition
| B symptoms; present with high stage disease |
|
|
Term
| What are the histological/immunological characteristics of ALCL, ALK+? |
|
Definition
| CD30+, ALK+, t(2;5)/NPM-ALK, loss of multiple pan-t cell antigens |
|
|
Term
|
Definition
| provisional category in WHO 2008 for older age group 40-65 yoa. poorer prognosis |
|
|
Term
| Where aer ALCL ALK- cases? |
|
Definition
| less freqently in extranodal sites |
|
|
Term
|
Definition
| anaplastic lymphoma kinase |
|
|
Term
| What is the histological hallmark for ALCL? |
|
Definition
| horseshoe shapped ALCL hallmark cells |
|
|
Term
| What is the survival rate for ALK+ ALCL versus ALK- ALCL? |
|
Definition
ALK+= 80% 5 year survival
ALK-= 40% 5 year survival |
|
|
Term
| What percent of patients with ALCL present with stage III to stage IV disease? What are the characteristics of stage III/IV? |
|
Definition
| 70% (with peripheral and/or abdominal dz, often with marrow involvement, often with extranodal sites; often with B symptoms) |
|
|
Term
| What is teh translocation pathology of ALCL? |
|
Definition
| t(2;5) juxtaposes ALK on ch 2 and NPM on ch.5. ALk encodes a tyrosine kinase protein that is oncogenic |
|
|
Term
| What causes cutaneous T cell lymphoma? |
|
Definition
| CD3+, CD4+ helper T cells that home to the skin |
|
|
Term
| T/F Mycosis fungoides and sezary syndrome are different manifestations of a single neoplastic entity. |
|
Definition
|
|
Term
| What is mycosis fungoides? |
|
Definition
| early pathc lesion with plaque and tumor stages. Indolent course |
|
|
Term
| What are the characteristics of sezary syndrome? |
|
Definition
generalized disease. Triad of erythroderma, generalized LAD, and sezary cells in lymph nodes, skin or peripheral blood
aggressive dz |
|
|
Term
| What histological feature is characteristic of mycosis fungoides? |
|
Definition
|
|
Term
| What neoplasm has cerebri looking lymphocytes? |
|
Definition
|
|
Term
| What part of the world is endemic for extranodal NK/T-cell lymphoma, nasal type? |
|
Definition
|
|
Term
| What patient population is most common for extranodal NK/T-cell lymphoma, nasal type? |
|
Definition
| asians, immunosuppressed, post-transplants pts |
|
|
Term
| What are the physical symptoms of extranodal NK/T-cell lymphoma, nasal type? |
|
Definition
| nasal obstruction, epistaxis, midfacial destructive lesions |
|
|
Term
| A "lethal midline granuloma" is characteristic of... |
|
Definition
| extranodal NK/T-cell lymphoma, nasal type |
|
|
Term
| Where can extranodal NK/T cell lymphoma, nasal type disseminate to? |
|
Definition
| skin, soft tissue, Gi, testis (marrow involvement very uncommon) |
|
|
Term
| What virus is associated with extranodal NK/T-cell lymphoma, nasal type? |
|
Definition
|
|
Term
| How do you treat extranodal NK/T cell lymphoma, nasal type? |
|
Definition
|
|
Term
| What is the gross growth pattern of extranodal NK/T-cell lymphoma, nasal type? |
|
Definition
| iffuse infiltrate with angiocentric and angiodestructive pattern. Causes vascular destruction with necrosis |
|
|
Term
| What is the cytotoxic phenotype of extranodal NK/T cell lymphoma, nasal type? |
|
Definition
| CD56+, CD2+, sCD3-, cyCD3+ |
|
|
Term
| What is the heterogenous, wastebasket cateogry of lymphoma? |
|
Definition
|
|
Term
|
Definition
| mostly nodal but any site can be involved. Usually generalized with marrow involvement. Blood often involved causing a leukemic presentation |
|
|
Term
| What are the symptoms of PTCL? |
|
Definition
| most B symptoms and poor performance status |
|
|
Term
| What are the paraneoplastic features of PTCL? |
|
Definition
| eosinophilia, pruritis, hemophagocytic syndrome |
|
|
Term
| What is the behavior of PTCL, indolent or aggressive? |
|
Definition
|
|
Term
| What does PTCL stand for? |
|
Definition
| peripheral T cell lymphoma, unspecified |
|
|
Term
| What is the pathognomic morphologic feature for PTCL, U? |
|
Definition
|
|
Term
| What CD markers are positive for PTCL, U? |
|
Definition
CD2, CD3, CD5, CD7 (T cell markers)
may drop out CD5 or CD7 |
|
|
Term
| What does NLPHL stand for? |
|
Definition
| nodular lymphocyte predominant HL |
|
|
Term
| What percent of all cases of HL are nodular lymphocyte predominat HL (NLPHL)? |
|
Definition
|
|
Term
| What are the different types of classic HL and their percent of incidence? |
|
Definition
nodular sclerosis (NSHL)- 70%
mixed cellularity (MCHL)- 20-25%
lymphocyte rich - 5%
lymphocyte depleted - <1% |
|
|
Term
| Which LN are affected by nodular lymphocyte predominant hodgkin lymphoma (NLPHL)? |
|
Definition
| high cervical, axillary or inguinal nodes (rare in mediastinal, splenic, BM rare) |
|
|
Term
| What is the age distribution of NLPHL? |
|
Definition
|
|
Term
| What is the M:F ratio of nodular lymphocyte predominant hodgkin lymphoma (NLPHL)? |
|
Definition
|
|
Term
| What percent of NLPHL is in stage I or II at diagnosis? |
|
Definition
|
|
Term
| What is the behavior/course/prognosis of nodular lymphocyte predominance hodgkin lymphoma? |
|
Definition
| indolent, remains responsive to therapy usually, early stage prognosis excellent, advanced stages have unfavorable outcomes. Can progress to LBCL |
|
|
Term
| What are "popcorn cells"? |
|
Definition
| characteristic cells of nodular lymphocyte predominance hodgkin lymphoma that are CD20+, CD15-, and CD30- |
|
|
Term
| What age is common for classic hodgkin lymphoma? |
|
Definition
| bimodal incidence peak: 15-30 and >55 yoa |
|
|
Term
| What percent of CHL exhibit EBV? |
|
Definition
|
|
Term
|
Definition
| painless enlargement of nodes or mediastinal mass |
|
|
Term
| Which LN are affected by HL? |
|
Definition
| cervical, mediastinal, axillary, periaortic regions |
|
|
Term
| What percent of patients with hodgkin lymphoma have B symptoms? |
|
Definition
| 40% (older patietns and young children HL have advanced disease with B symptoms) |
|
|
Term
|
Definition
| fever > 38 degrees C, drenching night sweats, unexplained loss of >10% of body weight in the previous 6 months |
|
|
Term
| What is teh most important prognostic factor for HL? |
|
Definition
|
|
Term
| What is the treatment for HL? |
|
Definition
| irradiation in localized disease, chemotherapy with disseminated |
|
|
Term
| Long-term survivors of HL have increased risk of.. |
|
Definition
|
|
Term
|
Definition
| involvement of single lymph node region (I) or single extranodal site (IE) |
|
|
Term
|
Definition
| involvement of two or more lymph node regions on the same side of diaphragm |
|
|
Term
|
Definition
| involvement of LN regions on both sides of the diaphragm |
|
|
Term
|
Definition
| multiple foci of involvement of one or more extralymphatic organs or tissues |
|
|
Term
| Each stage of HL can be divided into A or B, which means... |
|
Definition
| A menas absence of symptoms; B means presence of symptoms |
|
|
Term
|
Definition
| presence of reed sternberg or hodgkin cells in an appropriate cellular background. |
|
|
Term
|
Definition
| epithelial membrane antigen |
|
|
Term
| What is the immunophenotype of nodular LP? |
|
Definition
CD45+, CD20+, EMA+
CD30-, CD15- |
|
|
Term
| What is the immunophenotype of classic HL? |
|
Definition
CD30+, CD15+
CD45-, CD20-, EMA- |
|
|
Term
| What age/gender does nodular sclerosis affect? |
|
Definition
| teenage and young adults (median age 28), M:F::1:1 |
|
|
Term
| At what stage does nodular slcerosis HL present at? |
|
Definition
|
|
Term
| What is a common presentation of nodular slcerosis? |
|
Definition
| dyspnea due to frequent mediastinal involvement |
|
|
Term
| What characterizees nodular sclerosis HL? |
|
Definition
| collagen bands in node and lacunar RS cells |
|
|
Term
| How does the prognosis of nodular sclerosis HL compare to mixed cellularity or lymphocyte depleted? |
|
Definition
| prognosis of nodular sclerosis HL is better than mixed cellularity or lymphocyte depleted |
|
|
Term
| What percent of hodgkin lymphomas are lymphocyte rich? |
|
Definition
|
|
Term
| What type of HL has the highest median age? |
|
Definition
|
|
Term
| What is the gender preferance of lymphocyte rich? |
|
Definition
|
|
Term
| What HL has the best suvival rate of all clasical HL? |
|
Definition
|
|
Term
| Which nodes are involved in lymphocyte rich CHL? |
|
Definition
| peripheral nodes commonly involved |
|
|
Term
| What is histological description of mixed cellularity CHL? |
|
Definition
| mix of lymphocytes, plasma cell, eosinophils, and RS cells |
|
|
Term
| In what patient population is mixed cellularity CHL most common? |
|
Definition
| pts with HIV and in developing countries |
|
|
Term
| What is the age/gender preference of mixed cellularity CHL? |
|
Definition
|
|
Term
| Which HL has uncommon mediastinal involvement? |
|
Definition
|
|
Term
| What stage does mixed cellularity CHL present as? |
|
Definition
|
|
Term
| Does mixed cellularity CHL commonly have symptoms? |
|
Definition
|
|
Term
| What is lymphocyte depleted CHL? |
|
Definition
| diffuse form of CHL rich in RS cells and depleted of non-neoplastic cells; most often diagnosed in HIV+ patietns whose nodes are depleted of lymphocytes |
|
|
Term
| What is the median age and gender preference of lymphocyte depleted CHL? |
|
Definition
|
|
Term
| What is the presenting stage and symptoms of Lymphocyte depleted CHL? |
|
Definition
| usually advanced stage (70%) and B symptoms (80%) |
|
|
Term
| T/F Course of lymphocyte depleted CHL is comparable with other CHL of similar stage |
|
Definition
|
|
Term
| What are the functions of the spleen? |
|
Definition
| phagocytosis of blodo cells and particular matter (filtration of unwanted elements from the blood); antibody production; hematopoiesis (lymphoreticular cells and sometimes hematopoietic cells (extramedullary hematopoiesis in some disease staes), sequestration of blood elements (reserve pool and storage site) |
|
|
Term
| What percent of total platelet mass can be squestered by the spleen? |
|
Definition
|
|
Term
| Splenomegally may cause a condition called ___ characterized by... |
|
Definition
| hypersplenism; anemia, leukopenia, thrombocytopenia |
|
|
Term
| Splenic infarcts are most often caused by... |
|
Definition
| emboli, most often from heart valves (may be septic) |
|
|
Term
| Regardless of the cause of a splenic infarct, most splenic infarcts occur in.. |
|
Definition
| enlarged spleens b/c blood supply is tenuous and easily compromised |
|
|
Term
| What causes splenic insufficiency? |
|
Definition
| splenectomy, autoinfarction (sickle cell dz) |
|
|
Term
| Splenic insufficiency leads to increased susceptibility to sepsis by __________. |
|
Definition
| encapsulated bacteria (pneumococcus, meningococcus, H. influenzae) |
|
|
Term
| What are accessory spleens? |
|
Definition
| small and spherical extra spleens located anywhere in the abodminal cavity |
|
|
Term
| What is the clinical significance of accessory spleens? |
|
Definition
| if overlooked then the benefit of therapeutic splenectomy may be reduced or lost (hereditary spherocytosis, immune thrombocytopenia) |
|
|
Term
| What cells are present in the thymus? |
|
Definition
| naive T cells, thymic epithelial cells, b cells (may form thymic b cell lymphoma), dendritic cells |
|
|
Term
|
Definition
| uncommon rarely exceed 4 cm, usually discovered at autopsy or during surgery |
|
|
Term
| What developemental disorder is associated with aplasia of the thymus? |
|
Definition
|
|
Term
| What are the characteristics of DiGeorge syndrome? |
|
Definition
| severe defects in cell-mediated immunity, part of 22q11 deletion syndrome, recurrent viral and fungal disease, parathyroid hypoplasia, congenital heart disease |
|
|
Term
| What causes thymic (follicular) hyperplasia? |
|
Definition
chronic inflammatory and immunologic states; most frequently seen with myasthenia gravis but also seen in graves' disease, lupus, RA, and other autoimmune disorders
also seen in neoplasms |
|
|
Term
| Which neoplasms are associated with the thymus? |
|
Definition
| germ cell tumors, lymphomas, carcinoids, and thymomas |
|
|
Term
| What age/gender is typical of thymomas? |
|
Definition
|
|
Term
|
Definition
| anterior superior mediastinum (like lymphomas) |
|
|
Term
| What are the subtypes of thymoma? |
|
Definition
| cytologically benign and non-invasive; cytologically benign and invasive thru the capsule (may metastasize), cytologically malignant (thymic carcinoma) which usally invades adjacent structures and are difficult to remove |
|
|
Term
| What is the clinical presentation of thymomas? |
|
Definition
| impingement on mediastinal structures; myasthenia gravis and other autoimmune dzs such as pure red cell aplasia and graves' |
|
|
Term
| Why are AI dzs associated with thymomas? |
|
Definition
| long-lived CD4+ and CD8+ are likely to be associated with AI dzs |
|
|
Term
| How do you treat thymoma associated AI dzs? |
|
Definition
| removal of the thymoma can resolve the AI d/o |
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