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2012-05-17 19:58:05
USMLE Leukemia lymphoma

Boards info from Kaplan essentials
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  1. Follicular lymphoma
    Age, gene, sx, pathology
    • Median age 60-65
    • t(14;18) bcl-2
    • Painless adenopathy
    • Nodular pattern of growth and looks like germinal centers
  2. Well differentiated lymph
    Age, sx, pathology
    • Older pts
    • Hepatospenomegaly, bone marrow involvement
    • LN replaced by small, round lymphocytes with dark nuclei
  3. Poorly differentiated lymphocytic lymphoma (PDLL)
    Age, sx, pathology
    • Middle-aged or older
    • Infiltration of bone marrown, liver and spleen
    • Irregularl and indented dense chromatin nuclei
  4. Histiocytic lymphoma (B cell)
    Sx, prognosis, pathology
    • Nodal and extranodal involvement (skin, bone, GI, brain)
    • Rare liver and spleen involvment
    • Poor prognosis unless treated with chemo
    • Lrg cells with prominent nucleoli
  5. Mixed lymphocytic-histiocytic lymphoma (nodular)
    Atypical lymphocytes with histiocytes
  6. Lymphoblastic lymphoma (diffuse)
    Age, sx, prognosis, pathology
    • Bimodal - adolescents and 70's
    • Mediastinal mass (expresses T-cell markers)
    • Poor prognosis
    • Loculated or convoluted nuclear membrane
  7. Burkitt undifferentiated lymphoma
    Age, cause, gene, pathology
    • Children (endemic in Africa)
    • EBV
    • (8;14) c-myc gene
    • Large lymphocytes with lipid containing vacuoles interspersed with macrophages - "starry sky pattern"

    African kids like to see myc-ie and the Disney Starry Sky.
  8. Mantle Cell lymphoma
    Age, gene, sx, pathology
    • 60yo
    • t(11;14) bcl-1
    • Fever, night sweats, massive splenomegaly or hepatomegaly
    • Expansion of mantle zone surrounding germinal centers with small atypical lymphocytes
  9. Mycosis fungoides
    • Three phases of skin lesions: inflammation, plaque, and tumor
    • Epidermal and dermal infiltration by neoplastic T cells (CD4)
  10. Sezary Syndrome
    • Progressive pruritic erythroderma, exfoliation, and lymphadenopathy.
    • Sezary cells: T-cells with cerebriform nuclei in peripheral blood
  11. Acute lymphocytic leukemia (ALL)
    Age, sx, dx, pathology
    • Childhood (peak age 4)
    • Gingival petechiae, bone pain, thymic mass compressing trachea
    • CD10 (CALLA), TDT positive (immature cells)
  12. Acute myelogenous leukemia (AML)
    Age, sx, gene, pathology, Fab classification
    • 20% in children, most common acute leukemia in adults
    • Same sx as ALL plus lympadenopathy
    • t(15;17) protein with affinity to vit A, t(1;12) in acute promyelocytic leukemia, Auer rods (peroxidase stain), myeloblasts

    Fab classification: M0-M7
  13. Chronic myelogenous leukemia (CML)
    Age, sx, gene, pathology
    • Midde age
    • Night sweats, wt loss, giant splenomegaly
    • t(9;22) Philidelphia chromosome
  14. Hairy cell leukemia
    Sx, prognosis, pathology
    • Hepatosplenomegaly, pancytopenia
    • May be curred with 2-chloro-deoxyadenosine (apoptosis inducer)
    • Leukemic cells with "hair-like" projections, cells express tartrate-resistant acid phosphatase
  15. Adult T-cell leukemia/lymphoma
    Who?, sx, pathology
    • Endemic to Japan
    • Hepatospleno, skin involvment, hyperCa
    • Caused by Human T-cell leukemia/lymphoma virus (HTLV1)
  16. Myelodysplastic syndrome
    • Proliferation stem cell disorders
    • Presents as pancytopenia in elderly