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B cell lymphomas are more common in what population?
Males, older ages
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CD (cluster designation)20
Small B cell
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Hypogammaglobulinemia
CLL
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What age does CLL affect?
>40
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Most arise in post germinal center memory B cells
Marginal zone lymphoma
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m/c type of extranodal MZL
Gastric maltoma
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may arise from helicobacter pylori
Gastric maltoma
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Lymphoma seen in the breast, eye and skin
Gastric maltoma
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What autoimmune diseases are associated with extranodal MZL/MALToma?
Hashimotos, Sjogrens
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Lymphoma where cells may have villous projections, an indolent course, and found in older females
Splenic marginal zone lymphoma
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Associated w/ Deletion in chromosome 7q21
Splenic marginal zone lymphoma
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Lymphoma with neutrophil infiltration, marginal zone pattern, and monocytoid B cell component
Nodal marginal zone lymphoma
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What genetic mutations are involved with follicular cell lymphoma?
- t(14;18) translocation
- bcl-2 gene
- Addition of other genetic problems inactivating TP53 deleting P38/MAPK (antiapoptotic)
- Activation of C-MYC
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What is a low grade follicular lymphoma?
follicular small cell
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What is a higher grade follicular cell lymphoma?
Diffuse large cell
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What population is affected by mantle cell lymphoma typically?
middle aged and elderly males
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Aggressive small cell lymphoma with poor response to chemotherapy and extranodal involvement
Mantle cell lymphoma
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Mutation involved with mantle cell lymphoma
- Cyclin D , overexpression from t(11;14)
- Overcomes suppressor effects of retinoblastoma and p27 protein
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What is the survival rate for aggressive mantle cell lymphoma?
3-4 years
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Rapidly growing, sxmatic, lymphoma with a mass at a single site (either nodal or extranodal)
Large B cell lymphoma
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Cleaved and non-cleaved large cells, Diffuse counterpart of nodular follicular lymphoma, More aggressive
LBCL-centroblastic
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Large vesicular nucleus, prominent nucleolus, thick nuclear membrane, nuclear huff
LBCL-immunoblastic
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What diseases is LBCL-immunoblastic associated with?
Hashimotos, Sjogrens, SLE
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Big bubbly nucleus
Large B cell immunoblastic
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Reactive T cell population
LBCL-Tcell/histiocyte rich
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Diffuse growth pattern with fine interstitial fibrosis
LBCL-Tcell/histiocyte rich
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Large bizarre, tumor cells with vascular involvement
LBCL-anaplastic
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Superior vena cava syndrome-->enlarged neck veins, engorgement of the head
Primary mediastinal thymic LBCL
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Locally invasive, multilobulated cells
Primary mediastinal LBCL
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Primary CNS lymphoma is associated with what viruses
HIV primarily, also EBV
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Primary CNS lymphoma is associated with what dz and virus?
HIV primarily, also EBV
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HIV associated lymphoma caused by HHV-8
Primary effusion lymphoma
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Homogeneous medium sized cells, rounded nuclei, multiple nucleoli , basophilic cytoplasm
Burkitt Lymphoma
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Cytoplasmic lipid vacuoles with multiple large macrophages
Burkitt lymphoma
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Starry sky pattern
Burkitt lymphoma
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Rapid cell turnover, proliferation, and apoptosis
Burkitt lymphoma
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What type of Burkitt lymphoma involves jaw and facial bones, where EBV is 100%?
Endemic
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What type of Burkitt lymphoma involves abdominopelvic region, terminal ileum, cecum, and ovaries?
Non-endemic
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What type of Burkitt lymphoma is systemic, extranodal, not in CNS, associated with EBV?
Immunodeficiency
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Are Burkitt lymphomas passive or aggressive?
All are aggressive
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How do peripheral T cell lymphomas compare to B cell lymphomas?
They are less common than B cell lymphomas, some have a worse prognosis, some have a better prognosis
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Psoriasis type skin lesions
Adult T cell lymphoma/leukemia
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What population is most commonly affected by adult T-cell lymphoma/leukemia?
More common in Japan (rare in US)
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Aggressive lymphoma with hypercalcemia and lytic bone lesions due to increased osteoclastic activity
Adult T cell lymphoma/leukemia
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Associated with human retrovirus HTLV1
Adult T cell lymphoma/leukemia
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Anaplastic large cell lymphoma is more common in what population?
Young adults
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cell with large eccentrice nuclei with prominent nucleoli
Anaplastic large cell lymphoma
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ALK1 antigen***
Anaplastic large cell lymphoma
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Aggressive lymphoma with genearlized systemic sx and eosinophils
Angioimmunoblastic T-cell lymphoma
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Presents with advanced disease, prominent vascularity
Angioimmunoblastic T-cell lymphoma
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Pautrier's microabscesses
Mycosis fungoides
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Cells with cerebriform nuclei (convolusion and grooves, looking like the brain)
Mycosis fungoides
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Papillary dermal fibrosis
mycosis fungoides
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A lymphoma that arises in the skin, looks like a fungal infection, with an indolent but progressive course
Mycosis fungoides
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Mycosis fungoides with generalized adenopathy and cerebriform cells in the circulation
Sezary syndrome
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Mycosis fungoides with peripheral involvement
Sezary syndrome
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Lymphoma with trisomy of chromosome 8
Hepatosplenic T-cell lymphoma
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young black males
Hepatosplenic T-cell lymphoma
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Lymphoma with monotonous small to medium sized cells and an aggressive course
Hepatosplenic T-cell lymphoma
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Sinusoidal infiltration of liver, spleen, and marrow
Hepatosplenic T-cell lymphoma
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Reed-Sternberg cells
Hodgkins Disease
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Lymphocyte predominance, mixed cellularity, lymphocyte depletion, nodular sclerosis
Hodgkin Disease
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Popcorn cells
HD lymphocyte predominance
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Prognosis of HD-lymphocyte predominant
excellent
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HD with large number of lymphocytes mixed with histocytes
Lymphocyte predominance
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Heterogenous cellular infiltrate presenting more often as disseminated disease
HD-mixed cellularity
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Reed Sternberg cells plentiful
HD-mixed cellularity
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What population tends to be affected by HD-mixed cellularity?
Pts over 50, M>F
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What is the least common form of HD?
HD-lymphocyte depletion
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Disseminated disease, PAUCITY
OF LYMPHOCYTES,ABUNDANCE OF R-S CELLS
HD-lymphocyte depletion
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M/C form of Hodgkin's Disease
Nodular sclerosis
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Hyperlobate nuclei, multiple necleoli, surrounding by clear spaces
Lacunar cells, a R-S variant associated with HD-nodular sclerosis
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COLLAGEN BANDS DIVIDE LYMPHOID TISSUE INTO NODULES
HD-Nodular sclerosis
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INVOLVES LOWER CERVICAL, SUPRACLAVICULAR AND MEDIASTINAL LN
HD-Nodular sclerosis
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What population is most commonly affected by HD-nodular sclerosis?
F>M, adolescents or young adults
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What is the most important prognostic indicator of HD?
clinical stage, because it spreads from LN to LN
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Hodgkins lymphoma stage one
Single node region or single extralymphatic organ or site
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Hodgkins lymphoma stage two
two or more nodes on the same side of the diaphragm or localized involvement of an extralymphatic organ or site
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Hodgkins lymphoma stage three
Involvement of LN regions on both sides of the diaphragm or localized involvement of an extralymphatic organ or spleen or both
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Hodgkins lymphoma stage four
Diffuse or disseminated involvement of one or more extralymphatic organs with or without associated LN involvement
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