MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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Prompt
Does dale frank hate medical students? (T/F)
osteoclast activation leads to hypercalcemia
extreme paraprotein production
Zap 70+ or Zap 70 -
Observation/Rituximab/CHOP as treatment
hypovolemia due to hypercalcemia
3 cardinal features: small mature lymphos, monocytoid B cells, plasma cells
grading based on centroblast number/nodular vs. diffuse growth
Toughie: tumor inhibiting miR-15a/MiR-16-1 lost with 13q deletion
flame cell
peripheral blood involvement very common
starry sky
Most common NHL
spread quickly to other mucosal sites but may be treated with antibiotics early
male to female ratio is 2:1
spectrum from monoclonal gammopathy of undetermined significance
plasma cells account for 10% of cellularity
not technically a lymphoma, but does involve mature B cells
paratrabecular aggregates
severe immunodeficiency due to paraprotein
lipid vacuoles in cells
diagnosis (immunophenotype) of exclusion; BCL2+, CD10-, BCL6-
uncommon, less than 5 percent
really attacks facial bones
arises from chronic inflammation (h.pylori, campy, burrelia, HepC?)
morphology (centroblastic/immunoblastic) not important
Prompt
CD5+/BCL2+
prolymphocytes/paraimmunoblasts
t(8;14) cMYC translocation
15-30% become prolymphocytic leukemia
most common lymphoid malignancy in African Americans
extranodal involvement uncommon
30-50% transform to DLBCL
10-15% get AIHA caused by benign cells
EBV positive is sometimes seen (not burkitt's!)
renal failure (casting) due to paraprotein
rouleaux
aggressive extranodal with CNS involvement
pleiomorphic and heterogenous, difficult to predict behavior
serum hyperviscosity
50% IgG, 25% IgA
fish-flesh appearance
two main types: germinal center or activated b cell
MUM1 (IRF4), BCL6, BCL10 positive
can evolve or start de novo
express CD56 (NCAM)
Ki67 100%
huge expansion of marginal zone
1/3 of all NHL's
lymphoepithelial lesions
marrow replacement leads to severe anemia
Bence Jones protein
Prompt
13q/14q32
BCL2+
smudge cells
Ki67 rate is low
proliferation rate is high, Ki67+ 40-90%
diffuse effacement/psuedofollicles
85% Bone Marrow involvement
t(11:18) common/ also t(1:14) and t(14:18)
interstitial aggregates
10% undergo Richter's transformation
most common leukemia in adults
abdominal (ileocecal) masses more common
60% nodal, 40% extranodal in GI (unlike indolent lymphomas)
three separate diseases: nodal, extranodal, splenic
most common lymphoid malignancy in childhood
t(14:18)
age>60, LDH levels up, multiple extranodal involvement are all bad prognostic signs
treatment must begin IMMEDIATELY
paraprotein production (sometimes)
multifocal, destroys bone
BCL6+, CD10+, BCL2-
deletion 13q/11q/trisomy 12/17p
mott cells
three main types: endemic, sporadic, everyone has aids
presents at single site, bring patients in early

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