MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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