MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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Created Feb 5, 2012ReportNominate
Tags:NHL, buzzard, dale, frank