MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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