MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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