Science / MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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