MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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