MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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