MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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