Science / MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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