Science / MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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