MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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