MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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