MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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