MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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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)
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)
osteoclast activation leads to hypercalcemia
t(8;14) cMYC translocation
Does dale frank hate medical students? (T/F)
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
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
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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