MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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