Science Quiz / MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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