Science Quiz / MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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Prompt
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
prolymphocytes/paraimmunoblasts
peripheral blood involvement very common
pleiomorphic and heterogenous, difficult to predict behavior
t(14:18)
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
CD5+/BCL2+
starry sky
Prompt
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
Prompt
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-
rouleaux
13q/14q32
presents at single site, bring patients in early
flame cell
60% nodal, 40% extranodal in GI (unlike indolent lymphomas)
lipid vacuoles in cells
BCL2+
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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