Science Quiz / MDTI - Dale Frank Lectures

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Can you name the MDTI NHL buzzwords?

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

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