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49 Cards in this Set
- Front
- Back
Where are B cells typically found in lymph nodes?
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Cortex
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Where are T cells typically found in lymph nodes?
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Paracortex
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Where do lymphomas originate from in the lymph nodes?
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The germinal centers
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Where do mantle cell lymphomas originate from?
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the mantle zone
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What is a cause of marginal zone expansion in lymph nodes?
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Hyperplastic syndromes
Marginal zone lymphomas |
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What is a primary follicle?
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A follicle without a germinal center
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What are the most common types of B-cell non-Hodgkins lymphoma?
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1. Diffuse large B cell lymphoma
2. Follicular lymphoma |
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What are the most common types of Hodgkin lymphomas?
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Classic hodgkin lymphoma
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What are the different types of B-cell non-Hodgkin lymphomas?
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Chronic lymphocytic leukemia/small lymphocytic lymphoma
Follicular lymphoma Mantle cell lymphoma Diffuse large B-cell lymphoma Marginal zone lymphoma |
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What are the aggressive lymphomas?
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Mantle cell lymphoma
DLBCL Burkett lymphoma |
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What are the more indolent lymphomas?
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CLL/SLL
Marginal zone Follicular |
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What does it mean when referring to a B-cell lymphoma that is restricted?
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Monoclonal expression of a kappa;lambda light chain as determined by flow cytometry
This is abnormal! |
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What are good markers for B cells?
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CD20
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What are good markers for T cells? What do you have to confirm?
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CD2, 3, 5, 7
You need to see that they're expressed at the same level to confirm that there's not a T cell lymphoma |
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What does CLL/SLL look like?
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Nuclei that are odd looking
Too many T cells |
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How do you confirm a diagnois of CLL/SLL?
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Flow cytometry
Biopsy |
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What's diagnostic for CLL/SLL in a lymph node?
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Proliferation centers!
lots and lots of the CLL/SLL cells all growing in one place |
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What immunohistochemistry stains are used to diagnose CLL/SLL?
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CD20
CD5 CD5 is aberrantly expressed...normally it's a T cell marker! |
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What do you see in flow cytometry for CLL/SLL?
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Dim CD20
Dim immunoglobulin +CD23 |
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Where can mantle cell lymphomas present?
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Nodes
Inside the intestine as polyps Spleen |
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What is the appearance of the cells in mantle cell lymphomas?
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More angular
Lots of them Irregular nuclear patterns |
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What marker is specific for mantle cell lymphoma?
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Cyclin D1
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What are the immunohistochemial findings in mantle cell lymphoma?
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+CD20
+CD5 +cyclin D1 |
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What do you find in flow cytometry for mantle cell lymphoma?
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Moderate to bright CD20
Moderate to bright light chain |
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What do you find on FISH for mantle cell lymphoma?
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t(11;14) CCND1/IgH
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What does a lymph node look like in follicular lymphoma?
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Nodularity!
Lack of normal node structure |
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What is the appearance of the cells in follicular lymphoma?
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Small cells
Small cells with clefts: centrocytes Hollowed out nuclei with multiple nucleoli: centroblasts (grading) Dispersed chromatin with a central nucleoli: FDC (follicular dendritic cells) |
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What makes a follicular lymphoma higher grade?
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More centroblasts per high powered field.
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What are the findings in immunohistochemistry for follicular lymphomas?
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CD20
Germinal center markers: CD10 BCL6 |
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What do you find on FISH in follicular lymphoma?
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t(14,18): immunoglobulin heavy with the BCL2
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What's the zoomed out appearance of marginal zone lymphoma?
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Monocytoid: it looks more white than normal
Colonization of the germinal centers |
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What is a Dutcher body? What condition is it found in?
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Intranuclear inclusions of IgGs
It's found in marginal zone lymphomas |
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What are the subtypes of marginal zone lymphomas?
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Extranodal MALT: stomach, conjuctiva, salivary gland
Nodal marginal zone lymphoma Splenic marginal zone lymphoma |
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What is a common cause of gastric MALTs?
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H. pylori infection
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What do you see in marginal lymphomas?
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Lymphoepithelial lesions: the lymphocytes are invading the epithelium!
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What's the problem with the diagnosis of marginal zone lymphomas?
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They don' have any specific immunohistochemical markers
You can only use CD20 to confirm it's a B-cell; it's a diagnosis of exclusion |
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What's the appearance of the cells in a diffuse large B-cell lymphoma?
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Big!
Dark/hyperchromatic Atypical looking! |
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What do you find in large b cell lymphoma more than in other types?
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Necrosis.
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What immunohistochemistries do you do for large B cell lymphomas?
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CD20: see if it's a B cell
10: see if it came from a germinal center |
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What's the progression of a Burkitt lymphoma?
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Fast; it's an aggressive mass
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How does a Burkitt lymphoma typically present?
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Terminal mass in the ileum of a child
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What are the types of hodgkin lymphoma?
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Classical hodgkin lymphoma
Nodular lymphocyte predominant hodgkin lymphoma |
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What are the subtypes of classical hodgkin lymphoma subtypes?
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Nodular sclerosis
Mixed celluarity (inflammatory cells) Lymphocyte rich (lymphocytes all over the place) Lymphocyte depleted (rare!) |
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How does nodular sclerois typically present?
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Mediastinal mass in a young person
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What are the type of neoplastic cells in the nocular sclerosis subtype of hodgkin lymphoma?
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Reed-sternberg cells/variants
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What is the typical appearance of Reed-Sternberg cells?
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Lots of free space
Binucleate Prominent nuclei They look like owl eyes! |
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What type of cells are reed-sternberg cells?
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B cells
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What do you almost always see in Hodgkin lymphomas?
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Inflammatory background
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What is the immunophenotype for Hodgkin lymphoma?
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CD30
CD15 |