Chapter 13: Common Forms of Lymphoid Leukemia and Lymphoma Flashcards Preview

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Flashcards in Chapter 13: Common Forms of Lymphoid Leukemia and Lymphoma Deck (48)
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1

There is an association with smoking and which neoplastic proliferation of white cells?

Acute myeloid leukemia

2

Among lymphoid cells, potentially oncogenic mutations occur most frequently where and during what?

Germinal center B cells during attempted antibody diversification

3

What is CD11c expressed on?

- Granulocytes, monocytes, and macrophages

- Also expressed by hairy cell leukemias

4

How does the spread of Hodgkin lymphoma differ from that of NHL's?

- Hodgkin spreads in an orderly fashion

- Most forms of NHL spread widely early in their course and in less predictable fashion

5

Any child presenting with very low platelet counts has what until proven otherwise?

Acute lymphoblastic leukemia (ALL)

6

B-ALL is most often associated with what translocation?

t(12;21)

7

What is the cell of origin for B-ALL?

Bone marrow precursor B cell

8

90% of ALLs have numerical or structural chromosomal changes; most common is what?

Hyperploidy  (>50 chromosomes)

9

Which immunostaining marker and B-cell markers are positive in B-ALLs?

- (+) for TdT

- Express CD10, CD19, and CD20

10

A majority of T-ALLs have gain of function mutation in what gene?

NOTCH1

11

Which CD markers are expressed by the cells of T-ALLs?

CD2 to CD8

12

Although genetically and immunophenotypically distinct, what are the clinical features shared between ALL and AML?

- Abrupt onset within days to weeks

- Sx's related to depression of marrow function, fever, infection, bleeding

- Mass effects, including bone pain; generalized LAD, hepatosplenomegaly; testicular enlargement

13

CNS manifestations such as HA, vomiting, and nerve palsies from meningeal spread are more common in which neoplasia of WBC's?

ALL

14

What are 3 factors associated with a worse prognosis of ALL?

- Age <2 y/o

- Presentation in adolescence or young adults

- Peripheral blasts >100,000

15

What are 5 features of ALL which would be associated with a favorable prognosis?

- Age btw 2-10 y/o

- Low WBC count

- Hyperdiploidy

- Trisomy of chromosomes 4, 7, and 10

- Presence of t(12;22)

16

What are the most common genetic anomalies associated with CLL/SLL?

Trisomy 12, deletions of 11q, 13q, and 17p

17

Which distinct CD markers are expressed by the cells of CLL/SLL?

CD19 and CD20, as well as CD5*** and CD23

18

When present, which finding in the lymph nodes is pathognomonic for CLL/SLL?

Proliferation centers = large lymphocytes gathered in loos aggregates that contain mitotically active cells

19

What is the absolute lymphocyte count of peripheral blood in CLL that distinguishes it from SLL?

>5000 mm3

20

Uncommon, nucleated B cells known as prolymphocytes are sometimes seen in the lymph nodes assoc. w/ what neoplasm?

CLL/SLL

21

What is a characteristic finding on peripheral smear in CLL?

Smudge cells

22

How does the leukocyte count vary between CLL and SLL?

- CLL can have leukocyte counts in excess of 200,000 m3

- SLL can present have leukopenia with marrow involvement

23

Most common age group and salient clinical features of CLL/SLL; minority of patients develop what?

- Older adults w/ bone marrow, LN, spleen, and liver disease

- Autoimmune hemolysis and thrombocytopenia in a minority

24

Which finding due to disruption of normal immune function is common in CLL/SLL?

HYPOgammaglobulinemia which ↑ susceptibility to infections

25

The presence of which mutated gene is associated with worse outcomes in CLL/SLL?

NOTCH1

26

Development of a rapidly enlarging mass within a LN or spleen in pt with CLL/SLL is suggestive of what?

Richter syndrome --> prolymphocyte transformation to diffuse large B cell lymphoma = ominous event; survival <1 year

27

Follicular lymphoma arises from where; what is the hallmark translocation?

- Arise from germinal center B cells

- Hallmark = t(14;18) --> BCL2-IgH fusion gene

28

Follicular lymphoma most often occurs in what age group and which sex?

Middle aged adults; M=F

29

Which 4 features of follicular lymphoma distinguish it from reactive follicular hyperplasia?

- Disruption of normal LN architecture

- Lack of tingible body macrophages in germinal centers

- Bcl2 expression in follicles

- Monoclonality

30

The neoplastic cells of follicular lymphoma express which markers?

- CD19, CD20, CD10; surface Ig, and BCL6

- BCL2 is expressed in 90%