Chapter 13: Hodgkin Lymphoma and Myeloid Neoplasms Flashcards Preview

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Flashcards in Chapter 13: Hodgkin Lymphoma and Myeloid Neoplasms Deck (71)
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1

What are the role of Reed-Sternberg cells in Hodgkin Lymphoma?

Release factors that induce the accumulation of reactive lymphocytes, macrophages, and granulocytes

2

Activation of which TF is a common event in class Hodgkin Lymphoma?

NF-kB

3

The lacunar variant of Reed-Sternberg cells are associated with what subtype of HL?

Nodular sclerosis subtype

4

What markers are expressed by Reed-Sternberg cells in the "classical" subtypes of HL vs. the lymphocyte predominant subtype?

- Classical = CD15+ and CD30+ and PAX5+

- Lymphocyte predominant = CD20+ and BCL6

5

The nodular sclerosis type of HL has a propensity to involve which strucutres; most commonly in whom?

Lower cervical, supraclavicular, and mediastinal nodes of adolescents and young adults

6

Which 3 subtypes of HL are most often associated with EBV?

- Mixed cellularity type

- Lymphocyte depletion type

- Lymphocyte-rich

7

Which subtype of HL has the worst overall prognosis?

Lymphocyte depletion type

8

The mixed cellularity type of HL arises most often in what age groups and has a predominance for what sex?

- Biphasic age distribution (peaks in young adults and then older adults)

- Male predominance

9

Common presenting features of mixed cellularity type of HL?

Commonly has systemic sx's, such as night sweats and weight loss

10

How is the lymphocyte-rich type of HL distinguished from the lymphocyte predominant subtype?

By presence of mononuclear variants and diagnostic Reed-Sternberg cells w/ a "classical" immunophenotypic profile

11

The lymphocyte depleted type of HL occurs most frequently in whom?

More common in older males, HIV-infected, and developing countries

12

Describe the morphology of the Reed-Sternberg cell variants found in the lymphocyte predominant type of HL.

- Multilobed nucleus resembling popcorn kernel ("popcorn cell")

- Known as lymphohistiocytic variant

13

Majority of patients with lymphocyte predominant type of HL are what sex/age; how do they present?

Typically males, usually <35 y/o presenting w/ cervical or axillary LAD

14

Which 2 subtypes of HL are more likely to be (stage III-IV) and present with sx's such as fever, night sweats and weight loss?

- Mixed-cellularity type

- Lymphocyte depletion type

15

What is the most important prognostic variable for HL with current treatment protocols?

STAGE

16

How is stage II vs. stage III HL and NHL classified?

- Stage II: involvement of 2+ LN regions on same side of diaphragm

- Stage III: involvement of LN regions on both sides of diaphragm

17

Diagnosis of Acute Myeloid Leukemias (AML) is based on what?

Presence of >20% myeloid blasts in the bone marrow

18

What are the 2 most common chromosomal rearrangements seen in AML?

t(8;21) and inv(16)

19

Acute promyelocytic leukemia (APL - M3) is associated with what translocation?

t(15;17)

20

What is seen morphologically in Acute promyelocytic leukemia (APL); high incidence of what complication?

- Numerous Auer rods, often in budles within individual progranulocytes

- Primary granules very prominent

- High incidence of DIC

21

AML with what genetic aberration is associated with a poor prognosis?

Translocations involving MLL on chromosome 11q23

22

AML with t(11q23;v); diverse MLL fusion genes usually shows some degree of what differentiation?

Monocytic

23

How does AML with t(8;21) differ from those with inv(16) rearrangements in terms of morphology?

- t(8;21): shows full range of myelocytic differentiation; Auer rods easily found = AML w/ myelocytic maturation (M2 subtype)

- inv(16): myelocytic and monocytic differentiation; abnormal eosinophilic precursors w/ abnormal basophilic granules = AML w/ myelomonocytic maturation (M4 subtype)

24

Prognosis of AML w/ MDS-like features?

Poor

25

AML with monocytic maturation is characterized by what clinically?

High incidence of organomegaly, LAD, and tissue* infiltration

26

Which type of AML is represented by the FAB class M1, M2, M3, and M4?

- M1 = AML without maturation; ≥3% blasts MPO (+)

- M2 = AML with myelocytic maturation - t(8;21)

- M3 = Acute Promyelocytic leukemia - t(15;17) - P and 3

- M4 = Acute myelo-monocytic leukemia - inv(16) - has 4 letters

27

How do myeloblasts differ from monoblasts in terms of staining?

- Myeloblasts = MPO (+) = have Auer rods

- Monoblasts = nonspecific esterase (+) = lack Auer rods

28

Which CD markers are positive on myeloid blasts?

CD34(+) and CD33 (+)

29

What are the most common presenting signs/sx's of AML?

- Fatigue (anemia) + bleeding (thrombocytopenia) + fever/infection (neutropenia)

- Spontaneous mucosal and cutaneous bleeding very common

30

Fungal skin infections, leukemia cutis, orbital granulocytic sarcoma, and infiltration of the gingiva are common features of which type of AML?

Acute monocytic leukemia (M5a/b); any with monocytic differentiation