Lymphomas Practice Flashcards

A comprehensive set of 50 vocabulary flashcards covering the definitions, architectural patterns, clinical presentations, and subtypes of Hodgkin and Non-Hodgkin Lymphomas.

Lymphomas

Malignant neoplasms of cells native to lymphoid tissue predominantly nodes, and most often of B-cell origin.

Non-Hodgkin Lymphoma (NHL) Presentation

Clinical presentation includes lymphadenopathy, non-tender nodal involvement, potential for non-predictable spread between nodes, and dissemination to the spleen, liver, or bone marrow.

Follicular Lymphomas architecture

Replacement of the normal lymph node architecture by uniform nodular aggregates of neoplastic B lymphocytes.

Diffuse Lymphomas architecture

Partial to total obliteration of the normal nodal architecture by neoplastic cells without a proclivity to form follicles.

Primary paracortical involvement

Neoplastic cell infiltration of the T cell-dependent paracortex by neoplastic T lymphocytes or by leukemic cells.

Mantle cell lymphomas

A pattern involving initial variable expansion of the B-cell cuff that surrounds normal germinal centers.

Revised European-American Classification

A classification system that includes both lymphomas and lymphoid leukemias.

B-cell origin percentage (NHL)

Approximately $80-85\%$ of Non-Hodgkin Lymphomas are of B-cell origin.

Follicular lymphoma frequency

Accounts for $40\%$ of adult Non-Hodgkin Lymphomas.

Follicular lymphoma progression

Approximately $30\%$ of cases will progress to large B cell lymphoma.

Small lymphocytic lymphoma frequency

Accounts for $4\%$ of adult Non-Hodgkin Lymphomas.

Small lymphocytic lymphoma and CLL relationship

Identical to chronic lymphocytic leukemia when there is $60\%$ spillage into the blood.

Large B cell lymphoma (diffuse)

An aggressive, rapidly fatal lymphoma if untreated, where $60-80\%$ of patients achieve remission with intensive chemotherapy.

Large B cell lymphoma involvement

Often involves the bone, brain, and gastrointestinal tract (GIT).

Lymphoblastic lymphoma frequency

Comprises $40\%$ of childhood lymphomas.

Lymphoblastic lymphoma clinical sign

Presents as a mediastinal mass in $50\%-70\%$ of cases.

Starry sky histology

A histological pattern where macrophages are present, characteristic of Lymphoblastic and Burkitt's lymphoma.

Burkitt’s lymphoma (African form)

Presents in children with maxilla/mandible involvement and is associated with prior EBV infection.

Burkitt’s lymphoma (sporadic form)

A form of Burkitt's lymphoma that has no association with EBV.

Hodgkin Lymphoma (Disease)

A neoplasm arising in a single node or chain of nodes, being the most common malignancy in young adults.

Reed Sternberg (RS) Cell

A large cell, typically a crippled germinal B lymphocyte, necessary but not sufficient for a diagnosis of Hodgkin Lymphoma.

RS cell morphology

Characterized by a binucleate or bilobed symmetrical nucleus with an ‘owl-eyed’ appearance.

Classical RS cells

Binucleate cells resembling owl eyes, seen in mixed cellularity and nodular sclerosis type I Hodgkin Disease.

Mononuclear RS cells

RS cell variants mainly encountered in mixed cellularity Hodgkin disease.

Pleomorphic RS cells

Large cells with hyperchromatic nuclei seen in lymphocyte-depleted and nodular-sclerosing Type II disease.

Lacunar cells

RS cell variants surrounded by an artefactual space (lacune) in histological sections, seen in nodular-sclerosing Type I HD.

Popcorn cell

A lymphocytic histiocytic variant of the RS cell with a bubbly nuclear outline, seen in lymphocyte predominant disease.

Popcorn cell origin

This variant has been shown to express B-cell markers.

Hodgkin Disease spread

Very predictable spread involving lymph nodes, spleen, liver, and bone marrow.

Stage I (Clinical Staging)

Involvement of a single lymph node region or extralymphatic site.

Stage II (Clinical Staging)

Two or more nodal regions on the same side of the diaphragm or more than one extra-lymphatic site.

Stage III (Clinical Staging)

Involvement of nodes on both sides of the diaphragm (or extra-lymphatic sites).

Stage IV (Clinical Staging)

Diffuse, disseminated involvement of the disease.

Nodular-Sclerosis Hodgkin Lymphoma (NSHL) prevalence

Accounts for $70\%$ of classical Hodgkin Lymphoma (CHL), usually occurring between the ages of $20$ and $30$ years.

NSHL Morphology

Features lacunar variants and a nodular architecture in which lymphoid tissue is surrounded by fibrosis and collagen banding.

NSHL Prognosis

Considered to have an excellent prognosis; it is the most common form of Hodgkin Lymphoma.

NSHL Mediastinal involvement

Mediastinal involvement is most common in this specific type of Hodgkin Lymphoma.

Mixed-Cellularity Hodgkin Lymphoma (MCHL)

Contains Hodgkin/Reed-Sternberg (HRS) cells against a background of eosinophils, neutrophils, macrophages, and plasma cells.

MCHL Histology

Similar to the nodular-sclerosis variety but lacks collagen bands.

MCHL frequency rank

The second most common form of Hodgkin Lymphoma.

MCHL in HIV patients

The most frequent Hodgkin Lymphoma subtype found in HIV-1-infected patients.

MCHL Mediastinal involvement

Mediastinal involvement is uncommon in this Hodgkin Lymphoma subtype.

Lymphocyte-Rich Hodgkin Lymphoma (LRHL) frequency

An uncommon variant representing less than $6\%$ of cases.

LRHL Infiltrate

Consists of a diffuse infiltrate of mature lymphocytes and macrophages with difficult-to-find typical RS cells.

LRHL Prognosis

This variant is associated with an excellent prognosis; fever and weight loss are uncommon.

Lymphocyte-Depleted Hodgkin Lymphoma (LDHL) prevalence

The least common type of classical Hodgkin Lymphoma (CHL).

LDHL Histology

Shows a predominance of tumor cells and a marked absence of background lymphocytes.

LDHL Prognosis

Without treatment, this type of Hodgkin Lymphoma has the worst prognosis.

LDHL pathogen association

Frequently associated with HIV infection and most cases are positive for EBV.

Hodgkin vs Non-Hodgkin distinction

Hodgkin Lymphoma specifically features the Reed Sternberg (RS) cell plus non-neoplastic inflammatory cells.