The Lymphomas (Chapter 22)

What do lymphomas arise from?

• Lymph nodes

• Spleen

• Thymus

What is the hallmark of Hodgkin Lymphoma?

Reed-Sternberg cells

What kind of appearance do Reed-Sternberg cells give off?

“owls eye” appearance

What kind of cell is this?

Reed-Sternberg cell

What is the main cause of Hodgkin Lymphoma?

Unknown, however, it may involve the Epstein-Barr virus

How would you describe a Reed-Sternberg cell?

Clearing of the chromatin around the nucleoli forming a distinct halo

What is the most common subtype of HL?

Nodular Sclerosis

In Nodular Sclerosis HL, what kind of cells are often seen?

Lacunar cells

What kind of cell is this?

Lacunar Cell

Mixed cellularity HL

Characterized by Reed-Sternberg cells surrounded by a heterogeneous mixture of cells, including lymphocytes, histiocytes, plasma cells & eosinophils

What could this indicate?

Mixed cellularity HL

Lymphocyte-rich (LRHL)

• Characteristic background rich in lymphocytes

• About 5% of HL cases; fair prognosis

What is the rarest form of classic HL?

Lymphocyte-Depleted (LDHL)

__ is more prevalent than HL

Non-Hodgkin Lymphoma

Non-Hodgkin Lymphoma is thought to be caused by:

DNA damage leading to unregulated cell proliferation

B-Cell Non-Hodgkin Lymphomas

Arises from a single B lymphocyte that has lost its ability to control cell proliferation

Mantle cell lymphoma (MCL)

• Malignant lymphocytes that originate from the “mantle zone”

Mantle cell lymphoma is associated with the increased amount of _____

Cyclin D1 protein

When cyclin D1 is overproduced, what occurs?

Drives uncontrolled cell growth

In MCL, what genes are undergoing translocation?

Gene t(11;14)(q13;q32)

Extra-nodal MZL

Mucosa-associated lymphoid tissue (“MALT-lymphoma”) at sites such as stomach, salivary gland, lung, thyroid, or skin

Nodal MZL

Occurs within lymph nodes

• Patients with autoimmune disorders such as Sjogren’s syndrome or Hashimoto’s thyroiditis

Splenic MZL

Abnormal B cells collect in the spleen (splenomegaly)

___ and CLL are essentially the same disease

Small lymphocytic lymphoma

Richter’s transformation

Occurs when small lymphocytic lymphoma transforms to a more aggressive lymphoma

Richter’s transformation occurs in approximately ____% of patients with SLL

2-10

Hairy cell leukemia (HCL)

Rare; abundance of mature lymphocytes with oval/kidney-shaped nuclei and abundant cytoplasm and “hairy” cell surface projections

Virtually all cases of Hairy cell leukemia harbor a _____ gene mutation

BRAF V600E

Which cancer has the highest proliferation rate of all cancers?

Burkitt lymphoma

What kind of pattern does Burkitt lymphoma lead to?

A starry sky pattern of tingible-body macrophages

Where is Burkitt lymphoma endemic to?

Africa

What could these cells indicate?

Hairy cell leukemia

What could this indicate?

Burkitt Lymphoma

Peripheral T-cell lymphoma (PTCL)

Aggressive cancer mostly affecting adults; overall 5-year survival is only 25%; 20 subtypes

Anaplastic large cell lymphoma is characterized by:

“Hallmark cells” with horseshoe-shaped or kidney-shaped nuclei

What is the most frequently occurring type of primary cutaneous lymphoma?

Mycosis fungoides