Intro to Lymphomas

Aggressiveness of follicular lymphoma

Low‑grade, indolent lymphoma with slow progression

Cytogenetic abnormality in follicular lymphoma

t(14;18) in 85% of patients

Aggressiveness of Diffuse Large B Cell Lymphoma (DLBCL)

Intermediate‑grade, aggressive lymphoma requiring prompt treatment

Cytogenetic abnormality sometimes seen in Diffuse Large B Cell Lymphoma (DLBCL)

Up to 30% have t(14;18) (like Follicular lymphoma)

Aggressiveness of Burkitt lymphoma

High‑grade, extremely aggressive with 24–48 hr doubling time

Cytogenetic abnormality in Burkitt lymphoma

MYC rearrangement involving chromosome 8

Where treatment must be directed in addition to systemic therapy for Burkitt lymphoma

CNS prophylaxis is mandatory due to high CNS involvement risk because of aggressiveness

What is a lymphoma?

Genetic abnormalities resulting in uncontrolled proliferation of neoplastic lymphocytes at a particular developmental stage

Primary vs Secondary Lymphoid Tissues

Primary: Bone marrow (B cells) and Thymus (T cells)

Secondary: Lymph nodes, spleen, tonsils, and lymphoid tissue in GI and pulmonary tracts(where things enter body)

B cells in Primary Follicles are____

Naive B cells that havent been exposed to an antigen

B Cells in secondary follicles are____

Proliferating after an encounter with an antigen

Dark zone of germinal center consists of what cells?

Centroblasts (use tnt to BLAST in DARK caves)

Light zone in germinal center has what cells?

Centrocytes (Cytes bring the Lights)

Cortex of thymus hold___. The medulla of the thymus holds___.

Cortex contains developing lymphocytes (T cells). Medulla contains fully developed T cells (5%)

T cell receptor produced from alpha and beta genes are primarily located where?

They primarily stay in the Thymus. (normal alpha and beta don’t get to travel exotic places)

T cell receptor produced from gamma and delta genes are primarily located where?

Primarily migrate to various places in body (ex: epithelium of GI tract to help with mucosal defense)»Delta takes you to various places

Difference between Lymphoma and Leukemia

Lymphoma- not circulating in the blood (can be in lymph nodes, bone marrow, tonsils)

Leukemia(white blood)-circulates in the blood

Types of Non-Hodgkin Lymphomas (Don’t need to memorize)

Follicular Lymphoma diagnosis

“Small cleaved cells”, Flow cytometry: CD20+, CD10+, bcl-2+ and CD5-; 85% have t(14;18)

Follicular lymphoma treatment (general)

Chemo to mow the grass; not very aggressive cancer

Diffuse Large B Cell Lymphoma cell lineage + Flow cytometry

B Cell: CD19+ and CD20+

Diffuse Large B Cell Lymphoma (DLBCL) standard treatment

RCHOP: Rituximab, Cyclophosphamide, Hydroxy-doxorubicin(doxorubicin), Oncovin(vincristine), Prednisone

3 types of Burkitt’s Lymphoma/Leukemia

African(endemic)-affects jaw or facial bone, other extralnodal sites; EBV almost always found

American (sporadic): affects lymph nodes in abdomen, GI tract, kidneys, extranodal sites

Immunodeficiency-associated: primarily in HIV patients + allograft recipients

Diagnosis of Burkitt’s Lymphoma

Via tissue» Starry sky pattern, CD20+, CD10+, CD5(-)»MUST HAVE CHROMOSOME 8 C-MYC