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Leukemia within the tissues or the lymph system Lymphomas Develop in previously healthy people Lymphadenopathies Reactive Hyperplasia |
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Causes of an increased risk for developing lymphoid malignancies |
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Altered immune function Certain viruses and bacteria Exposure to chemicals or toxins |
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Enlarged lymph nodes Benign or Malignant Not necessarily a lymphoma |
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Reactive Hyperplasia (RH) |
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Non-malignant lymphomas 4 Types - Follicular, Paracortical, Sinusoidal, and Mixed Pattern |
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Most common reactive hyperplasia Seen in tonsils of children and adolescents Reaction to infections |
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Associated with virus reactions (Mono), drug reactions, and chronic skin disease Reactive Hyperplasia Type |
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Expanded subcapsular cortical medullary sinus in a lymph node Reactive Hyperplasia Type |
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Seen in toxoplasma gandhii Reactive Hyperplasia Type |
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Low Grade Lymphoid Malignancies |
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High Grade Lymphoid Malignancies |
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Clinically aggressive Kill rapidly if not treated |
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Suggests 4 stages of lymphomas |
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One single node region One single extralymphatic site Condensed to one area |
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2 or more lymph node regions of the same side of the diaphragm Either lower body (below the diaphragm) or upper body (above the diaphragm) Limited extralymphatic site |
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Lymph node regions on both sides of the diaphragm, including the spleen Limited contiguous extralymphatic site |
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Multiple or disseminated Involvement of 1 or more lymphatic organs or tissues |
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Chronic Leukemic Lymphoid Malignancies |
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Definition
Grouped together because the malignant cells are mature lymphs Primarily located in the blood and bone marrow 7 Types |
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B-Cell Chronic Lymphocytic Leukemia |
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Definition
Chronic Leukemic Lymphoid Malignancy Usually happens in older men Usually aymptomatic Lymphocytes are small with scanty cytoplasm -Ginger Snaps - >5x10^9 <10% prolymphocytes Smudge Cells CD5, CD19, CD23 with weak surface IgG Anemia, Thrombocytopenia, and Neutropenia Low grade 20% develop Richter's Transformation |
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Prolymphocytic Leukemia (PLL) |
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Definition
Chronic Leukemia Lymphoid Malignancy Aggressive leukemic disorder 2 Types - T-Cell and B-Cell |
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Definition
Symptoms include splenomegally, skin lesions, and lymphadenopathy Increased lymphocyte count with varied appearance CD2, CD5, CD7 Inv(14)q11q32 Anti-CD52 Monoclonal Antibody Therapy Most patients live 7.5 months |
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Term
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Definition
Usually found in adult males Increased lymphocytosis >300 x 10^9 55% are prolymphocytes -Large cells with moderate basophilic cytoplasm and moderately condensed chromatin and a single prominent nucleoli Anemia Decreased platelets CD20, FMC-7 with strong surface immunoglobulin Does not take well to treatment |
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Term
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Definition
Uncommon B-cell leukemia Found in middle-aged people, mostly males Lymphocytes have hairy projections on them and oval nuclei with fine chromatin Pancytopenia Massive splenomegally TRAP positive CD19, CD20, CD22, CD11c, CD25 with strong surface immunoglobulin Bone marrow lymphocytes have a "Fried Egg" appearance Dry Traps Increased cytokines Treatment is 2-chloro-deoxyadenosine, deoxycoformycine, a-interferons, or purine analogs |
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Large Granular Lymphocytic Leukemia |
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Definition
2 Types: T-Cell and Natural Killer (NK) |
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T-Cell Large Granular Lymphocytic Leukemia |
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Definition
Pancytopenia Lymphocytes have abundant pale-staining cytoplasm with azurophilic granules and are positive for rheumatoid factor CD2, CD3, CD8, CD16, CD56, CD57 The T-cell receptor is clonally rearranged Indolent Course 80% of patients live 10 years |
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NK Large Granular Lymphocytic Leukemia |
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Definition
More acute presentation Very aggressive Decreased WBC's and RBC's CD2, CD3, CD4, CD8, CD16, CD56, CD57 Rapidly fatal |
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Definition
Malignant lymphocytes with regular, convoluted nuclear outlines and fine chromatin Cutaneous T-cell leukemia Slow progression Localized treatment |
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Definition
Malignant lymphocytes with regular, convoluted nuclear outlines and fine chromatin |
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Definition
Lymphocytes with hairy projections on them, oval nucleus, and fine chromatin |
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Circulating Lymphoma Cells |
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Definition
Result from Non-Hodgkin's Lymphoma Irregular nuclear outlines with deep indentations Seen in Follicular Lymphoma aka Buttock Cells aka Butt Cells |
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Definition
2 Types: Non-Hodgkin's and Hodgkin's |
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Term
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Definition
9 Types -Small Lymphocytic Lymphoma -Follicular -Mantel Cell Lymphoma -Mucosal Associated Lymphoid Tissue Lymphoma (MALT) -Waldenstrom's Macroglobulinemia -Burkitt's Lymphoma -Lymphoblastic Lymphoma -Peripheral T/NK-Cell Lymphoma |
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Definition
2 Broad Categories: -Nodular Lymphomas -Classic Hodgkin's |
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Small Lymphocytic Lymphoma (SLL) |
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Definition
Tissue form of CLL Lymphadenopathy 10-year survival time Small lymphoid cells with course chromatin, inconspicuous nucleoli, and scanty cytoplasm Smudge cells Bone marrow shows nodular, diffuse, or interstitial infiltrations of small lymphoid cells WHO classifies this as a CLL |
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Term
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Definition
Originates from germal centers Has numerous, closely-spaced follicles that replace the normal architecture Medium-sized lymphoid cells with angular or indented nuclei Found in people aged 50-60 Most common Non-Hodgkin's Lymphoma |
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Mantel Cell Lymphoma (MCL) |
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Definition
Found in 60-year old men Absence of the large cell component Medium-sized lymphoid cells with irregular nuclear outlines Main site of involvement is the lymph nodes People live 3-5 years Poor response to therapy CD19, CD5, FMC7, slg |
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Mucosal Associated Lymphoid Tissue Lymphoma (MALT) |
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Definition
Lympho-epithelial lesions infiltrate with neoplastic lymphocytes Precede inflammatory disorders such as Helicobacter pylori, sjorins, and hashimotos Go away when the inflammatory reactions are treated 3 Types: Nodal, Extranodal, and Splenic |
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Waldenstrom's Macroglobulinemia |
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Definition
Lymphoid malignancy that causes an increased production of monoclonal IgM Symptoms include lymphadenopathies, hepatomegally, splenomegally, and hyperviscous syndrome No bone lesions Treatment involves plasmaphoresis Most people live 4 years |
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Diffuse Large B-Cell Lymphoma (DLBCL) |
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Definition
Diffuse proliferation of large lymphoid cells that replace the lymph architecture -Have single or multiple nucleoli Usually found in 60-year olds Localized and Aggressive Sensitive to multi-agent chemotherapy |
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Definition
High grade High incidence in Africa Found outside Africa in people with compromised immune systems (eg: HIV) Biopsy reveals a Starry Sky appearance -Sky = Blue nucleoli of neoplastic lymphocytes -Stars = Scattered pale-staining, chingable macrophages t(8;14) distinguishes this from DLBCL Treatment involves aggressive chemotherapy May see epstein-barr |
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Peripheral T/NK-Cell Lymphoma |
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Definition
Either have a mature T-cell or a mature NK cell Associated with post-epstein-barr infections Very aggressive Chemotherapy can work CD30 Seen in pediatric patients |
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Definition
Hodgkin's Lymphoma in which the B-cells are the neoplastic cells |
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Reed-Sternburg Cells 2+ nuclear lobes Have inclusions that look like nucleoli Have an area of nuclear clearing that looks like owl eyes |
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Definition
Rarely involve lymph nodes Secrete monoclonal immunoglobulin 3 Types: Multiple Myeloma, Plasmacytoma, Monoclonal Gammopathy of Undeteremined Significance (MGUS) |
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Definition
Multi-focal Can form multiple tumors and bone lesions throughout the body Usually found in men about 65 years-old Can be normal or abnormal plasma cells that contain Dutcher Bodies Rouloux due to increased immunoglobulins Bence Jones Proteins in the urine M-Spike on the electrophoresis Patients with 6 months without treatment -3 years with it -Longer with a bone marrow or stem cell transplant |
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Term
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Definition
Localized tumorous collection of monoclonal plasma cells Develops into MM |
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Monoclonal Gammopathy of Undetermined Significance (MGUS) |
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Definition
Clonal serum immunoglobulin Mild mirror of plasmacytoma Will see a low level of serum monoclonal protein without neoplasms Chance of this occurring increases with age 25% develop into MM |
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