Follicular Hyperplasia vs Lymphoma Quiz
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Questions and Answers

What characterizes follicular hyperplasia?

  • No invasion of the capsule (correct)
  • Pinpoint spaces occupied by macrophages
  • Loss of clear margins
  • Monomorphic follicles

    • Which feature distinguishes follicular lymphoma from follicular hyperplasia?

  • Clear well-defined margins
  • Limited proliferation
  • Polymorphic follicles
  • Monomorphic follicles (correct)

    • How does follicular lymphoma affect the capsule and adjacent fat?

  • It preserves the capsule
  • It reduces macrophage presence
  • It maintains distinct margins
  • It invades the capsule and adjacent fat (correct)

    • What is one of the key roles of Bcl-2 in follicular lymphoma?

    <p>Antagonize apoptosis</p> Signup and view all the answers

    What are the characteristics of the follicles in follicular hyperplasia compared to follicular lymphoma?

    <p>Follicles in hyperplasia show clear, well-defined margins</p> Signup and view all the answers

    What type of cells populate the germinal centers in follicular hyperplasia?

    <p>Polymorphic cells</p> Signup and view all the answers

    What happens to the space occupied by macrophages in follicular lymphoma?

    <p>It becomes pinpoint and lost</p> Signup and view all the answers

    What happens to apoptosis in the germinal center during follicular hyperplasia?

    <p>It is a normal occurrence</p> Signup and view all the answers

    How does Bcl-2 staining differ between benign follicles and malignant follicles?

    <p>In benign, only inactive lymphocytes stain</p> Signup and view all the answers

    What is the chromosomal abnormality associated with Follicular lymphoma?

    <p>Bcl-2-IgH t(14:18)</p> Signup and view all the answers

    Which lymphoma is described as being aggressive and responsive to treatment?

    <p>Diffuse Large B-Cell lymphoma</p> Signup and view all the answers

    What is the role of Bcl-2 in neoplastic growth?

    <p>Controls apoptosis</p> Signup and view all the answers

    Which lymphoma is identified as having the characteristic presence of follicles?

    <p>Follicular lymphoma</p> Signup and view all the answers

    What chromosomal translocation is typical for Mantle Cell lymphoma?

    <p>Cyclin D1-IgH t(11:14)</p> Signup and view all the answers

    What effect does the Cyclin D1-IgH t(11:14) have on cell cycle progression?

    <p>Promotes G1 to S progression</p> Signup and view all the answers

    What is a common characteristic of Burkitt's lymphoma?

    <p>C-myc loci t(8:14)</p> Signup and view all the answers

    Which factor is primarily controlled by Bcl-6 in lymphomas?

    <p>Maturation of B cells</p> Signup and view all the answers

    Which lymphoma exhibits features of the Warburg effect?

    <p>Burkitt's lymphoma</p> Signup and view all the answers

    Which lymphoma is typically treated for an indolent course?

    <p>Follicular lymphoma</p> Signup and view all the answers

    What is the cure rate for Stage 1 and Stage 2 diseases?

    <p>90%</p> Signup and view all the answers

    Which characteristic defines Stage 2 of the Ann Arbor Classification?

    <p>Two or more lymph node sites on one side of the diaphragm</p> Signup and view all the answers

    What is the significance of tumor cell composition in higher stages?

    <p>Few RS can be easily destroyed by chemotherapy</p> Signup and view all the answers

    What is a common complication of chemotherapy and radiation?

    <p>Development of other forms of cancer</p> Signup and view all the answers

    What defines Stage 4 of the Ann Arbor Classification?

    <p>Extensive involvement of extranodal sites</p> Signup and view all the answers

    What symptoms are used to further classify all stages of the Ann Arbor classification?

    <p>Fever, night sweats, or unexplained weight loss</p> Signup and view all the answers

    What characterizes the tumor phase of Large Granular T-cell Lymphocytic Leukemia?

    <p>Development of an enlarging mass/lesion on the skin</p> Signup and view all the answers

    Which statement is true regarding Mycosis Fungoides?

    <p>Malignant lymphocytes form a bulging, tumoral mass.</p> Signup and view all the answers

    What is the most common variant of Hodgkin's Lymphoma?

    <p>Nodular Sclerosis</p> Signup and view all the answers

    What is the prognosis for indolent tumors like Mycosis Fungoides?

    <p>Indolent with a good prognosis</p> Signup and view all the answers

    What distinguishes Sezary Syndrome from other conditions?

    <p>It is characterized by splenomegaly and lymphadenopathy.</p> Signup and view all the answers

    Which markers are positive in the Nodular Sclerosis variant of Hodgkin's Lymphoma?

    <p>CD15 and CD30</p> Signup and view all the answers

    What is the survival rate for patients with indolent tumors over a typical duration?

    <p>8 to 9 years</p> Signup and view all the answers

    In Nodular Sclerosis, what characterizes the tumor's structure?

    <p>Collagen or fibrous bands between nodules</p> Signup and view all the answers

    What type of cells replace the Reed-Sternberg cells in this tumor?

    <p>Lacunar cells</p> Signup and view all the answers

    What happens during the inflammatory phase of Mycosis Fungoides?

    <p>Appearance of flat, reddish patchy areas</p> Signup and view all the answers

    What potential development can occur if indolent tumors are left untreated?

    <p>They may evolve into a systemic condition.</p> Signup and view all the answers

    Which demographic is primarily affected by Nodular Sclerosis?

    <p>Young adults</p> Signup and view all the answers

    What structure is often observed in Nodular Sclerosis?

    <p>Acellular tissue with pink color</p> Signup and view all the answers

    Which characteristic describes indolent tumors regarding their location?

    <p>They are limited to the skin for long periods.</p> Signup and view all the answers

    What is the prognosis for patients with Nodular Sclerosis?

    <p>Very good prognosis</p> Signup and view all the answers

    What is the initial appearance of lesions in the inflammatory phase of Mycosis Fungoides?

    <p>Flat, reddish patchy areas</p> Signup and view all the answers

    What is the implication of tumor surface involvement in the prognosis of indolent tumors?

    <p>More involvement correlates with worse survival outcomes.</p> Signup and view all the answers

    How do lacunar cells appear under microscopy?

    <p>Large cells with clear space around nuclei</p> Signup and view all the answers

    What treatment consideration is essential for Hodgkin's Lymphoma with lymphocytic predominance?

    <p>Aggressive chemotherapy regimen</p> Signup and view all the answers

    Which lymphocyte markers are typically negative in the non-classic variants of Hodgkin's lymphoma?

    <p>CD15 and CD30</p> Signup and view all the answers

    Study Notes

    Follicular Hyperplasia vs Follicular Lymphoma

    • Follicular hyperplasia is benign, while follicular lymphoma is malignant.
    • Follicular hyperplasia has polymorphic follicles with a clear well-defined margin between the germinal center and inactive mantle zone.
    • Follicular lymphoma has monomorphic follicles with no clear margin between the germinal center and inactive mantle zone.
    • Germinal centers in follicular hyperplasia contain pinpoint pale areas due to macrophages, and proliferation is limited by the capsule.
    • Follicular lymphoma lacks macrophages and shows invasion of the capsule and adjacent fat.

    Bcl-2 Staining in Benign vs Malignant Follicles

    • In a benign follicle, Bcl-2 stains only the inactive lymphocytes of the mantle zone, not the germinal centers.
    • In a malignant follicle, Bcl-2 stains all cells, both in the central and peripheral zones.
    • Bcl-2 antagonizes apoptosis and promotes survival of follicular lymphoma cells.

    Types of Lymphomas and their Chromosomal Abnormalities

    • Follicular Lymphoma:
      • Involves Bcl 2-IgH t(14:18) translocation.
      • Bcl-2 controls apoptosis.
    • Diffuse Large B-Cell Lymphoma:
      • Involves Bcl-6 (30%) and Bcl-2 (10%) mutations.
      • Bcl-6 controls maturation and inhibits p53.
    • Mantle Cell Lymphoma:
      • Involves Cyclin D1-IgH t(11:14) translocation.
      • Cyclin D1 promotes G1 to S phase progression and causes the Warburg effect.
    • Burkitt Lymphoma:
      • Involves C-myc loci t(8:14) translocation.
      • These translocations play a role in neoplastic growth and contribute to the characteristics of each lymphoma type.

    Mycosis Fungoides

    • It is an indolent tumor that is limited to the skin for long periods.
    • It involves infiltration of the skin by neoplastic CD4 T cells.
    • Prognosis: Good, but may evolve into a systemic condition if left untreated.
    • Survival rate: 8 to 9 years.

    Clinical Stages of Mycosis Fungoides

    • Inflammatory Phase (Patch Stage): Flat-reddish patchy areas usually in the trunk.
    • Plaque Stage: Multiple, flat, map-like, reddish areas usually in the trunk, progressing to involve the extremities.
    • Tumoral Stage: Malignant lymphocytes form a bulging, tumoral mass, instead of a flat, elevated lesion.
    • Sezary Syndrome: Involves invasion of the circulation causing splenomegaly, lymphadenopathy, and invasion of other organs.

    Nodular Sclerosis Variant of Hodgkin's Lymphoma

    • It is the most common variant of Hodgkin's lymphoma.
    • It is characterized by collagen or fibrous bands separating lymph nodes into circumscribed tumor nodules.
    • Shows lacunar cells, large cells with clear spaces around the nuclei, replacing Reed-Sternberg cells.
    • It affects young adults equally in males and females.
    • Has a very good prognosis.
    • Positive markers: CD15 and CD30.

    Ann Arbor Classification of Hodgkin's Lymphoma

    • Stage 1: Only a single lymph node group or a single extranodal site involved.
    • Stage 2: Two or more lymph node sites on one side of the diaphragm are involved, or limited contiguous extranodal site involvement.
    • Stage 3: Lymph node sites on both sides of the diaphragm are involved, with splenic or limited contiguous extranodal involvement, or both.
    • Stage 4: Extensive involvement of extranodal sites, with or without lymph node involvement.
    • All stages are further divided based on the presence or absence of fever, night sweats, and unexplained weight loss.
    • Stages 1 and 2 have a cure rate of 90%, disseminated diseases have a 70% cure rate.
    • The 5-year survival rate remains high even in higher stages due to the tumor cells consisting only of a few Reed-Sternberg cells.

    Important Considerations

    • Chemotherapy and radiation are effective treatments for Hodgkin's lymphoma.
    • However, complications can arise for patients treated with these therapies.
    • Hodgkin's lymphoma patients may develop other forms of cancer.
    • The five types of Hodgkin's lymphoma are classified based on their cell type and histological appearance.
    • Understanding the characteristics of each type is crucial for diagnosis and treatment planning.

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    Description

    Test your knowledge on the differences between follicular hyperplasia and follicular lymphoma. This quiz covers key characteristics, pathology findings, and the significance of Bcl-2 staining in benign vs malignant follicles. Perfect for students and professionals in pathology and oncology.

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