Hematology: Lymphoma Overview
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Questions and Answers

What are lymphomas?

Lymphomas are a group of diseases caused by malignant lymphocytes that accumulate in lymph nodes and cause the characteristic clinical features of lymphadenopathy.

What are the two main types of lymphoma?

  • Leukemia
  • Hodgkin's lymphoma (correct)
  • Myeloma
  • Non-Hodgkin's lymphoma (correct)

What is the main difference between Hodgkin's and Non-Hodgkin's lymphoma?

Hodgkin's lymphoma is characterized by the presence of Reed-Sternberg cells, while Non-Hodgkin's lymphoma does not.

What histological subtype of Hodgkin's disease is characterized by collagen bands and lacunar cells?

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

Which of these is NOT a clinical symptom of Hodgkin's lymphoma?

<p>Painless, non-tender, asymmetrical, firm, discrete, and rubbery enlargement of superficial lymph nodes (D)</p> Signup and view all the answers

Hodgkin's lymphoma typically arises in a single node or chain of nodes and spreads characteristically to contiguous lymph nodes.

<p>True (A)</p> Signup and view all the answers

What type of lymphoma is characterized by large cells with prominent nucleoli that efface nodal architecture?

<p>Diffuse large B cell lymphoma</p> Signup and view all the answers

What type of lymphoma is characterized by a "starry sky" appearance?

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

What is the predominant feature of myelofibrosis?

<p>Progressive generalized reactive fibrosis of the bone marrow.</p> Signup and view all the answers

What is the blood film in myelofibrosis characterized by?

<p>Tear drop cells (C)</p> Signup and view all the answers

What is the main characteristic of essential thrombocythemia?

<p>A persistently elevated platelet count greater than 450,000/μL.</p> Signup and view all the answers

Polycythemia Vera is a clonal stem cell disorder characterized by increased red cell production.

<p>True (A)</p> Signup and view all the answers

Flashcards

Lymphomas

Diseases caused by malignant lymphocytes that accumulate in lymph nodes, leading to characteristic lymphadenopathy. May sometimes spread to the blood ('leukaemic phase') or infiltrate organs outside the lymphoid tissue.

Myeloproliferative Disorders (MPDs)

A group of disorders arising from bone marrow stem cells characterized by clonal proliferation of one or more hematopoietic components in the bone marrow.

Reactive Nodular Hyperplasia

Reactive nodular hyperplasia is a non-malignant, reactive process that occurs in lymph nodes in response to various stimuli like infections, autoimmune disorders, or inflammation.

Hodgkin's Lymphoma (HL)

Marked by the presence of Reed-Sternberg cells in lymph nodes. These cells are large, binucleated or bilobed, with prominent nucleoli.

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Non-Hodgkin's Lymphomas (NHL)

A group of lymphomas characterized by the absence of Reed-Sternberg cells, and are generally more aggressive than Hodgkin's lymphoma.

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Reed-Sternberg (RS) Cells

Large, abnormal cells found in Hodgkin's lymphoma, characterized by binucleated or bilobed nuclei with prominent nucleoli.

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Lymphocyte-Rich Hodgkin's Lymphoma

A subcategory of Hodgkin's lymphoma with lymphocyte-rich infiltrate and a few Reed-Sternberg cells.

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Mixed Cellularity Hodgkin's Lymphoma

A subcategory of Hodgkin's lymphoma with a mixed infiltrate of lymphocytes and Reed-Sternberg cells.

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Nodular Sclerosis Hodgkin's Lymphoma

A subcategory of Hodgkin's lymphoma characterized by broad bands of fibrosis separating tumor nodules., featuring lacunar cells - large cells with a prominent surrounding space.

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Lymphocyte-Depleted Hodgkin's Lymphoma

A subcategory of Hodgkin's lymphoma with sparse lymphocytes and abundant Reed-Sternberg cells.

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Nodular Lymphocyte-Predominant Hodgkin's Lymphoma

A subcategory of Hodgkin's lymphoma characterized by a nodular architecture and the presence of 'popcorn cells' - large, pale-staining lymphohistiocytic cells.

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Burkitt's Lymphoma

A highly aggressive B-cell lymphoma characterized by a starry-sky appearance due to tingible body macrophages containing nuclear debris scattered among tumor cells.

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Diffuse Large B Cell Lymphoma

A common and aggressive subtype of NHL. It is characterized by large, atypical B cells with prominent nucleoli.

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Polycythemia Vera (PV)

One of the three major types of MPDs, characterized by an excess of red blood cells, leading to a high hematocrit.

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Essential Thrombocythemia (ET)

One of the three major types of MPDs, characterized by unusually high platelet count.

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Myelofibrosis (MF)

One of the three major types of MPDs, characterized by bone marrow fibrosis, splenomegaly, and often anemia.

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Erythromelalgia

A clinical manifestation of PV, characterized by burning pain, redness, and swelling in the extremities.

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JAK2, CALR, or MPL mutation testing

A blood test used to detect the presence of specific mutations in the JAK2, CALR, or MPL genes, which are characteristic of certain MPDs.

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Bone Marrow Biopsy

A procedure involving extraction of bone marrow for microscopic examination to assess the cellularity, morphology, and presence of fibrosis.

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Erythropoietin (EPO) Level

A blood test that measures the level of erythropoietin in the blood. Erythropoietin is a hormone that stimulates red blood cell production.

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Neutrophil Alkaline Phosphatase (NAP) score

A measure of the overall activity of neutrophils, a type of white blood cell. Elevated NAP scores are usually associated with infections.

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B symptoms

A group of signs and symptoms commonly seen in some lymphomas, including fever, night sweats, and unintentional weight loss.

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Positron Emission Tomography (PET) Scan

A method of imaging that uses a radioactive tracer to detect abnormal metabolic activity in tissues and organs.

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PET-CT Scan

A type of medical imaging that combines the anatomical detail of CT scans with the functional information of PET scans.

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Biopsy

A diagnostic procedure involving removal of a section of tissue for microscopic examination.

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Excisional Biopsy

The removal of an entire tumor or lesion for analysis.

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Splenomegaly

An abnormal increase in the size of the spleen.

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Hepatomegaly

An abnormal increase in the size of the liver.

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Blood Smear

A microscopic examination of a blood sample to assess the number, size, and shape of blood cells.

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Leukoerythroblastosis

The appearance of immature red and white blood cells in the peripheral blood, often seen in myelofibrosis.

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Tear-Drop Cells

A type of red blood cell with a teardrop shape, often seen in myelofibrosis.

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Chemistry Panel

A blood test that measures the levels of specific chemicals in the blood, such as lactate dehydrogenase (LDH) and uric acid.

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Complete Blood Count (CBC)

A complete blood count, a test that measures the different types of blood cells in the blood.

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Study Notes

Hematology

  • Hematology is the study of blood and blood disorders.
  • Lymphomas are diseases caused by malignant lymphocytes accumulating in lymph nodes.
  • Lymphadenopathy is a characteristic feature of lymphomas, often accompanied by splenomegaly
  • Lymphomas are divided into Hodgkin's and Non-Hodgkin's lymphomas.
  • Hodgkin's lymphoma is characterized by Reed-Sternberg (RS) cells.
  • RS cells are large, binucleated, with a clear halo surrounding the nucleus.
  • Hodgkin's lymphoma subtypes include nodular sclerosis, mixed cellularity, lymphocyte-rich, and lymphocyte-depleted.
  • Lymph node architecture is often effaced by large cells in Non-Hodgkin lymphomas.
  • Non-Hodgkin's lymphomas include Burkitt's lymphoma and diffuse large B-cell lymphoma.
  • Burkitt's lymphoma is characterized by a high mitotic rate, typically affecting children and young adults.
  • Diffuse large B-cell lymphoma is characterized by large cells with prominent nucleoli and open chromatin.
  • Reactive nodular hyperplasia is a reactive lymphoid tissue response.
  • Reactive hyperplasia is often characterized by lymphoid follicles with germinal centers.
  • Essential thrombocytosis is a chronic myeloproliferative neoplasm, characterized by a persistently elevated platelet count

Myeloproliferative Neoplasms

  • Myeloproliferative disorders involve uncontrolled proliferation of blood-forming cells.
  • These include Polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF).
  • Polycythemia vera is associated with increased red blood cell production, and often presents with elevated Hb and Hct levels.
  • Essential thrombocythemia is characterized by an elevated platelet count.
  • Myelofibrosis features bone marrow fibrosis along with extramedullary hematopoiesis in organs such as the spleen and liver.
  • Myelofibrosis may exhibit peripheral blood changes such as leukoerythroblastosis.
  • Clinical features of these disorders may include fatigue, splenomegaly, thrombosis, or pruritus.
  • Laboratory findings may vary.
  • Molecular analysis often reveals mutations in genes like JAK2, CALR, and MPL.
  • Bone marrow analysis shows characteristic features for each condition

Diagnostic Approach

  • Clinical evaluation is crucial in diagnosing blood disorders. These include thorough history taking and physical examination.
  • Laboratory tests, such as complete blood counts (CBC), blood chemistry studies, and bone marrow biopsies aid diagnosis.
  • Imaging with PET/CT can be used to determine spread of disease.

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Description

This quiz covers key concepts in hematology, focusing on lymphomas. You'll learn about Hodgkin's and Non-Hodgkin's lymphomas, their characteristics, and subtypes such as Burkitt's lymphoma. Test your knowledge on the features and classification of these blood disorders.

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