Hematopathology: Lymphoma and Lymph Node Structure
22 Questions
1 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What characterizes Burkitt's lymphoma at the microscopic level?

  • Nodal architecture effaced by medium-sized cells with a starry sky appearance (correct)
  • Nodal architecture with irregular large cells
  • Prominent nucleoli with round nuclei surrounded by clear spaces
  • Presence of scattered neutrophils and small lymphocytes
  • Which finding is NOT typically associated with the diagnosis of Essential Thrombocythemia (ET)?

  • Rule out significant infection or malignancy
  • Increased platelet count
  • Leucoerythroblastic blood film (correct)
  • Bone marrow showing increased megakaryocytes
  • Which statement about Myelofibrosis can be considered accurate?

  • It is characterized by tear drop-shaped red blood cells and a hypercellular bone marrow. (correct)
  • It typically presents with elevated platelet counts and normal bone marrow.
  • Transformation to acute myeloid leukaemia occurs in less than 5% of patients.
  • High levels of both serum uric acid and LDH are rarely seen in patients.
  • What is a common laboratory finding during the investigation of Myelofibrosis?

    <p>Anemia with subsequent leukopenia and thrombocytopenia (B)</p> Signup and view all the answers

    Which finding would be indicative of Diffuse Large B Cell Lymphoma (DLBCL)?

    <p>Large cells with prominent nucleoli and irregular nuclei (C)</p> Signup and view all the answers

    What is a characteristic feature of Hodgkin’s lymphoma cells?

    <p>Binucleated Reed-Sternberg cells (B)</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly associated with widespread Hodgkin's lymphoma?

    <p>Weight gain (B)</p> Signup and view all the answers

    Which lymph node region is involved first in Hodgkin’s lymphoma?

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

    What is the typical gross appearance of lymph nodes affected by Hodgkin's lymphoma?

    <p>Enlarged with a rubbery consistency (B)</p> Signup and view all the answers

    How do Non-Hodgkin’s Lymphomas (NHL) typically differ from Hodgkin’s lymphoma?

    <p>They do not involve Reed-Sternberg cells. (B)</p> Signup and view all the answers

    What is the identifying histological feature of Burkitt’s lymphoma?

    <p>Starry sky appearance due to macrophages (B)</p> Signup and view all the answers

    What age group is most commonly affected by Hodgkin’s lymphoma?

    <p>Young adults aged 15-35 (C)</p> Signup and view all the answers

    What histological feature is primarily associated with nodular sclerosis type of Hodgkin's lymphoma?

    <p>Presence of lacunar cells (C)</p> Signup and view all the answers

    In the mixed cellularity subtype of Hodgkin's lymphoma, which type of cell is notably present?

    <p>High numbers of eosinophils (B)</p> Signup and view all the answers

    Which characteristic is seen in the lymphocyte depletion subtype of Hodgkin's lymphoma?

    <p>Dominance of Reed-Sternberg cells (B)</p> Signup and view all the answers

    What differentiates the lymphocyte predominance subtype from other types of Hodgkin's lymphoma?

    <p>Absence of classic Reed-Sternberg cells (B)</p> Signup and view all the answers

    What type of lymphoma is Burkitt's lymphoma classified as?

    <p>B-cell lymphoma (B)</p> Signup and view all the answers

    Which statement accurately describes the tumor composition in Hodgkin's lymphoma mixed cellularity?

    <p>Prominent eosinophils and histiocytes (D)</p> Signup and view all the answers

    What visual feature is indicative of the nodular sclerosis type in histological slides?

    <p>Broad fibrous bands (C)</p> Signup and view all the answers

    Among the following, which is a defining feature of lymphocyte predominance in Hodgkin's lymphoma?

    <p>Little to no activation of Reid-Sternberg cells (B)</p> Signup and view all the answers

    Which population is most affected by Burkitt's lymphoma?

    <p>Children and young adults (C)</p> Signup and view all the answers

    What histological element is most scarce in the lymphocyte predominance type of Hodgkin's lymphoma?

    <p>Reed-Sternberg cells (A)</p> Signup and view all the answers

    Flashcards

    Burkitt's Lymphoma

    This type of lymphoma features cells with rounded nuclei, prominent nucleoli, and scattered tingible body macrophages, creating a "starry sky" appearance.

    Diffuse Large B Cell Lymphoma

    This lymphoma shows large cells with open chromatin, prominent nucleoli, and irregularly shaped nuclei.

    Myeloproliferative Neoplasms (MPNs)

    A group of blood disorders characterized by excessive production of certain types of blood cells in the bone marrow.

    Essential Thrombocythemia (ET)

    An MPN characterized by an abnormally high number of platelets in the blood.

    Signup and view all the flashcards

    Myelofibrosis

    An MPN characterized by excessive fibrosis in the bone marrow, leading to anemia, high WBC count initially, and later leucopenia and thrombocytopenia.

    Signup and view all the flashcards

    Hodgkin's Lymphoma

    A type of lymphoma characterized by the presence of Reed-Sternberg cells, typically arising in a single or chain of lymph nodes and spreading to adjacent nodes.

    Signup and view all the flashcards

    Reed-Sternberg (RS) Cells

    A type of lymphoma characterized by the presence of Reed-Sternberg cells, which are large, binucleated or bilobed cells with prominent nucleoli.

    Signup and view all the flashcards

    Non-Hodgkin's Lymphoma (NHL)

    A type of lymphoma that includes various subtypes and lacks Reed-Sternberg cells, demonstrating a broader range of cell types.

    Signup and view all the flashcards

    Lymphadenopathy

    An enlargement of lymph nodes that can be caused by various factors, including infection, inflammation, or malignancy.

    Signup and view all the flashcards

    Reactive Hyperplasia

    A process where lymphoid tissue undergoes a response to an antigen, characterized by an increase in the size and number of lymphocytes in lymph nodes.

    Signup and view all the flashcards

    Primary Site of Involvement

    The initial site of lymph node involvement in Hodgkin's disease, characterized by a single or chain of lymph nodes that enlarge.

    Signup and view all the flashcards

    Large Cell Lymphoma

    A type of lymphoma characterized by a rapid growth rate and large cells, often associated with a high risk of metastasis.

    Signup and view all the flashcards

    Hodgkin's Lymphoma - Nodular Sclerosis

    A type of Hodgkin's Lymphoma characterized by the presence of Reed-Sternberg cells with a prominent clear space surrounding them, often called "lacunar" cells. Collagen bands separate tumor nodules.

    Signup and view all the flashcards

    Lacunar Cell

    A Reed-Sternberg cell variant found in Nodular Sclerosis Hodgkin's Lymphoma. It's large with a prominent clear space around it, an artifact of formalin fixation.

    Signup and view all the flashcards

    Hodgkin's Lymphoma - Mixed Cellularity

    A type of Hodgkin's Lymphoma characterized by a mixed population of cells including Reed-Sternberg cells, lymphocytes, eosinophils, plasma cells, and macrophages.

    Signup and view all the flashcards

    Hodgkin's Lymphoma - Lymphocyte Depleted

    A type of Hodgkin's Lymphoma characterized by a dominance of Reed-Sternberg cells with few lymphocytes or a pattern of diffuse fibrosis. This is a less common type.

    Signup and view all the flashcards

    Hodgkin's Lymphoma - Lymphocyte Predominance

    A type of Hodgkin's Lymphoma characterized by a predominance of small lymphocytes and benign histiocytes. Reed-Sternberg cells are few.

    Signup and view all the flashcards

    Reed-Sternberg Cell

    A large, abnormal cell characteristic of Hodgkin's Lymphoma. It has a distinctive "owl eye" appearance due to its two large nuclei.

    Signup and view all the flashcards

    Small Non-Cleaved Cell Lymphoma

    A type of Non-Hodgkin Lymphoma characterized by small, non-cleaved cells. It can be classified as Burkitt's type.

    Signup and view all the flashcards

    Nodular Sclerosis Hodgkin's Lymphoma

    A type of Hodgkin's Lymphoma characterized by the presence of collagen bands that divide the lymph node into nodules. It is a common type.

    Signup and view all the flashcards

    Study Notes

    Hematopathology

    • Hawler Medical University, College of Medicine, Department of Pathology are mentioned.
    • This is a study on the lymphoid system, including reactive nodular hyperplasia, Hodgkin's disease, and Non-Hodgkin Lymphoma (NHL)
    • Objectives:
      • Define lymphomas and understand differences between Hodgkin's and Non-Hodgkin's lymphoma
      • Identify different histological subtypes of Hodgkin's disease
      • Identify Burkitt's lymphoma and large cell lymphoma as examples of NHL
    • Contents:
      • Reactive nodular hyperplasia
      • Lymphomas (Hodgkin's disease, NHL)

    Normal Lymph Node

    • Afferent lymphatic vessels enter the lymph node.
    • The subcapsular sinus receives lymph.
    • The cortex contains primary follicles, secondary follicles (with germinal centers), and mantle zones.
    • Trabeculae are fibrous partitions.
    • The paracortex, containing T lymphocytes, is between cortex and medulla.
    • Medullary cords contain lymphocytes, plasma cells, and macrophages.
    • Medullary sinuses drain lymph to the efferent lymphatic vessels at the hilum.
    • High endothelial venules facilitate lymphocyte entry.

    Reactive Hyperplasia - Follicular Type

    • The capsule and subcapsular sinus receive lymphatic drainage from surrounding tissue.
    • The paracortical region has lymphoid follicles and a pale germinal center.
    • Sinusoids extend to the node's center, involved in immune responses.
    • At higher magnification, the germinal centers show larger lymphocytes undergoing activation.
    • The subcapsular sinus is visible.

    Lymphomas

    • Lymphomas are malignancies of lymphoid tissues.
    • Malignant lymphocytes accumulate in lymph nodes, causing lymphadenopathy.
    • Lymphomas may spill over into the blood or infiltrate organs outside lymphoid tissue.
    • Lymphomas are classified as Hodgkin's and Non-Hodgkin's lymphomas.

    Hodgkin's Lymphoma

    • Reed-Sternberg (RS) cells (neoplastic element):

      • Large (15-45 microns), binucleated or bilobed
      • Large inclusion-like nucleoli surrounded by a clear halo
      • Abundant, weakly eosinophilic cytoplasm
    • Clinical presentation:

      • Painless, non-tender, asymmetrical, firm, discrete, and rubbery enlargement of superficial lymph nodes
      • Constitutional symptoms (fever, sweats, weight loss, pruritus) are prominent in widespread disease.
    • Gross appearance:

      • Enlargement of cervical lymph nodes (most frequent)
      • Individual nodes are discrete
      • Grayish tan or pale tan color
    • Histology (WHO classification):

      • Nodular sclerosis: Reed-Sternberg cells/lacunar variant. Collagen bands. Polymorphous background of lymphocytes, eosinophils, plasma cells, and macrophages.
      • Mixed cellularity: Classic type RS cells numerous. Diffuse effacement by heterogeneous population of small lymphocytes, eosinophils,plasma cells, benign macrophages.
      • Lymphocyte-depleted: Either RS cell dominance, few lymphocytes, or diffuse fibrosis.
      • Lymphocyte-predominant: Effacement of the lymph node, vague nodular pattern by infiltrate of small lymphocytes. Classic RS cells are few; popcorn variants are more common.
    • Lacunar cells: characteristic for nodular sclerosis type. Scattered large cells with prominent clear space (artifact of formalin fixation).

    Non-Hodgkin Lymphomas

    • Burkitt's lymphoma:

      • High mitotic rate
      • Affects children and young adults, often extranodal sites.
      • Microscopically: nodal architecture effaced, medium-sized cells with rounded nuclei, coarsely clumped chromatin, and 2-5 prominent nucleoli. Scattered tingible body macrophages with clear space give "starry sky" appearance.
    • Diffuse large B-cell lymphoma:

      • Nodal architecture effaced by large cells.
      • Open chromatin, prominent nucleoli.
      • Nuclei may be round, irregular, or cleaved.

    Myeloproliferative Neoplasms (MPNs)

    • Essential Thrombocythemia (ET):

      • Diagnosis of exclusion, ruling out other causes of elevated platelet count.
      • Blood film shows increased platelets.
      • Bone marrow shows increased megakaryocytes.
    • Myelofibrosis:

      • Anemia, high WBC at presentation, later leucopenia and thrombocytopenia.
      • Leukoerythroblastic blood film, tear drop red cells.
      • Bone marrow aspiration fails due to fibrosis, trephine biopsy shows fibrotic hypercellular marrow.
      • Increased NAP score, transformation to acute myeloid leukemia in 10-20% of patients.
      • High serum uric acid and LDH levels.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    This quiz delves into hematopathology, focusing on the lymphoid system, including the distinctions between Hodgkin's and Non-Hodgkin lymphoma. It covers histological subtypes, reactive nodular hyperplasia, and the structure of normal lymph nodes. Test your understanding of key concepts and terminology in this specialized field.

    More Like This

    Use Quizgecko on...
    Browser
    Browser