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Questions and Answers
What is a key characteristic of lymphoid neoplasms?
What is a key characteristic of lymphoid neoplasms?
- They develop exclusively in the bone marrow.
- They do not affect immune function.
- They primarily affect red blood cells.
- They are characterized by abnormal proliferation of B and T cells. (correct)
Which symptom is NOT typically associated with Hodgkin lymphoma?
Which symptom is NOT typically associated with Hodgkin lymphoma?
- Hyperglycemia (correct)
- Splenomegaly
- B-symptoms like fever and night sweats
- Painless lymphadenopathy
What distinguishes Hodgkin lymphoma from Non-Hodgkin lymphoma?
What distinguishes Hodgkin lymphoma from Non-Hodgkin lymphoma?
- It is always asymptomatic.
- It only affects T cells.
- Presence of Reed-Sternberg cells (correct)
- It has a bimodal age distribution. (correct)
What does the term 'neoplastic proliferations are monoclonal' imply?
What does the term 'neoplastic proliferations are monoclonal' imply?
Which age groups are bimodal for Hodgkin lymphoma incidence?
Which age groups are bimodal for Hodgkin lymphoma incidence?
Which of the following statements is true regarding plasma cell myeloma?
Which of the following statements is true regarding plasma cell myeloma?
What is the primary site of involvement for leukemias?
What is the primary site of involvement for leukemias?
Which group of cells is primarily involved in the immunologic reaction to tumors in Hodgkin lymphoma?
Which group of cells is primarily involved in the immunologic reaction to tumors in Hodgkin lymphoma?
What characteristic appearance is associated with classic Reed-Sternberg cells?
What characteristic appearance is associated with classic Reed-Sternberg cells?
Which characteristic is NOT associated with classical Hodgkin Lymphoma?
Which characteristic is NOT associated with classical Hodgkin Lymphoma?
Which variant of Reed-Sternberg cells is insufficient for diagnosis?
Which variant of Reed-Sternberg cells is insufficient for diagnosis?
What is a common immunophenotype finding in classical Hodgkin Lymphoma?
What is a common immunophenotype finding in classical Hodgkin Lymphoma?
Which Hodgkin Lymphoma subtype has the most common form associated with adolescents or young adults?
Which Hodgkin Lymphoma subtype has the most common form associated with adolescents or young adults?
The presence of which type of cell is typically seen in Mixed Cellularity variant of Hodgkin Lymphoma?
The presence of which type of cell is typically seen in Mixed Cellularity variant of Hodgkin Lymphoma?
Which statement about lacunar cells is incorrect?
Which statement about lacunar cells is incorrect?
What is the prognosis associated with Nodular Sclerosis subtype of Hodgkin Lymphoma?
What is the prognosis associated with Nodular Sclerosis subtype of Hodgkin Lymphoma?
What characterizes the Lymphocyte Rich subtype of Classical Hodgkin Lymphoma?
What characterizes the Lymphocyte Rich subtype of Classical Hodgkin Lymphoma?
Which statement about Lymphocyte Depleted Classical Hodgkin Lymphoma is correct?
Which statement about Lymphocyte Depleted Classical Hodgkin Lymphoma is correct?
Identify the true statement about Non-Classical Hodgkin Lymphoma, specifically Nodular Lymphocyte Predominant Lymphoma (NLPHL).
Identify the true statement about Non-Classical Hodgkin Lymphoma, specifically Nodular Lymphocyte Predominant Lymphoma (NLPHL).
What unique feature is associated with the Reed-Sternberg cells in Nodular Lymphocyte Predominant Lymphoma?
What unique feature is associated with the Reed-Sternberg cells in Nodular Lymphocyte Predominant Lymphoma?
What is the immunophenotypic characteristic of Lymphocyte Predominance type of Hodgkin lymphoma?
What is the immunophenotypic characteristic of Lymphocyte Predominance type of Hodgkin lymphoma?
In the Ann Arbor classification, what does Stage I indicate?
In the Ann Arbor classification, what does Stage I indicate?
Which characteristic is typically not seen in Lymphocyte Rich Classical Hodgkin Lymphoma?
Which characteristic is typically not seen in Lymphocyte Rich Classical Hodgkin Lymphoma?
Which of the following is NOT a common type of reactive cell found in Non-Classical Hodgkin Lymphoma Nodular Lymphocyte predominant?
Which of the following is NOT a common type of reactive cell found in Non-Classical Hodgkin Lymphoma Nodular Lymphocyte predominant?
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Study Notes
Lymphoid Neoplasm
- Malignant tumors originating in lymphoid tissue, leading to abnormal proliferation of B and T cells.
- Two main types: Precursor B-cell neoplasm and Mature B Neoplasm.
Leukemia and Lymphoma
- Leukemia: Tumors primarily affecting bone marrow and peripheral blood.
- Lymphoma: Tumors primarily affecting lymph nodes or other organs.
- Plasma cell myeloma is characterized by bone confinement, forming discrete masses without lymph node involvement.
Neoplastic Proliferations
- Neoplastic proliferations are monoclonal, contrasting with polyclonal reactive conditions.
- Lymphoid neoplasms can disrupt immune function, potentially causing immunodeficiency and autoimmunity.
Hodgkin vs. Non-Hodgkin Lymphoma
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Hodgkin Lymphoma:
- Originates from B-cells, arises in a single lymph node or chain, spreading stepwise to adjacent nodes, spleen, liver, and bone marrow.
- Bimodal age distribution: Peaks at ages 20-30 and over 50.
- Most common affected regions: Cervical and supraclavicular nodes.
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Clinical Presentation of Hodgkin Lymphoma:
- Painless lymphadenopathy.
- B-symptoms: Fever, night sweats, weight loss (≥ 10% body weight).
- 16% of cases show splenomegaly; 5% may exhibit anemia due to bone marrow involvement.
Morphological Features
- Characteristic neoplastic cells: Reed-Sternberg cells (RS cells) derived from B cells.
- Immunologic response includes various cell types: lymphocytes, histiocytes, eosinophils, plasma cells, neutrophils.
- Morphology of classic RS cells:
- Large (15-45 μm), polylobated nucleus, round nucleoli.
- Slightly eosinophilic cytoplasm creating an "owl-eye" appearance.
Variants of Reed-Sternberg Cells
- Hodgkin cells: Mononuclear variant, not sufficient for diagnosis.
- Mummified cells: Degenerative cells with dark smudge and pyknotic nuclei.
- Lacunar cells: Large nuclei surrounded by pale cytoplasm, inconspicuous nucleoli.
- L&H cells: Hyperlobated nuclei and small nucleoli.
Immunophenotyping of Hodgkin Lymphoma
- Classical Hodgkin Lymphoma:
- RS cells: CD45-, CD20-, CD15+, CD30+, weak variable PAX5+.
- Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL):
- RS cells: CD45+, CD20+, strong PAX5, CD15-, CD30-.
Types of Classical Hodgkin Lymphoma
- Nodular Sclerosis: Most common form, especially in adolescents, exhibits excellent prognosis.
- Mixed Cellularity: Common in patients >50 years, good prognosis but higher association with EBV.
- Lymphocyte Rich: Predominantly reactive lymphocytes, good to excellent prognosis; also associated with EBV.
- Lymphocyte Depleted: Aggressive form, poor prognosis, characterized by pleomorphic RS cells and necrosis.
Non-Classical Hodgkin Lymphoma
- NLPHL: Comprises about 5% of Hodgkin lymphoma; nodules with resting lymphocytes and L&H variant RS cells described as "popcorn cells".
Clinical Staging of Hodgkin and Non-Hodgkin Lymphomas
- Ann Arbor Classification:
- Stage I: Involvement of a single lymph node region or a single extra-lymphatic organ.
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