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MLS 4131 Week 4
Terms in this set (97)
The sites for antigen recognition & processing, plus lymphopoiesis, is the function of what tissue type?
What is the location of lymph nodes which drain the peripheral areas?
Cervix, axillary, and inguinal.
Where is the regional location of lymph nodes of internal organs?
Mediastinal, hilar, and mesenteric.
What is the location of lymph nodes of the respiratory and digestive tract?
What are the primary sites of antigenic contact?
What are the 3 sections of a normal lymph node?
Cortex, paracortex, and medulla.
Where are the primary and secondary follicles of the lymph node located?
Where are the cellular contents of the lymph node located?
Where are the cords and sinuses of the lymph node located?
Within the Cortex, where are the germinal center and mantle zone of the lymph node located?
What are the primary follicles of the lymph node made of?
Naïve B lymphocytes.
Which classification determinants make up naïve B lymphocytes?
5, 19, & 20.
Which B lymphocytes within lymph nodes have specific immunophenotypes?
Which classification determinants make up mantle zone B lymphocytes?
10 & BCL-6
What protein is lacking from mantle zone B lymphocytes?
What do centroblasts within the lymph node cortex differentiate into?
What do centrocytes within the lymph node cortex differentiate into?
Memory B cells
Where are plasma cells stored within lymph nodes?
Which classification determinants make up plasma cells?
38, 138, and cytoplasmic IGs
Within lymph nodes, where are immunocompetent T cells generated?
What kinds of cells occupy the paracortex of lymph nodes?
Immunocompetent T cells, interdigitating dendritic cells, and high endothelial venules.
Which classification determinants make up T cells?
2-8, except 6.
What is another term for the macrophages within lymph node medullary sinuses?
What types of cells are stored within lymph node medullary sinuses?
What is the role of macrophages in the medullary sinuses of lymph nodes?
Antigen capture and processing
Which cells compose the germinal centers of B cell differentiation?
Centroblasts and centrocytes
CD 19 & 20 are within each stage of B cell except which?
What classification determinant differentiates centroblasts from centrocytes & memory B cells?
centroblasts are slg negative
The classification determinant "slg" is missing from which two stages of B cells?
Naïve & primary follicle B cells
What classification determinants differentiates centrocytes from memory B cells?
Centrocytes have CD 10 & BCL-6, while memory B cells have BCL-2.
What are the preferred specimen types for processing lymph nodes?
What are the 4 patterns of classification for reactive lymphadenopathies?
Follicular, paracortical, sinusoidal, and mixed.
Which pattern of classification for reactive lymphadenopathies is the most common?
When are follicular patterns of reactive lymphadenopathies frequently seen in children?
Reaction to infection(s).
When are follicular patterns of reactive lymphadenopathies seen in adults?
Autoimmune diseases/disorders, syphilis, and early HIV.
When are paracortical patterns of reactive lymphadenopathies seen?
In association with viral infections (mono), drug reactions, and chronic skin diseases.
What are paracortical patterns of reactive lymphadenopathies composed of?
Small lymphocytes and immunoblasts.
Where are sinusoidal patterns of reactive lymphadenopathies located?
The drainings of limbs of abdominal organs.
What are sinusoidal patterns of reactive lymphadenopathies composed of?
Histiocytes showing abundant cytoplasm.
In what conditions are monocytoid B cells seen?
HIV-associated lymphadenopathy and toxoplasma lymphadenitis
In what condition is mixed reactive lymphadenopathies seen?
How is Toxoplasma gondii transmitted?
Ingestion of raw meat and/or exposure to cat litter.
What do all B-cell lymphomas produce?
Monoclonal light chain and/or clonal immunoglobulin gene arrangement
What are the most common mature B cell lymphomas?
Follicular and diffuse large B cell lymphoma (DLBCL)
Where are most mature B cell lymphomas localized?
In what patient population do most mature B cell lymphomas occur?
What are the 8 subtypes of mature B cell lymphomas?
*Chronic Lymphocytic Lymphoma (CLL)
*Small Lymphocytic Lymphoma
*Mantle Cell Lymphoma
*Mucosa-Associated Lymphatic Tissue (MALT) Lymphoma
*Plasma Cell Neoplasms
*Diffuse Large B-Cell Lymphoma (DLBCL)
What are some characteristics of CLL & SLL?
*Small lymphoid cell in PB, BM, and lymphoid organs
*Recirculating lymphoid cell expressing CD5, IgM, & IgD
What are the sites of involvement for CLL?
PB & BM
What are the expected types of cell and measurement for CLL, and aids with how CLL is diagnosed?
>5x10^9/L monoclonal B cells
What are the names of the two FAB-proposed categories of CLL?
Typical and atypical
What classifies Typical CLL?
>90% small mature lymphocytes & <10% prolymphocytes
What classifies Atypical CLL?
*Atypical lymphoid cells w/ cleaved nuclei
*Large lymphoid cells w/ atypical appearance
*May contain up to 55% prolymphocytes
What are the sites of involvement for SLL, and aids with how SLL is diagnosed?
Lymph nodes & lymphoid organs
What characteristic feature lends to CLL?
"Soccer ball" appearance of small lymphoid cells
What types of cells can help distinguish CLL from other malignant lymphomas in the PB?
Smudge cells representing disintegrated lymphoid cells
What does the BM biopsy of CLL show?
Nodular, diffuse, or interstitial infiltrates of small lymphoid cells
What are growth centers composed of medium-sized and large lymphoid cells with dispersed chromatin and distinct nucleoli?
Diffuse proliferation of small lymphoid cells with pseudofollicles is characteristic of what condition?
Which CDs would be expected to increase in monoclonal B lymphocytes which might aid in the diagnosis of CLL?
5, 19, 20, 23, and 79b.
What 3 chromosomal abnormalities contribute to a prognosis of CLL?
What is a common name for DLBCL?
What is the final diagnosis of CLL/SLL based on?
Morphology and immunophenotyping
What enzyme is negative for CLL, but not SLL?
What is a diagnostic criterion for B-cell Prolymphocytic Leukemia (PLL)?
>55% circulating prolymphocytes
What description of the nucleolus aids in identifying B-cell PLL?
What is a typical WBC count for B-cell PLL?
What markers aid in identifying B-cell PLL?
CDs 19, 20, 22, & FMC 7.
Which CD makes it difficult to differentiate between B-cell PLL & Mantle Cell Leukemia?
What cytogenic of molecular analysis helps differentiate B-cell PLL from Mantle Cell Leukemia?
What kind of cells resemble T-cell PLL?
In what condition is cytoplasmic blebbing common?
What organs are involved in T-cell PLL?
T-prolymphocytes are positive for what markers?
CDs 2-8, except 6.
Which tumor suppressor gene mutation is of high incident in B-cell PLL?
Which antibody treatment has improved treatment of T-cell PLL?
Where are hairy cells typically found?
BM & red pulp of spleen
Which leukemia produces fibrogenic cytokines resulting in BM showing an increase in reticulin fibers?
Hairy Cell Leukemia
In what media are the cytologic characters best seen in Hairy Cell Leukemia?
BM aspirate and PB
Which two markers are unique for Hairy Cell Leukemia?
CD 11c & 103
Which tests are Hairy Cell Leukemia positive for?
TRAP, DBA-44, CD123, & Annexin A1
Which markers help differentiate Hairy Cell Leukemia from Splenic Marginal Zone Lymphoma?
CD123 & Annexin A1
What symptoms are classic to Hairy Cell Leukemia?
Splenomegaly, marrow fibrosis, and pancytopenia.
Which treatments can provide durable remission for Hairy Cell Leukemia?
Interferon α or purine analogues.
What types of cells are indicative of Mantle Cell Lymphoma?
Medium-sized lymphoid cells w/ irregular nuclear outlines f/ follicular mantle zone.
What are the sites of presentation for Mantle Cell Lymphoma?
Lymph nodes, PB, BM, spleen, and GI tract.
Which lymphoma can Mantle Cell Lymphoma mimic in the PB?
Which marker is absent that is frequently found in other lymphomas?
Which markers are lighter in CLL/SLL, but are stronger in Mantle Cell Lymphoma?
CD20 & light chains
What is the defining feature of MCL?
Immunoreactivity of cyclin D1 (BCL1).
What is a proto-oncogene involved in cell regulation of G1 to S phase progression?
Which translocation expresses the cyclin D1 gene in MCL?
Which lymphoma originates from the germinal centers of lymph nodes?
Medium sized lymphoid cells with angular or indented nuclei with mixture of large lymphoid cells resemble what types of cells in Follicular Lymphoma?
Large lymphoid cells show oval nuclei with vesicular chromatin and multiple nucleoli near nuclear membrane resemble what types of cells in Follicular Lymphoma?
How many grades are in Follicular Lymphoma?
What grade of Follicular Lymphoma contains numerous centroblasts?
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