Dr. Wasim High Yield Notes (FCPS I Hematology)

Lymphomas:

Hodgkin Lymphomas:

Diffuse Large B Cell Lymphoma:

Burkitt Lymphoma:

T-cell Lymphomas:

High Yield One Liners:

Lymphoid neoplasms ................. Malignancies of B cells or T cells
Main lymphoid neoplasms ................. HL, NHL, T-cell leukemias/lymphomas

ATLL cause ................. HTLV-1 infection
HTLV-1 target cell ................. CD4+ T cell
ATLL pathogenesis ................. HTLV-1 → uncontrolled CD4+ T-cell proliferation
ATLL common regions ................. Japan, Caribbean, West Africa
ATLL skin finding ................. Skin lesions
ATLL nodal finding ................. Lymphadenopathy
ATLL organ finding ................. Hepatosplenomegaly
ATLL lab clue ................. Hypercalcemia
ATLL blood finding ................. Abnormal lymphocytes
ATLL immunophenotype ................. CD4+ CD25+
CD25 in ATLL ................. IL-2 receptor expression
ATLL prognosis ................. Very aggressive; poor treatment response
PTCL concept ................. Group of mature T-cell tumors
PTCL frequency ................. ~10% of adult lymphomas
PTCL behavior ................. Aggressive disease
PTCL prognosis ................. Poor prognosis
PTCL symptoms ................. Cytokine-driven even with small tumor burden
Hodgkin lymphoma origin ................. Germinal center B cell
HL key diagnostic cell ................. Reed–Sternberg cell
Reed–Sternberg cell ................. Large binucleate/multilobed cell
RS nucleoli ................. Prominent nucleoli
RS appearance ................. Owl-eye appearance
Owl-eye cell ................. Hodgkin lymphoma
HL EBV association ................. Seen in many cases
EBV strongest HL subtype link ................. Mixed cellularity
RS cells release IL-5 ................. Attracts eosinophils
RS cells release TGF-β ................. Causes fibrosis
RS cells release IL-13 ................. Promotes tumor growth
HL mass composition ................. Few tumor cells + many inflammatory cells
HL inflammatory background ................. Due to RS-cell cytokines
RS immune escape ................. PD-L1/PD-L2 expression
PD-L1/PD-L2 effect ................. Blocks T-cell response
Anti-PD-1 therapy ................. Useful in HL immune escape
Classic HL subtypes ................. Nodular sclerosis, mixed cellularity, lymphocyte-rich, lymphocyte-depleted
Separate HL subtype ................. Nodular lymphocyte-predominant HL
Most common HL subtype ................. Nodular sclerosis
Nodular sclerosis age group ................. Young adults
Nodular sclerosis site ................. Mediastinal nodes
Nodular sclerosis cell ................. Lacunar cell
Nodular sclerosis histology ................. Collagen bands divide tissue
Mixed cellularity HL ................. Older patients + EBV association
Mixed cellularity background ................. Mixed inflammatory cells
Mixed cellularity RS cells ................. Many RS cells
Lymphocyte-rich HL ................. Many lymphocytes
Lymphocyte-rich prognosis ................. Good prognosis
Lymphocyte-depleted HL ................. Few lymphocytes
Lymphocyte-depleted prognosis ................. Worse prognosis
NLPHL key cell ................. Popcorn cell / L&H cell
Popcorn cell ................. Multilobed nucleus
NLPHL immunophenotype ................. CD20+ CD15− CD30−
NLPHL prognosis ................. Excellent prognosis
Lacunar cell ................. Nodular sclerosis HL
Lacunar cell appearance ................. Cytoplasm shrinks → empty space
HL background cells ................. Lymphocytes, eosinophils, macrophages, plasma cells
Classic HL markers ................. CD15+ CD30+
Classic HL CD45 ................. Negative
NLPHL marker ................. CD20+
NLPHL CD15/CD30 ................. Negative
Most common HL presentation ................. Painless lymph node enlargement
Common HL node sites ................. Cervical, supraclavicular, mediastinal
HL B symptoms ................. Fever, weight loss, night sweats
HL other symptoms ................. Pruritus, fatigue, anemia
Hodgkin spread pattern ................. Stepwise/orderly spread
Hodgkin node pattern ................. Single lymph node group often involved
Hodgkin extranodal disease ................. Rare
NHL spread pattern ................. Random/scattered spread
NHL node pattern ................. Multiple node groups
NHL extranodal disease ................. Common
Memory hook ................. Hodgkin = orderly; NHL = scattered
Ann Arbor Stage I ................. Single lymph node region
Ann Arbor Stage II ................. ≥2 node regions same side of diaphragm
Ann Arbor Stage III ................. Nodes on both sides of diaphragm
Ann Arbor Stage IV ................. Extranodal organ involvement
Ann Arbor A ................. No B symptoms
Ann Arbor B ................. Fever, weight loss, night sweats
Best HL diagnostic test ................. Excisional lymph node biopsy
HL biopsy finding ................. RS cells + reactive background
HL confirmation ................. Immunohistochemistry
HL staging test ................. PET-CT
HL treatment depends on ................. Stage, symptoms, subtype
HL chemotherapy regimen ................. ABVD
HL treatment options ................. Chemotherapy, radiotherapy, immunotherapy
HL immunotherapy ................. Anti-PD-1 drugs
Early-stage HL prognosis ................. Excellent; often >90% survival
Advanced HL prognosis ................. Still relatively good vs many cancers
Owl-eye cell ................. Reed–Sternberg cell
CD15+ CD30+ ................. Classic Hodgkin lymphoma
Popcorn cell ................. Nodular lymphocyte-predominant HL
Lacunar cell ................. Nodular sclerosis HL
EBV association ................. Mixed cellularity HL
Painless lymphadenopathy ................. Classic HL presentation
Persistent lymph node >4–6 weeks ................. Needs biopsy consideration
Repeated antibiotics for persistent node ................. Avoid without clear infection
Hard lymph node ................. Red flag
Supraclavicular node ................. Red flag
B symptoms with lymphadenopathy ................. Red flag
AMC approach to suspicious node ................. Excisional biopsy + urgent referral
AMC staging after diagnosis ................. PET-CT staging
Final HL memory line ................. RS owl-eye + inflammatory background + orderly spread
Final T-cell lymphoma memory line ................. Aggressive + cytokine-driven symptoms

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