CPHON END OF COURSE SET QUESTIONS AND
ANSWERS SURE A+
✔✔Burkitt's or Burkitt's-like Lymphoma (BL or BLL) - ✔✔t(8,14). Must remove tumor
completely. Endemic BL: associated with jaw and EBV. Fastest growing tumor.
Presents in abdomen and/or pelvis with associated s/s (GI). Tumor lysis risk.
✔✔Diffuse Large B-Cell Lymphoma (DLBL) - ✔✔Heterogeneous group of tumors. B-
Cell Markers: CD19, CD20, CD22, CD79a (express surface immunoglobulins). Presents
in abdomen and lymph nodes (more than BL in nodes)
✔✔Anaplastic Large Cell Lymphoma (ALCL) - ✔✔Anaplastic features (Kidney-shaped
nuclei). Express null cell or t-cell antigens and CD30. ALK expression better prognosis.
Present with hepatosplenomegaly, fever, weight loss. Poor prognosis if in BM, nodes,
and skin. Bone can be primary site. Peripheral, intrathoracic, and/or abdominal lymph
nodes.
✔✔Classic Hodgekin's lymphoma (CHL): All subtypes - ✔✔90% of CHL is characterized
by CD15 and CD30-positive cells. Hallmark: Reed-Steinberg Cell (Bilobed nucleus: Owl
Eyes). Mostly comprised of inflammatory cells and fibrosis (from cytokine release).
Usually present with painless adenopathy. B-Symptoms.
✔✔CHL: Nodular Sclerosis Hodgekin Lymphoma (NSHL) - ✔✔Most common. CD20+
Cells. Lower cervical, supraclavicular, and mediastinal lymph nodes
✔✔CHL: Mixed-Cellularity Hodgekin Lymphoma (MCHL) - ✔✔Disease frequently
advanced, extranodal involvement. Lots of R-S cells with inflamm. background (mixed
cellularity)
✔✔CHL: Lymphocyte Rich Classic Hodgekin Lymphoma (LRCHL) - ✔✔Localized. R-S
Cells in a background of mostly B Lymphocytes
, ✔✔CHL: Lymphocyte Depleted Hodgekin Lymphoma (LDHL) - ✔✔Associated with HIV
patients. Late stage in bones in bm. R-S cell, few lymphocytes, and diffuse fibrosis and
necrosis.
✔✔Nodular Lymphocyte Predominant Hodgekin Lymphoma - ✔✔Closely resembles
LRCHL. Affects mostly males 10 and under. Localized and asymptomatic. "Popcorn
Cells" (Multilobed nuclei)
✔✔Hodgekin's Unfavorable Prognosis - ✔✔1. Advanced stage
2. Presence of "B" symptoms
3. Bulky Disease
4. Extranodal Disease
5. Male Gender
6. ^Sed rate
✔✔Osteosarcoma Definition - ✔✔Malignant tumor of bone. Radio-resistant
✔✔Osteosarcoma Presentation - ✔✔Pain: Dull, aching, constant. Worse at night.
Usually long bones. Mets to lungs and bone. May have soft tissue mass.
✔✔Osteosarcoma Diagnostics - ✔✔Biopsy for diagnosis. X-ray: sunburst pattern. ^alk
phos and LDH. Sometimes p53 mutations.
✔✔Osteosarcoma Poor Prognosis - ✔✔Pulm mets, spinal primary, large tumor
(>15cm), pts <10, ^alk phos
✔✔Ewings Definition - ✔✔Malignant tumor of bone and surrounding soft tissue. Radio-
sensitive. Neural crest origin and small round cell tumor (ESFT family)
✔✔Ewings Presentation - ✔✔Pain: Mild, intermittent, worse overtime. Worse at night.
Even distribution between extremities and central axis. May have soft tissue mass. Mets
to lungs, bone, and bm
✔✔Ewings Diagnostics - ✔✔Biopsy for diagnosis. X-ray: moth eaten and onion skin.
^ESR, WBC, and LDH. Sometimes p53 mutations.
✔✔Ewings Poor Prognosis - ✔✔Pelvis primary, mets on dx, p53, older age, ^LDH
✔✔Wilm's Tumor - ✔✔Fragile Gelatinous Capsule; rapidly growing abdominal tumor.
Gene deletion 11p13. Mets to lungs, liver, and lymph nodes. Anaplastic less favorable.
✔✔Rhabdomyosarcoma: Embryonal (ERMS) - ✔✔<8 yo. Subtypes: Botryoid and
Spindle Cell (best prognosis). Presents in head, neck, bladder, vagina, prostate, and
testicles. LOH at 11p15.
ANSWERS SURE A+
✔✔Burkitt's or Burkitt's-like Lymphoma (BL or BLL) - ✔✔t(8,14). Must remove tumor
completely. Endemic BL: associated with jaw and EBV. Fastest growing tumor.
Presents in abdomen and/or pelvis with associated s/s (GI). Tumor lysis risk.
✔✔Diffuse Large B-Cell Lymphoma (DLBL) - ✔✔Heterogeneous group of tumors. B-
Cell Markers: CD19, CD20, CD22, CD79a (express surface immunoglobulins). Presents
in abdomen and lymph nodes (more than BL in nodes)
✔✔Anaplastic Large Cell Lymphoma (ALCL) - ✔✔Anaplastic features (Kidney-shaped
nuclei). Express null cell or t-cell antigens and CD30. ALK expression better prognosis.
Present with hepatosplenomegaly, fever, weight loss. Poor prognosis if in BM, nodes,
and skin. Bone can be primary site. Peripheral, intrathoracic, and/or abdominal lymph
nodes.
✔✔Classic Hodgekin's lymphoma (CHL): All subtypes - ✔✔90% of CHL is characterized
by CD15 and CD30-positive cells. Hallmark: Reed-Steinberg Cell (Bilobed nucleus: Owl
Eyes). Mostly comprised of inflammatory cells and fibrosis (from cytokine release).
Usually present with painless adenopathy. B-Symptoms.
✔✔CHL: Nodular Sclerosis Hodgekin Lymphoma (NSHL) - ✔✔Most common. CD20+
Cells. Lower cervical, supraclavicular, and mediastinal lymph nodes
✔✔CHL: Mixed-Cellularity Hodgekin Lymphoma (MCHL) - ✔✔Disease frequently
advanced, extranodal involvement. Lots of R-S cells with inflamm. background (mixed
cellularity)
✔✔CHL: Lymphocyte Rich Classic Hodgekin Lymphoma (LRCHL) - ✔✔Localized. R-S
Cells in a background of mostly B Lymphocytes
, ✔✔CHL: Lymphocyte Depleted Hodgekin Lymphoma (LDHL) - ✔✔Associated with HIV
patients. Late stage in bones in bm. R-S cell, few lymphocytes, and diffuse fibrosis and
necrosis.
✔✔Nodular Lymphocyte Predominant Hodgekin Lymphoma - ✔✔Closely resembles
LRCHL. Affects mostly males 10 and under. Localized and asymptomatic. "Popcorn
Cells" (Multilobed nuclei)
✔✔Hodgekin's Unfavorable Prognosis - ✔✔1. Advanced stage
2. Presence of "B" symptoms
3. Bulky Disease
4. Extranodal Disease
5. Male Gender
6. ^Sed rate
✔✔Osteosarcoma Definition - ✔✔Malignant tumor of bone. Radio-resistant
✔✔Osteosarcoma Presentation - ✔✔Pain: Dull, aching, constant. Worse at night.
Usually long bones. Mets to lungs and bone. May have soft tissue mass.
✔✔Osteosarcoma Diagnostics - ✔✔Biopsy for diagnosis. X-ray: sunburst pattern. ^alk
phos and LDH. Sometimes p53 mutations.
✔✔Osteosarcoma Poor Prognosis - ✔✔Pulm mets, spinal primary, large tumor
(>15cm), pts <10, ^alk phos
✔✔Ewings Definition - ✔✔Malignant tumor of bone and surrounding soft tissue. Radio-
sensitive. Neural crest origin and small round cell tumor (ESFT family)
✔✔Ewings Presentation - ✔✔Pain: Mild, intermittent, worse overtime. Worse at night.
Even distribution between extremities and central axis. May have soft tissue mass. Mets
to lungs, bone, and bm
✔✔Ewings Diagnostics - ✔✔Biopsy for diagnosis. X-ray: moth eaten and onion skin.
^ESR, WBC, and LDH. Sometimes p53 mutations.
✔✔Ewings Poor Prognosis - ✔✔Pelvis primary, mets on dx, p53, older age, ^LDH
✔✔Wilm's Tumor - ✔✔Fragile Gelatinous Capsule; rapidly growing abdominal tumor.
Gene deletion 11p13. Mets to lungs, liver, and lymph nodes. Anaplastic less favorable.
✔✔Rhabdomyosarcoma: Embryonal (ERMS) - ✔✔<8 yo. Subtypes: Botryoid and
Spindle Cell (best prognosis). Presents in head, neck, bladder, vagina, prostate, and
testicles. LOH at 11p15.
