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Path 2 Neoplasia
Burkitt's Lymphoma
Adolescents or young adults
C-myc gene moves next to heavy chain Ig gene
T 8;14
Starry sky appearance
Sheets of lymphocytes with interspersed macrophages
Jaw lesion in endemic (African) form
Pelvis or abdomen in non endemic form (American form)
Associated with EBV
2 mins
Chronic Myelogenous Leukemia (CML)
Pathophysiology
BCR-ABL
9;22 Translocation
Philadelphia Chromosome
Signs & Symptoms
Tyrosine Kinase
Low Alkaline Phosphatase
Splenomegaly
Considerations
Blast Crisis
Age 30 to 90 Years
Responds to Imatinib
3 mins
Follicular Lymphoma
Derives from Germinal Center
Occurs in adults
T14;18
BCL 2 overexpression
BCL 2 inhibits apoptosis
Indolent
Generalized lymphadenopathy
Bone marrow involvement
2 mins
Non-Hodgkin's Lymphoma Assessment
Cause
Lymphatic Cancer
Non-Contiguous Spread
B or T Cells
Assessment
Painless Lymphadenopathy
Constitutional B Signs
Night Sweats
Fever
Weight Loss
Mediastinal or Abdominal Mass
Considerations
Older Adults
> 60 Subtypes
2 mins
Hodgkin Lymphoma Pathophysiology
Pathophysiology
Reed-Sternberg Cells
Binucleate
Owl's Eyes Appearance
CD 15 and CD 30
B Cell Origin
Bimodal Age Distribution
2 mins
Craniopharyngioma
Hypopituitarism
Remnants of Rathke's Pouch
Tooth-enamel Like Calcification
Cholesterol Crystals
Yellow Viscous Fluid
Headache
Bitemporal Hemianopsia
1 min
Melanoma Mechanism and Characteristics
Mechanism
Associated with Sunlight Exposure
Mutation in B-RAF kinase
Large Number of Moles
Fair-Skinned People at Higher Risk
Growth Phases
Radial Growth Phase
No Metastasis
Vertical Growth Phase
Depth of Tumor Correlates with Risk of Metastasis
1 min
Small Cell (Oat Cell) Carcinoma
Characteristics
Aggressively Malignant
Strong Correlation with Smoking
Central Location
Amplification of Myc Oncogenes
Signs and Symptoms
Narrowing of Bronchial Airways
Cushing's Syndrome
Ectopic ACTH
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Lambert-Eaton Syndrome
Diagnosis
Kulchitsky Cells
Neuron-Specific Enolase Positive
Chromogranin A Positive
Treatment
Chemotherapy and Radiation
3 mins
Von Hippel-Lindau Disease
Pathophysiology
Chromosome 3
Presentation
Hemangioblastomas
Medulla, Retina, Cerebellum
Cysts
Kidney, Liver, Pancreas
Develop Bilateral Renal Carcinomas
Pheochromocytomas
2 mins
Hemangioblastoma
Most Often Cerebellar
Associated with Von Hippel-Lindau
Retinal Angiomas
Can Produce EPO
Secondary Polycythemia
Foamy Cells
High Vascularity
59 secs
Human Papillomavirus (HPV)
Characteristics
Non-enveloped
Circular
Double Stranded DNA
Disease
Warts 1, 2, 6, 11
Condyloma acuminata
Type 16, 18
Cervical Carcinoma
Penile Carcinoma
AIDS/Immunocompromised
Worsened by Smoking
Diagnosis
Koilocytic change in squamous epithelium
Pyknotic Nuclei Surrounded by Clear Halo
Treatment
Vaccine Available
4 mins
Epstein Barr Virus
Characteristics
Herpesvirus 4
Double Stranded DNA
Linear
Enveloped
Signs and Symptoms
Infectious Mononucleosis
Virus Attaches to CD21 in B Cells
Nasopharyngeal Carcinoma
Burkitt's Lymphoma
Hodgkin's Lymphoma
1 min
Hepatitis B Virus Characteristics
Hepadnavirus
Enveloped
Circular
Partially Double-stranded DNA
Has Reverse Transcriptase
IV Drug Use
Sex
Maternal Fetal Routes
3 Month Incubation Period
2 mins
Herpes Simplex Virus (HSV)
Characteristics
Enveloped
Double Stranded DNA
Linear
Signs and Symptoms
Type 1 HSV
Gingivostomatitis
Keratoconjunctivitis
Encephalitis of Temporal Lobes
Latent in Trigeminal Ganglia
Type 2 HSV
Genital Vesicles
Neonatal Herpes
TORCHES
Latent in Sacral Ganglia
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusions
Treatment
Acyclovir
2 mins
Rituximab
Indications
Chronic Lymphocytic Leukemia (CLL)
Non-Hodgkin Lymphoma
Rheumatoid Arthritis
Microscopic Polyangiitis (MPA)
Granulomatosis with Polyangiitis (Formerly Wegener's)
Mechanism
Monoclonal Antibody Against CD20
Found on B Cell Neoplasms
Side Effects
Infusion Reactions
Skin and Mouth Reactions
Reactivation of Hepatitis B Virus (HBV)
Progressive Multifocal Leukoencephalopathy (PML)
3 mins
TNF-Alpha Inhibitor Drugs and Complications
Etanercept
Decoy TNF- Alpha receptor
Anti-TNF- Alpha antibody
Adalimumab
Infliximab
Complications
Increased risk of infection
Predispose to Tuberculosis (TB) reactivation
Order Baseline PPD- skin test
Quantiferon Gold In-Tube
Order Chest X-Ray
2 mins
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