Devita, Hellman, and Rosenberg's Cancer

LWBK1006-30 LWW-Govindan-Review December 12, 2011 19:35

Chapter 30•Lymphomas 429

Answer 30.8. The answer is C.

The poor prognostic factors in the IPI include age greater than 60, PS

greater than or equal to 2, increased LDH, Ann Arbor stage III or IV, and

greater than or equal to 2 extranodal sites. Hemoglobin less than 12 is a

poor risk factor in the Follicular Index.

Answer 30.9. The answer is A.

HHV-8 is the putative etiology of Castleman’s disease. Endemic Burkitt’s

lymphoma and monocytoid B-cell lymphoma have been associated with

EBV and hepatitis C viruses, respectively.

Answer 30.10. The answer is B.

Primary effusion lymphoma, hairy cell leukemia and lymphomatoid gran-

ulomatosis are mature B-cell neoplasms, whereas anaplastic large cell

lymphoma is a mature T-cell neoplasm.

Answer 30.11. The answer is A.

Thet(11;18)(q21;q21) translocation seen in MALT lymphomas produces

the antiapoptotic API2-MLT fusion protein, which is activated as a con-

sequence of the fusion. Isochromosome 7q deletion is characteristic of

hepatosplenic T-cell lymphoma and not CLL.

Answer 30.12. The answer is C.

Unmutated Ig V region is associated with aggressive disease and correlates

with ZAP-70 expression (a tyrosine kinase protein normally expressed

in T and NK cells) and CD38 antigen expression. (Rassenti LZ, Jain S,

Keating MJ et al. Relative value of ZAP-70, CD38, and immunoglobulin

mutation status in predicting aggressive disease in chronic lymphocytic

leukemia. Blood 2008;112:1923–1930.)

Answer 30.13. The answer is D.

Although CD10 andt(14;18) are characteristic features of follicular lym-

phoma, they may also be present in DLBCL. Lymphoplasmacytic lym-

phoma is CD 10 negative and is associated with thet(9;14) translocation.

Answer 30.14. The answer is C.

IMIDs such as thalidomide and lenalinomide, as well as bortezomib,

have demonstrated activity in lymphoplasmacytic lymphomas. Like most

CD20 positive B-cell lymphomas, the combined use of chemotherapy and

immunotherapy with rituxan has improved the disease-free interval and

led to greater complete remissions.

Answer 30.15. The answer is B.

The most common TCR subtype observed in lymphomas is the.

TCRis seen in hepatosplenic T-cell lymphoma and some cases of

enteropathy-type T-cell lymphoma.