B-cell lymphoma and myeloma- quiz with answers

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The typical immunophenotype of CLL/ SLL tumor cells includes:

Bright expression of surface Ig and B- cell markers, along with positivity for CD5 and CD23

Dim expression of surface Ig and B- cell markers, along with positivity for CD5 and CD23

CD10, CD20 and CD5 positivity

Cyclin D1, CD20 and CD5 positivity

None

Which of the following imparts a poor prognosis for patients with CLL/SLL?

CD38 negativity

ZAP- 70 negativity

Presence of deletion 13q

Presence of trisomy 12

None

A 60- year old man presented with weight loss and fatigue. Examination of complete blood counts showed anemia and leukocytosis, peripheral smear shows > 55% of the cells having the morpology ( in picture). Which of the following is the correct statement regarding this condition

On immunophenotyping the cells strongly express surface IgM and IgD

CD 5 and CD 23 are positive in 100 % cases

ZAP 70 and CD 38 are always negative

All are true

None

A 65 year old man presented with weakness and abdominal distension. On examination he had pallor and splenomegaly. Blood counts were as follows. Hb- 6.0 g/dl WBC- 2 X 109 /L PLT- 40,000 X 106/ L Cells shown in the peripheral smear were TRAP positive. Which is true regarding this condition?

Splenectomy is the treatment of choice

CD27 is positive in immunophenotyping

Only 30 % show BRAFV600E mutation

Does not involve the white pulp of spleen

None

A distinct feature seen in hairy cell leukemia variant but not in hairy cell leukemia is:

Splenomegaly

Circulating neoplastic lymphocytes in the peripheral blood

Pancytopenia

Prominent nucleoli

None

This low-power photomicrograph shows a lymphoma composed of CD10-positive and CD5-negative lymphocytes with high levels of cytoplasmic IgG. Which of the following cytogenetic abnormalities is most likely to be present?

Follicular lumphoma

t(8;14)

t(11;14)

Trisomy 12

t(14;18)

None

TRAP ( Tartrate resistant alkaline phosphatase positivity) is seen in all of the following conditions except

Gaucher disease

Hodgkins lymphoma

Osteoporosis

Osteoclastoma

None

All of the following markers may be used to differentiate Hairy cell leukemia and splenic marginal zone lymphoma except?

Annexin A1

Surface immunoglobins

CD25

CD103

None

Which of the following is true regarding mantle cell lymphoma?

Blastoid variant cells are always CD 5 positive

Small cell variant of mantle cell has an indolent course

CD 5 is positive in in-situ mantle cell lymphoma

Leukemic non nodal mantle cell lymphoma is an entity with significant lymphadenopathy

None

What is the grade of the follicular lymphoma- containing 6-15 centroblasts per high power field.

Grade 1

Grade 2

Grade 3A

Grade 3B

None

Which is true regarding treatment of Marginal zone lymphoma

Extranodal marginal zone lymphoma with lack of genetic translocations are associated with poor response to Have. pylori eradication

Nodal marginal zone lymphomas are always negative for CD 43

Most common translocation associated with nodal marginal zone lymphoma is – t(11;18).

H. Pylori is involved in the pathogenesis of Cutaneous MALT lymphomas

None

Identify the true statement regarding prognostic factors of Diffuse large B cell lymphoma

Germinal center type phenotype carries a bad prognosis

Double expression of bcl2 and MYC has poor prognosis

Bcl-6 rearrangement has a poor prognosis

All are true

None

Which of the following positive immunohistochemical stains should make one reconsider a diagnosis of Burkitt lymphoma?

Bcl2 positivity

CD10 positivity

Bcl 6 positivity

CD20 positivity

None

A biopsy of an enlarged cervical lymph node reveals a nodular growth pattern that effaces the nodal architecture, sparing an attenuated rim of residual lymphoid tissue. Within a cellular background rich in small lymphocytes, classic RS cells are identified. The latter express CD15, but not CD45. Which of the following is the HL variant in this case?

Rs cells in hodgkins lymphoms

Lymphocyte-depleted HL

Lymphocyte-rich classic HL

Nodular lymphocyte-predominant HL

Nodular sclerosis HL

None

Which of the following is true about lymphocyte-depleted Hodgkin lymphoma (LDHL)?

Accounts for more than 50% of HL cases.

Bone marrow involvement is rare.

Most patients present with localized cervical lymphadenopathy.

Some cases show diffuse fibrosis with PAS-positive material.

None

Which is false regarding the condition shown in this picture?

Hyaline vascular castleman disease

Follicular atrophy

Onion skinning of mantle zones

Plasma cell infiltrates

Penetrating vessels in the germinal centers

None

38. Most common genetic change in splenic marginal zone lymphoma?

A. Deletion 7q

B. NOTCH 2

C. 14 q

D. p53

None

39. True regarding Nodular lymphocyte predominant hodgkins lymphoma (NLPHL)

A. Neoplastic cells are positive for CD 20

B. Neoplastic cells are positive for CD 30

C. Neoplastic cells are positive for CD 15

D. Neoplastic cells are positive for EBV

None

40. All of the following CD markers are positive in plasma cell leukemia except?

A. CD 138

B. CD 38

C. CD 79a

D. CD 56

None

What is the risk status based on the karyogram of this patient with plasma cell myeloma?

Multiple myeloma

Standard risk

Low risk

High risk

Intermediate risk

None

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