Nomenclature Leukemia and lymphoma.docx

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University of Manitoba
Biochem. and Medical Genetics
BGEN 3020
Jason Leboe- Mcgowan

Lecture 9 Nomenclature: Leukemia and lymphoma MC on the boards: Auer rod from myeloblast, and hypersegmented neutrophil from B12 and folate deficiency. A. Leukemia = malignancy of stem cells in the BM, and they can metastasize (like all cancer) and to lymph nodes, leading to generalized lymphadenopathy and hepatosplenomegaly. Derived from stem cells in the marrow and metastasize. B. Malignant lymphoma: arise from LYMPH nodes, and can metastasize anywhere, include BM. The MC site in body for lymphoma NOT developing in lymph node: stomach Most extranodal (outside lymph node) primary lymphomas occur in the stomach; H. pylori can produce these. nd 2 MCC location (lymphoid organ in the GI tract) = Payer’s patches (located in the terminal ileum). MC lymphoma = follicular B cell lymphoma. This is an example of knocking off apoptosis gene - 14:18 translocation of a heavy chain; when you get the translocation, B cells will make bcl-2, which inactivates apoptotic gene in the B cell, therefore, the apoptotic gene is immortal, leads to cancer. Nomenclature of Trophoblastic Tumors A. Hydatidiform mole, presents with cluster of grapes. It manifests in the first trimester with signs of preeclampsia (HP, proteinuria, edema in the first trimester). On ultrasound, will see uterus too large for its gestational age, with a snowstorm appearance = classic complete mole; and can progress to choriocarcinoma. B. Choriocarcinoma mole is a benign tumor of the chorionic villus; chorionic villi are lined with trophoblastic cells, including synctiotrophoblast on the outside (has contact with the blood, from which O i2 extracted); under the synctiotrophoblast is the cytotrophoblast, then have warten’s jelly in the chorionic villus, then have vessel that becomes the umbilical vein, which has the most O in2 the vessels of the fetus. So, hydatidiform mole is a B9 tumor of the WHOLE chorionic villus, and it looks like grapes b/c it’s dilated up. Choriocarcinoma is a malignancy of the lining of the chorionic villus: the synctiotrophoblast and the cytotrophoblast (not the actual chorionic villus). Which makes hormones? The syncytiotrophoblast synthesizes B-HCG and human placental lactogen (growth hormone of pregnancy – it gives aa’s and glucose from mom to baby). So, when gestationally derived, and even when they metastasize to the lungs, they respond well to chemotherapy (methotrexate, chlabucil). Therefore, these are highly malignant tumors, but go away with chemotherapy. Things that end in “–oma”: Everything that end in –oma is not necessarily b9 – ie melanoma (malignant tumor of melanocytes), lymphoma (malignant tumor of lymph nodes) Also, all that ends in –oma is not necessarily a neoplasm – ie hemartoma = overgrowth of tissue that is normally present in that area. Example: A bronchial hemartoma seen lung which is b9 cartilage and a solitary coin lesion is seen in lung (also wonder if it’s a granuloma). The polyp in Peutz Jeghers syndrome is a hemartoma (not even a neoplasm), that’s why there is no increase in risk of poly cancer. Hyperplastic polyp (MC polyp in GI) is a hemartoma, it’s a B9 tissue in place it is not suppose to be (ie pancreatic tissue in the stomach) – this is called a choristoma, or heterotopic ret. Meckel’s Diverticulum MC complication of Meckel’s Diverticulum = bleeding from a gastric mucosa that is ulcerated, or pancreatic tissue that is ulcerated. Should gastric mucosa be in the meckel’s diverticulum? No, b/c it is in the small bowel (about 2 ft from the ileocecal valve). Hemartomas are non-neoplastic, and therefore do not have cancer producing potential. Malignant Cells Increased mitotic rate does not mean cancer. What makes mitosis malignant is having an atypical mitotic spindle (they are aneuploid and have more than the normal 46 c’somes). Key thing that determines if it is malignant is its ability to metastasize. Malignant cells usually have a longer cell cycle than the cells t
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