Question 1

The malignant lymphomas are divided into which major categories?

Accepted Answer

The malignant lymphomas are divided into two major categories: Hodgkin's lymphoma (disease) and non-Hodgkin's lymphomas (lymphocytic lymphomas). Choice B and C are not accurate categories for malignant lymphomas.

Question 2

The selection of appropriate therapy for Hodgkin's lymphoma is most directly related to:

Accepted Answer

The stage of the disease is the most critical factor in determining the appropriate therapy for Hodgkin's lymphoma, as it guides treatment intensity and modality.

Question 3

Which of the following are diseases in which Reed-Sternberg-like cells have been reported?

Accepted Answer

Reed-Sternberg-like cells have been reported in all of the listed diseases, including melanoma, viral infections, myeloproliferative disorders, and stromal malignancies.

Question 4

In __________, Reed-Sternberg cells and Reed-Sternberg variants predominate; and lymphocytes are sparse.

Accepted Answer

In lymphocyte depletion Hodgkin's lymphoma, Reed-Sternberg cells and Reed-Sternberg variants are the predominant cells, while lymphocytes are sparse. This is in contrast to the other subtypes of Hodgkin's lymphoma, which have varying degrees of lymphocyte infiltration.

Question 5

All of the following are conditions associated with an increased risk of developing non-Hodgkin's lymphoma except:

Accepted Answer

Niemann-Pick disease is a genetic disorder that affects lipid metabolism and is not known to be associated with an increased risk of non-Hodgkin's lymphoma. However, Sjögren's syndrome, sarcoidosis, systemic lupus erythematosus, and AIDS are conditions that have been linked to a higher risk of developing this type of cancer.

Question 6

A commonly used classification scheme for Hodgkin's lymphoma is:

Accepted Answer

The answer of A commonly used classification scheme for Hodgkin's...

Question 7

An asymptomatic mediastinal mass affecting a young female is a common form of presentation for which form of Hodgkin's lymphoma?

Accepted Answer

Nodular sclerosing Hodgkin's lymphoma is the most common form of Hodgkin's lymphoma and often presents with an asymptomatic mediastinal mass in young females. It can also cause cough or shortness of breath due to compression of the airways. This type of lymphoma has a better prognosis than other types, with a 5-year survival rate of approximately 95%.

Question 8

The diagnosis of Hodgkin's lymphoma requires a __________ and microscopic evaluation.

Accepted Answer

The diagnosis of Hodgkin's lymphoma typically requires a tissue biopsy, such as a lymph node or bone marrow biopsy, that is then evaluated microscopically for the presence of characteristic cells known as Reed-Sternberg cells. Other diagnostic tests may be performed to support the diagnosis, but a tissue biopsy is usually required to confirm the diagnosis. Bone marrow aspirate and biopsy may be performed to determine the extent of disease involvement, but they are not typically used to confirm the diagnosis of Hodgkin's lymphoma. Peripheral blood smear is not typically useful for diagnosing Hodgkin's lymphoma.

Question 9

The most widely used staging system for Hodgkin's lymphoma is the __________ classification.

Accepted Answer

The most commonly used staging system for Hodgkin's lymphoma is the Ann Arbor classification, which categorizes the disease from stage I (involving a single lymph node region or organ) to stage IV (involving multiple organs or lymph node regions). This system is used to determine the extent of the disease and aid in treatment planning.

Question 10

The morphologic hallmark of Hodgkin's lymphoma is a peculiar cell called the __________ cell.

Accepted Answer

The peculiar cell seen in Hodgkin's lymphoma is called the Reed-Sternberg cell. It is large, multinucleated, and has a characteristic "owl's eye" appearance with a large nucleolus surrounded by a clear halo.

Question 11

The accepted etiology for non-Hodgkin's lymphoma is damage to the regions of genetic code that regulate the growth and reproduction of cells of the immune system. What mutagenic factor(s) play(s) a role in initiation of this damage?

Accepted Answer

Chemicals, ionizing radiation, and viruses all have been linked to mutations in the genetic code that regulate the growth and reproduction of immune cells, leading to non-Hodgkin's lymphoma.

Question 12

What current view is accepted as the etiology for Hodgkin's disease?

Accepted Answer

The current accepted view for the etiology of Hodgkin's disease is that it is a malignant proliferation of Reed-Sternberg cells and their variants. These abnormal cells are thought to arise from B-lymphocytes that have undergone genetic mutations which prevent normal cell death and allow them to proliferate uncontrollably.

Question 13

Most patients with Hodgkin's lymphoma present with which symptom?

Accepted Answer

The most common presentation of Hodgkin's lymphoma is painless lymph node swelling, usually in the neck, but it can occur in other parts of the body as well. Other symptoms may also be present, such as fever, fatigue, and night sweats, but these are less common. Pallor is not a typical symptom of Hodgkin's lymphoma.

Question 14

The most frequently occurring subtype of Hodgkin's lymphoma is:

Accepted Answer

The answer of The most frequently occurring subtype of Hodgkin's...

Question 15

Which name is given to the Reed-Sternberg variant cell seen in nodular sclerosing (NS) Hodgkin's lymphoma?

Accepted Answer

The Reed-Sternberg variant cell seen in nodular sclerosing (NS) Hodgkin's lymphoma is known as the lacunar cell.

Question 16

Which of the following are morphological characteristics of the Reed-Sternberg cell?

Accepted Answer

- A) Up to 45 µm in diameter: Reed-Sternberg cells are typically large, ranging from 20-50 µm in diameter.
- B) Multinucleated nucleus: Reed-Sternberg cells have large, often bilobed nuclei that can appear multinucleated.
- C) Distinct halo around macronucleoli: Reed-Sternberg cells often have prominent nucleoli surrounded by a clear area, giving them a characteristic "owl's eye" appearance.

Question 17

With appropriate therapy the 10-year survival of Stage I and II Hodgkin's lymphoma is:

Accepted Answer

With appropriate therapy, the 10-year survival of Stage I and II Hodgkin's lymphoma is greater than 80%. This is because these stages of Hodgkin's lymphoma are often localized, and therefore respond well to treatment. However, survival rates vary depending on individual factors such as age, overall health, and specific subtype of the disease.

Question 18

Which infectious agent is most commonly associated with the pathogenesis of Hodgkin's disease?

Accepted Answer

Epstein-Barr virus (EBV) is most commonly associated with the pathogenesis of Hodgkin's disease. In fact, it has been found that almost all cases of Hodgkin's disease are associated with the presence of EBV.

Question 19

Which Ann Arbor stage corresponds to disseminated involvement of extralymphatic organs with associated lymph node involvement?

Accepted Answer

Stage IV corresponds to disseminated involvement of extralymphatic organs with associated lymph node involvement.

Question 20

Which of the following cell types are commonly found in mixed cellularity Hodgkin's disease?

Accepted Answer

Mixed cellularity Hodgkin's disease is characterized by the presence of all these cell types: lymphocytes, histiocytes, plasma cells, and the distinctive Reed-Sternberg cells.

Quiz 21: The Lymphomas