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Old 07-26-2011
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Question What would you expect to have in this Lymphoma!

A 32-year-old man has had worsening headaches for the past 2 months. On physical examination he is afebrile. He has no lymphadenopathy or hepatosplenomegaly. A head CT scan reveals a 3 cm mass lesion to the right of midline next to the lateral ventricle. A stereotaxic brain biopsy is performed and microscopic examination shows diffuse large B cell lymphoma. A bone marrow biopsy is performed and on microscopic examination shows slightly decreased cellularity of all cell lines. Which of the following laboratory test findings is this patient most likely to have?

A Elevated terminal deoxyribonucleodidyl transferase
B Bence-Jones proteinuria
C Elevated serum IgM
D HIV-1 RNA of 8000 copies/mL
E Lymphoma positive for tartrate-resistant acid phosphatase

Please Answer with Explanation
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Old 07-26-2011
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C. Elevated serum IgM.

Im not too sure but considering there is a slight decrease in all other cell lines... this would be my answer.

E. is hairy cell leukemia
B. Is multiple Myeloma
A. is ALL
D. ?
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Old 07-26-2011
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C Elevated serum IgM because it's B cell lymphoma.
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Old 07-26-2011
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Quote:
Originally Posted by mkamal23 View Post
C. Elevated serum IgM.

Im not too sure but considering there is a slight decrease in all other cell lines... this would be my answer.

E. is hairy cell leukemia
B. Is multiple Myeloma
A. is ALL
D. ?
D. Primary CNS lymphoma
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Old 07-26-2011
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Star D

D HIV-1 RNA of 8000 copies/mL

Its Primary B cell lymphoma

Most common Cancer associated with HIV
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Old 07-26-2011
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I'll also go with D, i think is primary CNS lymphoma related to AIDS.
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Old 07-26-2011
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i would go wid D... Primary B cell lymphoma ...
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Old 07-26-2011
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my answer D

c is not much,Waldenstrom's macroglobulinemia(hyperviscosity, retinal hemorhag,strokes,platelet aggregation defect)
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Old 07-26-2011
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Quote:
Originally Posted by rulz View Post
I'll also go with D, i think is primary CNS lymphoma related to AIDS.
D must be the answer
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Old 07-27-2011
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Default Explanation

SOURCE : Webpath

(A) Incorrect. An elevated TdT is typical for acute lymphoblastic T cell leukemia/lymphoma.

(B) Incorrect. Multiple myeloma does not typically involve the brain. Myeloma is a disease of older adults and is composed of plasma cells.

(C) Incorrect. Macroglobulinemia can be seen in some lymphoplasmacytic lymphomas in the marrow (and possibly spleen, liver, and lymph nodes) of older adult

(D) CORRECT. He has a cerebral lymphoma typical for AIDS with HIV infection.

(E) Incorrect. Though hairy cell leukemia is seen in middle aged males, it is accompanied by marked splenomegaly, and there is no CNS involvement.
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