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Folliculair non-Hodgkin Lymfoom Blok oncologie, April 2012

Folliculair non-Hodgkin Lymfoom Blok oncologie, April 2012. Prof. Dr. Steven Pals, afdeling Pathlogie AMC s.t.pals@amc.uva.nl. Kanker. Celdeling. Celdood. Folliculaire non-Hodgkin Lymfoom. Paradigma voor tumor met. Apoptose defect!. t(14,18 ) deregulatie BCL-2. Structuur lymfklier.

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Folliculair non-Hodgkin Lymfoom Blok oncologie, April 2012

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  1. Folliculair non-Hodgkin LymfoomBlok oncologie, April 2012 Prof. Dr. Steven Pals, afdeling Pathlogie AMC s.t.pals@amc.uva.nl

  2. Kanker Celdeling Celdood

  3. Folliculaire non-Hodgkin Lymfoom Paradigma voor tumor met Apoptose defect! t(14,18) deregulatieBCL-2

  4. Structuur lymfklier

  5. De kiemcentrum reactie(= “Germinal center reaction”) KC KC KC Lymffollikels met kiemcentra

  6. De Kiemcentrum reactie Lymffollikel met Kiemcentrum

  7. B cel ontwikkeling stam cel pro-B pre-B imm. B mature B centroblast centrocyte memory B plasma cel plasma cel ligand? antigeen ! beenmerg milt/lymfklier kiemcentrum bloed, lymfklier, beenmerg

  8. B cel ontwikkeling Diversiteit hoge affiniteit plasma cell

  9. CC CC CC CC CB CB CB CB CB CB CB CB CB Antigeen-specific B cel differentiatie in het Kiemcentrum =germinal center Memory B plasma cell Centrocyte selection: Survival or apoptosis FDC FDC class-switch recombination somatic hypermutation CXCL13 FDC TH FDC TH Centroblast Proliferation/expansion B APC Naïve B antigeen T cell area

  10. CD20 CD3 CD21 BCL2 Het Kiemcentrum in B cel differentiatie

  11. Apoptose van kiemcentrum B cellen rustende B cellen kiemcentrum B cellen

  12. t(14,18) deregulatieBCL-2

  13. BCL-2 en apoptose BCL-2

  14. Bcl-2 translocatie in het Folliculair Lymfoom A) normale B cel maturatie Plasmacel Memory-B Pre-B Mature B GC-B apoptosis B) maturatie van cloon met t(14,18) t(14,18) Pre-B Mature B GC-B Expansion=tumor

  15. BCL-2 expressie in normale and neoplastische kiemcentra

  16. Fluorescence in situhybridization (FISH) BCL-2 #18

  17. Interphase FISH assays BCL-2 # 18 # 14 IgH breakpoint normal break Segregation assay # 18

  18. tumor control

  19. Folliculair non-Hodgkin Lymfoom (samenvatting) kliniek • Meest voorkomende non-Hogkin lymfoom • Oudere patienten groep • Relatief indolent biologie • Tumor van kiemcentrum B cellen • Folliculaire groeiwijze • Apoptose defect door BCL-2 translocatie

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