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Richter Transformation

Quiz by Sadeq K. Ali Al-Salait

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14 questions
Show answers
  • Q1
    What is Richter transformation commonly defined as?
    A type of viral infection
    A form of benign lymphadenopathy
    A genetic mutation in CLL
    A histologic transformation of CLL to an aggressive lymphoma
    30s
  • Q2
    What is the most common type of lymphoma associated with Richter transformation?
    Hodgkin lymphoma
    B-lymphoblastic leukemia
    Plasmablastic lymphoma
    Diffuse large B-cell lymphoma
    30s
  • Q3
    What percentage of CLL patients typically undergo Richter transformation?
    1–5%
    2–10%
    20–30%
    10–20%
    30s
  • Q4
    Which finding significantly increases the risk of Richter transformation?
    weak expression of the CD19 marker
    Normal telomere length
    High levels of beta-2 microglobulin

    Complex karyotype 

    IGHV-unmutated status of leukemic B cells
    30s
  • Q5
    What clinical symptoms indicate the onset of Richter transformation?
    Stable lymph node size and low-grade fever
    High blood pressure and dizziness
    Clinical syndrome related to immune deficiency 
    Accelerated increase in lymphadenopathy, splenomegaly, and B symptoms
    30s
  • Q6
    What is the gold standard for diagnosing Richter transformation?
    Biopsy of an affected lymph node or involved extra nodal site

    Flowcytometry on peripheral blood sample

    Imaging studies
    Physical examination
    Blood tests including blood film morphology and biochemical panel
    30s
  • Q7
    What is a significant prognostic factor for patients with DLBCL-type Richter transformation?

    Biochemical markers (B2MG and M protein)

    Clonal relationship between CLL and DLBCL
    Presence of specific symptoms

    Tumor burden assessed by number and size of nodes involved

    Patient's age at diagnosis
    30s
  • Q8
    Which treatment is recommended for clonally unrelated CLL and DLBCL?
    Treat as de novo DLBCL with R-CHOP
    Immediate stem cell transplant

    Immunotherapy alone by rituximab 

    Observation without treatment
    High-dose chemotherapy alone
    30s
  • Q9
    What is the typical median overall survival for patients diagnosed with HL-type Richter transformation?
    1–2 years
    2.6–3.9 years

    Similar to age-matched CLL patient 

    5–7 years
    10 years
    30s
  • Q10
    What is a key histopathological feature of DLBCL in Richter transformation?
    Small lymphocyte foci

    Heterogeneous

    Presence of RS-like cells 
    Necrotic tissue without lymphocytes
    Sheets of large B-lymphoid cells
    30s
  • Q11

    Which genetic alteration is most strongly associated with a high risk of Richter Transformation?

    Normal karyotype

    t(8;14)

    del(17p13)

    t(11;14)

    Trisomy 12

    30s
  • Q12

    What extramedullary site is most commonly involved in RT?

    Skin

    Lung

    Adrenals

    CNS

    GIT

    30s
  • Q13

    What SUV value on PET/CT typically raises suspicion for RT?a) SUV >2.0

    b) SUV >3.0

    c) SUV >5.0

    d) SUV >7.0

    e) SUV >10.0

    >10.0

    >7.0

    >5.0

    >2.0

    >3.0

    30s
  • Q14

    Which immunophenotypic marker is most commonly expressed in RT-DLBCL?

    CD20, CD30, CD15

    CD10, CD117, CD20

    CD20, CD22, PAX5

    CD19, CD5, CD23

    CD19, CD25, HLA-DR

    30s

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