Children (3-5 yrs)

Pancytopenia

h/o radiation tx

a/w Down's syndrome

>30 yrs

Pancytopenia

Auer Rods (cytoplasmic needles)

DIC

30-50 yrs

WBC >50

Philadelphia Chromosome (t9;22)

Blast Crisis (-> ~AML)
Splenomegaly

>50 yrs

Males

Lymphadenopathy

Lymphocytosis (B cells)

Infections

Smudge cells (fragile; artifact of smearing)

Splenomegaly

Adults

Subtype of CLL

(Mature B cell neoplasm)

Splenomegaly

Hairy cytoplasmic projections from B cells

Mycosis fungoides

(Sézary syndrome)

>50 yrs

Cutaneous CD4 T cell lymphoma (non-Hodgkin's)

Plaque-like, itchy skin rash; does not improve c tx

Smear: cerebriform (convoluted) nuclei

Pautrier miccroabscesses in epidermis

Clearly, not a fungus!

Children

B cells

c-myc translocation

"Starry sky" - macrophages c apoptic reside inside

a/w Epstein-Barr Virus

Adults

a/w HIV-AIDS

Ring-enhancing lesions on CT head

(ddx: toxoplasmosis)

Adults

Mature T cells

Cause - ?HTLV-1

15-34 yrs

B cell lymphoma

Reed-Sternberg Cells (binucleate B cells)

Cervical lymphadenopathy

Night sweats

Any age

Best prog: small follicular

Worst prog: large diffuse

Primary tumor: ?GI tract

Myelodysplasia

Myelofibrosis

>50 yrs

Anemia

Teardrop RBCs

Dry tap on marrow bx

High MCV and RBC distribution width

a/w CML

>40 yrs

Plasma cells

Bence Jones protein (urinary free light chains)

-------50% IgG, 25% IgA

Osteolytic lesions

RBC rouleaux

Hypercalcemia

Renal failure

>40 yrs

Hyperviscous serum

Monoclonal IgM spike

Cold agglutins (Raynaud's)

Chronic oozing from nose, gums

>40 yrs

High Hb

Pruritus s/p hot bath/shower

Tx: Phlebotomy

>50 yrs

Platelets >1,000,000

Bleedings or thrombosis