Term
What hematologic disease matches the following statement?
- Most common lymphoma in US
- Reed-Sternberg cells
- Particularly associated with EBV
- Associated with long term celiac disease
- Lymphoma equivalent of CLL
- “Starry-sky pattern” due to phagocytosis of apoptotic tumor cells
- Associated with Sjogren syndrome, Hashimoto thyroiditis, and H. pylori |
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Definition
Most common lymphoma in US: Diffuse large B-cell lymphoma
Reed-Sternberg cells: Hodgkin lymphoma
Particularly associated with EBV: Burkitt and Hodgkin Lymphomas
Associated with long term celiac disease: Intestinal T-cell lymphoma
Lymphoma equivalent of CLL: Small lymphocytic lymphoma
“Starry-sky pattern” due to phagocytosis of apoptotic tumor cells: Burkitt lymphoma
Associated with Sjogren syndrome, Hashimoto thyroiditis, and H. pylori: Marginal cell MALToma |
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Term
| Compare the age distribution of those affected by Hodgkin lymphoma to those affected by non-Hodgkin lymphoma |
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Definition
| Hodkin: bimodal; Non-hodgkin: 40-60, pretty disperse |
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Term
| What is the most common type of non-Hodgkin lymphoma in adults? In children? |
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Definition
| Adults: diffuse B large cell lymphoma; children: lymphoblastic lymphoma |
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Term
| What clinical presentation might lead you to suspect a patient may have lymphoma? |
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Definition
| B-signs, Reed-sternberg cells (Hodgkins); non-tender painless lymphadanopathy, extranodal involvement (non-Hodgkins) |
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Term
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Definition
• Rapid onset and rapidly progressive
• Over 50% myeloblasts (AML) or lymphoblasts (ALL) in the bone marrow
• Numerous blast (immature) cells (> 20% blasts)
• Often associated with pancytopenia (anemia, bleeding tendency, infection) |
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Term
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Definition
• Philadelphia chromosome may be seen (poor prognosis)
• Most common in children and young adults
• Males > females, whites > blacks
• B cell types more common that T cell
• 3 morphologic variants and 5 phenotypic variants
• Bone pain is common
• Most have the enzyme terminal deoxynucleotide transferase
(TdT)
• Very good prognosis in children (up to 90% remission)
• PAS (+)
• Difficult to diagnose on blood smear (others can be diagnosed with smear) |
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Term
| What are common features of AML? |
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Definition
• Philadelphia chromosome rarely seen
• Characteristic Auer rods
• 8 different morphological classifications
• Most all are CD 13/33 (+)
• Usually nonspecific esterase (+) myeloid cells
• Median age of onset is 50
• PAS (-)
• Associated with numerous risk factors |
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Term
| What are the 8 types of AML? |
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Definition
• M0 undifferentiated
• M1 minimal differentiation/maturation
• M2 with differentiation/maturation
• M3 acute promyelocytic
• M4 myelomonocytic /myelomonoblastic
• M5 pure monocytic /monoblastic
• M6 erythroleukemia
• M7 megakaryocytic |
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Term
| What are some risk factors of AML? |
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Definition
• Radiation, benzene, or alkylating agents (such as in Hodgkin lymphoma treatment)
• Myeloproliferative disease, myelodysplastic syndrome, or aplastic anemia
• Down anemia, Fanconi syndrome, or Bloom syndrome |
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Term
| What are the morphological types of ALL? The phenotypic types? |
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Definition
ALL type by morphology
• L1- small blasts
• L2- large blasts with prominent nucleoli
• L3- large blasts with cytoplasmic vacuoles
ALL types by phenotype
• common (= L1)
• null (= L1)
• T (= L2)
• B (= L3) |
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Term
| Describe the progression of chronic leukemia? What is the blast percentage? |
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Definition
• Insidious onset and gradual progression (months to years)
• Mature cells (rather than blasts) (< 5% blasts)
• Can be either myeloid (CML) or lymphoid (CLL)
• Associated with hepatosplenomegaly and lymphadenopathy
• Prominent infiltration of bone marrow by leukemic cells and peripheral WBC counts may be high |
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Term
| What is the most common adult leukemia seen in western countries? |
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Definition
CLL
• Males > females, whites > blacks
• Adults over age 50
• 95% have B cell markers (rather than T cell)
• 10% progress to ALL
• Characteristic smudge cells and
• Autoimmune hemolytic anemia
• Tends to be indolent |
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Term
| What can CML progress to? |
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Definition
• May progress to AML (80%) or ALL (20%)
• Numerous basophils and PMNs are LAP (-)
• Adults ages 25-60
• Hyperplasia of all 3 cell lines (granulocytic, erythroid, and megakaryocytic) but granulocyte precursors predominate
• Philadelphia chromosome (t 9;22) is always present
• Fatigue, abdominal pain, splenomegaly, bleeding tendency |
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Term
| A patient with anemia, hypercalcemia, and bone pain receives a bone marrow biopsy which reveals plasma cells (large, round, off-center nucleus). What is the diagnosis, and what may be found on urinalysis? |
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Definition
| Multiple myelmoa, nothing on urinalysis, Urine protein electrophoresis: see monoclonal |
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Term
| What's the most common leukemia in children? |
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Definition
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Term
| What's the most common leukemia in adults in the US? |
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Definition
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Term
| What has characteristic Auer rods? |
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Definition
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Term
| What do myelodysplastic syndromes tend to progress to? |
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Definition
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Term
| What do myeloproliferative disorders tend to progress to? |
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Definition
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Term
| What leukemia demonstrates greater than 20% blasts in marrow? |
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Definition
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Term
| What is the leukemia that presents with more mature cells and less than 5% blasts? |
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Definition
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Term
| What acute leukemia is PAS+? |
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Definition
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Term
| What leukemia commonly presents with bone pain? |
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Definition
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Term
| What leukemia presents with numerous basophils, splenomegaly, and negative for leukocyte alkaline phosphatase (LAP)? |
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Definition
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Term
| What leukemia is always positive for the Philadelphia chromosome (t9;22) |
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Definition
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Term
| What acute leukemia is positive for peroxidase? |
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Definition
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Term
| What leukemia shows solid sheets of lymphoblasts in the marrow? |
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Definition
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Term
| What is the PAS(-) acute leukemia? |
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Definition
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Term
| What leukemia is always associated with the BCR-ABL genes? |
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Definition
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