Term
| How do you differentaite acute leukemia vs. chronic leukemia? |
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Definition
Bone marrow aspirate with blast count:
acute > 20% blasts
chronic < 10% blasts |
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Term
| Which leukemia has CNS and testicle involvement? |
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Definition
| ALL (acute lymphoblastic leukemia) |
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Term
| Which leukemia has skin involvement? |
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Definition
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Term
Clinical symptoms of
Acute vs. Chronic leukemias. |
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Definition
Both:
haptosplenomegaly (metastatic)
generalized painless lymphadenopathy (metastatic)
Acute Leukemia:
abrupt onset
fever (infection)
bleeding (thrombocytopenia)
fatigue (anemia)
bone pain (marrow expansion)
Hypercellular marrow >20% blasts
Chronic Leukemia:
insidious onset
thrombocytopenia except in some CML |
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Term
What are Neoplastic Myeloid Disorders?
Types? |
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Definition
neoplasias of stem cells that may involve one or more stem cell lines.
Classified:
- Acute myeloblastic leukemia (AML)
- Myelodysplastic syndrome
- Chronic myeloproliferative disorders (Polycythemia vera, CML, Essential thrombocythemia, Myeloid metaplasia with myelofibrosis) |
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Term
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Definition
short rod structure in cytosol of myeloblasts. Peroxidase-positive, in granulocytes and myeloblasts.
AML!! (not CML) |
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Term
|
Definition
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Term
What leukemia is most common in the following age ranges:
Children (newborn-14yo)
Young Adult (15-39)
Adult (40-60)
Old Age (>60) |
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Definition
Children - ALL * most common cancer in children
Young Adult - AML (*but median age for AML is 60, there is just less going on with young adults)
Adult - AML, then CML.
* differentiate by blasts in marrow, over 20% is AML, under 10% is CML
Old Age - CLL
* CLL is the most common cause of generalized lymphadenopathy in those over 60 |
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Term
| Pruritis all over after showering? |
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Definition
| Polycythemia vera from mast cells releasing histamine. |
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Term
|
Definition
"owl eyes"
Multinucleated-binucleated giant cells
Eosinophilic inclusion-like nucleoli
Severity of Hodgkins lymphoma is proportional to number of these cells (inverse to the number of reactive lymphoctyes)
Neoplastic cell of Hodgkin's lymphoma
CD15 and CD30 positive |
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Term
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Definition
left-sided supraclavicular lymph nodes
inflamed indicates metastatic abdominal cancer
vs. Right sided supraclavicular indicate metastatic lung and esophageal cancer |
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Term
| Epitrochlear lymph nodes enlarged, think of... |
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Definition
syphilis
Cat-scratch disease
Non-Hodgkin's lymphoma |
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Term
| Inflamed Hilar lymph nodes, think |
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Definition
Sarcoidosis (bilateral)
metastatic lung cnacer |
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Term
| Para-aortic lymph node inflammation, think |
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Definition
Burkitt's lymphoma (B-cell Non-Hodgkin's lymphoma)
Testicular metastatic cancer |
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Term
| Painful vs Painless lymphadenopathy |
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Definition
Painless - malignancy
Painful - inflammation |
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Term
|
Definition
Myeloid =
Exclusively from the marrow
Lymphoid =
From marrow, thymus, or lymph node
Undergo multiple DNA slicing events
Can divide even after mature |
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Term
| Hodgkin's vs. Non-Hodgkins |
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Definition
Hodgkin's
RS cells
Constitutional "B" symptoms more common
Single group of nodes, rarely extranodal
Contiguous spread
Half tied to EBV
Most common in young and old
Non-Hodgkins
Constitutional symptoms less common
Multiple peripheral nodes, extranodal common
Noncontiguous spread
Some tied to HIV and immunosuppression
Most common in young adults |
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Term
| Burkitt's lymphoma has what translocation? |
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Definition
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Term
| Mantle cell lymphoma has what translocation? |
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Definition
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Term
| Follicular lymphoma has what translocation? |
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Definition
| t(14;18) bcl-2 expression |
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Term
| What stains TRAP positive? |
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Definition
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Term
|
Definition
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Term
Myeloproliferative dz's
Characteristics |
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Definition
Thrombosis
Hemorrhage
Fatigue, bone pain, pruritis
Splenomegaly, which can lead to GI symptoms
Teardrop shaped RBCs
Promyelocytes in smear
Nucleated RBCs
Types:
Polycethemia Vera
CML
Essential Polycythemia
Primary Myelofibrosis |
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Term
| Which chronic myeloproliferative disorder do you commonly see with bleeding gums and epistaxis (bloody nose)? |
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Definition
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Term
International Prognostic Index
(Staging)
for Non-Hodgkins Lymphoma |
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Definition
APLES
Age >60
Performance status poor
LDH
Extranodal involvement
Stage (ann Arbor stage3-4) |
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Term
International Prognostic Index
(Staging)
for Hodgkins Lymphoma |
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Definition
Serum albumin < 4
hemoglobin < 10.5
male
Ann Arbor stage 4
Age >45
WBC > 15000
Lymphocyte < 600 |
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Term
| Ann Arbor Staging for Hodgkins Lymphoma |
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Definition
1.
single site (node or extralymphatic organ)
2.
two sites on same side of diaphragm
3.
sites on both sides of diaphragm
OR
on same side of diaphragm with local invasion of extralymphatic site
4.
disseminated |
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Term
| Ann Arbor staging for Non-Hodgkins Lymphoma |
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Definition
1.
Single lymph node region
2.
two or more lymph node regions on same side of diaphragm
3.
both sides of diaphragm
4.
multifocal |
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Term
Compare pros and cons
Flow cytometry
Standard cytogenetics
FISH
PCR |
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Definition
Flow cytometry
Can check up to 10 surface antigens at once
Requires expertise and quality assurance
Standard cytogenetics
Helps prognosis and treatment
Requires dividing cells
Poor sensitivity
Doesn't detect balanced translocations or small deletions
FISH
Doesn't require dividing cells
Sensitive
Can be done on archived tissue
You have to know what you're looking for
PCR
Can be used to monitor response to treatment
Most Specific
Most expensive |
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Term
Compare uses for diagnosis and Prognosis
Flow cytometry
Standard cytogenetics
FISH
PCR |
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Definition
Flow cytometry
dx: lymphomas, Paroxysmal nocturnal hematuria (PNH), autoimmune dzs, RBC membrane dzs
prog: minimal residual dz in ALL, risk of thrombosis in PNH
Standard cytogenetics
dx: lymphomas, AML
prog: Multiple myeloma, CLL
FISH
dx:CML, ALL
prog: CLL, Multiple myeloma
PCR
dx: leukemias
prog: AML, Minimal residual dz |
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