20: Hematopathology Flashcards
Peripheral blood smear with many prolymphocytes: small- to medium-sized lymphocytes with clumped nuclear chromatin. Scattered smudge cells (osmotically fragile cells) are also present. What disease?
B cell SLL/CLL (small lymphocytic lymphoma / chronic lymphocytic lymphoma)
Peripheral blood shows smaller RBCs, intense staining and lack of central pallor?
Hereditary spherocytosis
In peripheral blood: anisocytosis (diff sizes), poikilocytosis (teardrop form), nucleated RBCs
In bone marrow: collagen fibrosis, osteosclerosis, abnormal megakaryocytes
Idiopathic/primary myelofibrosis
AML-related neoplastic myeloid cells that have gathered in the skin.
Myeloid Sarcoma / Monoblastic Sarcoma / Granulocytic Sarcoma / Chloroma
A. Partially effaced lymph node with accumulation of malignant cells in the subcapsular sinus. B. Hallmark cells: large and pleomorphic intrasinusoidal lymphoma cells with kidney-shaped nuclei and an eosinophilic zone near the nucleus. What disease?
Anaplastic large cell lymphoma (ALCL)
What disease presents with hypochromic, microcytic RBCs in peripheral blood; anisopoikilocytosis, target cells, and nucleated red blood cells?
Thalassemia
These lytic bone lesions are associated with what disease?
Plasma cell myeloma
Broad bands of fibrosis in the lymph node against a dense inflammatory background. What Hodgkin subtype?
Nodular sclerosis Hodgkin lymphoma
Reed-Sternberg cells at the arrow, mixed inflammatory background, many small T cells, no fibrotic bands. What Hodgkin subtype?
Mixed cellularity Hodgkin lymphoma
Peripheral smear of what disease?
Hairy cell leukemia
Cells with mirror-image nuclei containing large eosinophilic nucleoli are given what name and are characteristic for what disease?
Reed-Sternbery cells; Hodgkin’s lymphoma
Neoplastic follicles with small centrocytes (cleaved cells) and few centroblasts. What grade of follicular lymphoma?
Grade 1
Neoplastic follicle with predominantly centroblasts and few centrocytes. What grade of follicular lymphoma?
Grade 3
What disease presents with lack of central pallor and irregular spikes on RBCs?
Acanthocytosis
Thickened capsule, broad bands of fibrosis, foci of necrosis. What Hodgkin subtype?
Nodular sclerosis Hodgkin lymphoma
These atypical lymphoctyes are characteristic of what EBV presentation?
Infectious mononucleosis
Follicular hyperplasia surrounded by small collections of interfollicular epithelioid macrophages can be seen in what infectious disease?
Toxoplasmosis
Neoplasm showing bone marrow with increased atypical, hypolobated megakaryocytes
Essential thrombocythemia
Bone marrow smear featuring deeply basophilic cytoplasm and lipid vacuoles. What disease?
Burkitt lymphoma
Kind of anemia in B12 deficiency.
Megaloblastic anemia / pernicious anemia
(arrows point to megaloblasts, RBC precursors)
Anemia where bone marrow consists largely of fat cells and lacks hematopoietic activity.
Aplastic Anemia
Neoplastic follicle with small and large cleaved cells and centroblasts with mutliple nucleoli. What grade of follicular lymphoma?
Grade 2
In this blood smear showing microangiopathic hemolytic anemia due to DIC, what do the curved and straight arrows point to?
Curved: schistocytes
Straight: Howell-Jolly bodies
Lymphoblasts are in the peripheral blood. They have irregular and indented nuclei with fine nuclear chromatin, visible nucleoli, and variable amounts of agranular cytoplasm. What type of blood neoplasm is this?
Acute lymphoblastic leukemia
A stomach biopsy with lymphoepithelial lesions and infiltrating B cells is characteristic of what neoplasm?
MALT lymphoma
Hodgkin/Reed-Sternberg cells in a fibrotic background with reduced reactive lymphocytes. What Hodgkin subtype?
Lymphocyte-depleted Hodgkin lymphoma
Ringed sideroblast (A) and dysplastic megakaryocyte with nuclear separation (B). What disease?
Myelodysplastic syndrome
Neoplastic epithelial cells and normal lymphocytes in what kind of tumor?
Thymoma
PTAH stained glomerulus shows several microthrombi due to what thrombocytopenic condition?
DIC (disseminated intravascular coagulation)
Hereditary elliptocytosis
Hyperplasia of what organ shown here is most commonly associated with myasthenia gravis?
Thymus
Eosinophilic granuloma, shown in this rib section, is a subtype of what kind of neoplasm? (Hint: the electron micrograph shows a Birbeck granule)
Langerhans cell histiocytosis
Neoplastic immune cells can show variable cytologic features ranging from normal-appearing cells (A) to cells resembling blasts (B). Total number, clonality and clinicopathologic findings help distinguish what neoplasm shown?
Plasma cell myeloma
Macrophage engulfing bone marrow cells
Hemophagocytic syndrome
Hypocellular bone marrow, with normal architecture effaced by myeloblasts. What disease?
AML
What kind of cells are seen in this blood smear from a patient with vitamin B12 deficiency?
Hypersegemented granulocytes
APL (subtype of AML). What kind of cytoplasmic inclusions are pointed out by the arrows?
Auer rods
Nucleated RBCs are particularly numerous in what hemolytic disease?
Hemolytic disease of the newborn
Agglutination caused by what?
Cold agglutinins / Cold antibody AIHA (autoimmune hemolytic anemia)
Dsyplastic, large erythroid precursors in the bone marrow
Myelodysplastic syndrome
Sickle cell anemia
What tumor?
Thymoma
These cerebriform “Sezary cells” are found in the leukemic phase of what neoplasm?
Mycosis fungoides (cutaneous T-cell lymphoma)
Normal lymph node architecture effaced by sheets of mast cells?
Mastocytosis
Schistocytes in a patient with TTP are due to what kind of anemia?
Microangiopathic hemolytic anemia
Lymph node architecture is replaced by a diffuse proliferation of small lymphocytes mixed with larger paraimmunoblasts. What disease?
B-cell SLL/CLL (small lymphocytic lymphoma / chronic lymphocytic lymphoma)
Diffuse proliferation of large lymphoid cells with clonal Ig gene rearrangements. Similar to diffuse large B-cell lymphoma, but occurs in immunocompromised patients. Inset shows EBV+ neoplastic lymphocytes. What disease?
Posttransplant lymphoproliferative disorders
Normal lymph node architecture is replaced by malignant lymphoid follicles in a back-to-back pattern. The inset shows malignant lymphoid follicle germinal centers positive for Bcl-2. What disease?
Follicular lymphoma
Bone marrow biopsy showing infiltration by small to medium-sized lymphocytes with oval to reniform nuclei and pale cytoplasm; circumferential hair projections seen in peripheral blood and bone marrow aspirate smears. What disease?
Hairy cell leukemia
Disease caused by increased megakaryocytes in the bone marrow?
Idiopathic thrombocytopenic purpura
Bcl-1 / Cyclin D1 positive nuclear stain that corresponds to t(11;14). What disease is shown?
Mantle cell lymphoma
“Fried egg” lymphocytes with kidney-shaped nuclei are infiltrating the bone marrow in what disease?
Hairy cell leukemia
Hypercellular bone marrow with granulocytes at various stages of development?
CML
Sheets of large B cells with prominent nucleoli are present in the lymph nodes of what disease?
Diffuse large B cell lymphoma
CD15+, CD30+, CD45-, EBV LMP+ stain. What disease?
Hodgkin lymphoma
Mixed inflammatory background with eosinophils, Reed-Sternberg cells, and lacunar cells. What Hodgkin subtype?
Nodular sclerosis Hodgkin lymphoma
Lymph node effaced by neoplastic lymphocytes with several “starry-sky” macrophages. What disease?
Burkitt lymphoma
Toxoplasmosis with follicular hyperplasia. What are the pink cells?
Epitheliod macrophages
