21) CLL Flashcards
patients with widespread ——— often have worse CLL prognosis
lymphoma
the ann arbor staging system is used for…
malignant lymphoma
CLL/SLL
chronic lymphocytic leukemia/small lymphocytic leukemia
different clinical manifestations of one disease entity
CLL/SLL
CLL presents with…
SLL presents with…
PB lymphocytosis
lymphadenopathy
sustained absolute monoclonal lymphocytosis
(>5 x 10^3)
CLL/SLL
lymphocytosis + smudge cells
CLL/SLL
if lymphocytosis is <5 x 10^3, it’s not CLL, its…
B-cell monoclonal lymphocytosis
no chemo yet
CD5
CD20
CD23
CD200
LEF-1 +
CLL/SLL
CD5
CD23=
FMC-7 +
cyclin D1 +
mantle cell lymphoma
CLL/SLL must be distinguished from…
how?
mantle cell lymphoma
MCL is CD23=, FMC-7+, LEF-1=
t(11;14)
mantle cell lymphoma
Richter’s transformation
transformation from CLL → aggressive large B-cell lymphoma
anti-CD20 mAbs
used to tx CLL/SLL
ibrutinib
used to tx CLL/SLL
B-PLL
B-cell prolymphocytic leukemia
B-PLL survival
7.5 months
> 55% prolymphocytes
marked lymphocytosis
B-PLL
HCL
hairy cell leukemia
uncommon B-cell neoplasm more common in males (7:1)
HCL
lymph disorder
massive splenomegaly
no lymphocytosis
pancytopenia
HCL
how is HCL different from CLL?
pancytopenia
other name for MM
plasma cell neoplasm
M-spike
functional hypogammaglobulinemia
Bence Jones protein
MM/plasma cell neoplasm
4 types of plasma cell neoplasms
- symptomatic MM
- asymptomatic MM (smoldering)
- monoclonal gammopathy of undetermined significance
- plasmacytoma
M spike >30 g/L
no organ/tissue damage
BM clonal plasma cells >10%
asymptomatic/smoldering MM
M spike <30 g/L
no organ/tissue damage
BM clonal plasma cells <10%
MGUS
solitary collection of clonal plasma cells
may have M spike
plasmacytoma
MM
hypercalcemia
renal insufficiency
anemia
lytic bone lesions
MM
MM patients often present with…
pathologic fracture
rouleaux
Mott cells
flame cells
Dutcher bodies
PB stains dark blue background (protein)
MM
MM survival (symptomatic)
3-4 years
<65 yo: high-dose chemo + SCT
>65 yo: melphalan chemo + prednisone
MM tx
heterogeneous morphology
histiocytes, plasma cells, eos mixed in
peripheral T-cell lymphoma
usually CD4+/CD8=
complex karyotype
peripheral T-cell lymphoma
marked lymphocytosis
skin lesions
hepatosplenomegaly
variable morphology
peripheral T-cell prolymphocytic leukemia
modest but prolonged lymphocytosis
must differentiate from reactive lymphocytosis
usually requires evidence of abnormal phenotype/clonality
T-cell large granular lymphocytic leukemia
the only frequent T-cell lymphoma, with a good prognosis
T-cell large granular lymphocytic leukemia
associated with RA
T-cell large granular lymphocytic leukemia
Felty’s syndrome (RA, splenomegaly, neutropenia) associated with…
T-cell large granular lymphocytic leukemia
CD4=/CD8+
T-cell large granular lymphocytic leukemia
T-cell large granular lymphocytic leukemia requires ….. to dx
molecular studies on clonal T-cell receptor rearrangement
ATLL
adult t-cell leukemia/lymphoma
caused by HTLV-1
adult t-cell leukemia/lymphoma
hyperlobated, cloverleaf nuclei
adult t-cell leukemia/lymphoma
FoxP3
adult t-cell leukemia/lymphoma
