Acute Leukaemia and Lymphoma Flashcards
What can be used to differentiate between lymphoid and non-lymphoid cells?
Morphological assessment
Immunophenotyping
Describe malignant haemopoeisis?
Increased number of abnormal/dysfunctional cells
Outline the problem in acute leukaemias?
Normal proliferation of abnormally immature cells which then have altered differentiation
Outline the problem in chronic myeloprolierative disorders?
Proliferation of abnormal progenitor cells
What is a driver mutation?
A mutation in a parent cell which is present in daughter cells which gives a growth advantage
What is a passenger mutation?
Mutations which do not give a growth advantage but just happens to be present in the ancestor cell when it acquired the driver mutation
Malignant haemopoeisis is normally polyclonal true/false
False - it is monoclonal
What is the type of malignancy dependent on?
Lineage
Developmental stage
Anatomical site
Which cells are mostly involved in CLL?
B cells
Which cells are mostly involved in myeloma?
Plasma cells
What is a lymphoma?
Lymphoid malignancy with lymph node involvement
Which histological features are present in acute leukaemia cells?
High nuclear:cytoplasmic ratio
Prominent nuclei
Rapid proliferation
How do acute leukaemias present?
Bone marrow failure symptoms
What in an acute leukaemia?
Rapidly progressive clonal malignancy of marrow with maturation defects
Which group commonly gets AML?
> 60
Which subtype of AML is associated with a coagulopathy?
T(15;17)
What is ALL?
Acute lymphoblastic leukaemia
Disease of lymphoblasts
How does ALL present?
Anaemia
Bleeding
Infection
Bone pain
What does FBC show in ALL?
low Hb
low platelets
low neutrophils
What are auer rods?
Abnormal collections of granules
Needle shaped
Within cells
In which conditions are Auer rods seen?
AML
What can be used to differentiate between AML and ALL?
Immunophenotyping
Describe the morphology of bone marrow aspirate in ALL?
Hypercellular
Cells looks similar
Large cells
High N:C ratio
What is a trephine biopsy?
Circular piece of bone sawed out when the bone marrow aspirate is shit
How is AML treated?
2-4 cycles of chemo
5-10 days of chemo followed by 2-4 weeks of recovery
What infections are patients with marrow suppression particularly at risk of?
Gram neg
When should broad spec antibiotics be given in bone marrow suppression?
Soon as there is a neutropenic fever
Describe the lymphadenopathy seen in lymphoma
Slow onset
Painless
Rubbery/soft
Smooth
Describe the lymphadenopathy seen in viral infection?
Painful
Hard
Smooth
Describe the lymphadenopathy seen in bacterial infection
Painful
Hard
Smoothed
Inflamed
How does lymphoma present?
Night sweats Weight loss Itch Alcohol induced pain Fatigue
How is suspected lymphoma investigated?
Lymph node biopsy
What is the role of immunohistochemistry in lymphoma investigation?
Confirm and sub-classify lymphoma
Where is Burkitt’s lymphoma seen most commonly?
Bone marrow
