Burkitt, ALL, B-ALL, T-ALL Flashcards
Burkitt Lymphoma Morphology:
-Wright stained blood or Cytologic Preps
Deep blue cytoplasm w/
-Lipid vacuoles
B-ALL clinical presentation.
MC malignancy of Children
-Peaks at 3 years of age
T-ALL Molecular abnormality.
TCR rearrangement in nearly ALL cases
-IgH rearrangement in 10-20%
Lymphoblastic Leukemia (ALL) Vs Lymphoblastic Lymphoma (LBL): -Lesions involving tissue and sparing blood and BM.
LBL
General characteristics of African (endemic) BL.
- Location
- Age
- EBV association
- Jaw mass
- Kids
- EBV Positive
T-LBL vs. Thymoma is best distinguished by what?
Epithelial Markers
-EMA
B-ALL/LBL favorable prognosis findings:
- WBC count
- Ages
- M/F
- Chemo response
- Chromosome number
B-ALL/LBL favorable prognosis findings:
- Low initial WBC count
- Ages 2-10 y/o
- Females
- Complete remission (d14 BM)
- Hyperdiploidy is favorable (higher chromosome number)
B-ALL/LBL IHC:
-Negative for (2)
- CD20
- sIg
B-ALL/LBL with recurrent genetic abnormalities:
- Most common structural abnormality
- Good or Poor prognosis
t(9;22) BCR/ABL1
- minor breakpoint (m-bcr) rearrangement
- chimeric protein of 190kD
Poor prognosis
B-ALL/LBL molecular/cytogenetic findings.
6q, 9p, 12p abnormalities
B-ALL/LBL IHC:
-Positive for (7)
- CD10
- CD19
- CD34
- CD99
- PAX-5
- TdT (nuclear)
- HLA-DR
T/F: PCNA (Ki67) is positive in >99% of cells in BL.
True
Burkitt Lymphoma IHC:
-Negative for (5)
- CD5
- CD23
- CD34
- Tdt
- bcl-2
T-ALL IHC:
- Positive for (7)
- Variable (1)
- Negative (1)
Positive for:
- CD2
- CD3 (cytoplasmic)
- CD5
- CD7
- CD99
- TdT (nuclear)
- CD13/CD33 in some cases (myeloid markers)
Variable for: CD34
Negative for: HLA-DR
Burkitt Lymphoma IHC:
-Positive for (7)
- CD10
- CD19
- CD20
- CD22
- bcl-6
- C-myc
- Surface Ig (sIg)
What are the 3 clinicopathologic types of Burkitt Lymphoma (BL)?
- African (endemic)
- Western (sporadic)
- Burkitt-like lymphoma
T-ALL expression of CD4 and CD8?
Both Positive or Both Negative
By Flow Cytometry, Hematogones display a range of expression of what markers? (5)
- CD10
- CD20
- CD34
- Tdt
- sIg
General characteristics of Western (sporadic) BL.
- Location
- Age
- EBV association
- Nodal or Extranodal (often intraabdominal)
- Children/Young Adults
- EBV Negative
What IHC markers make Burkitt UNLIKELY (vs. DLBCL)? (3)
- CD10 Neg
- bcl-6 Neg
- bcl-2 Pos
*Also - BCL2 or BCL6 rearrangements (NOT in BL)
T/F: Sometimes C-MYC is rearranged with Ig(kappa)(2p12) or Ig(lambda)(22q11).
True
30-50% of B-ALL/LBL express at least one what?
myeloid antigen
-CD13 or CD33
B-ALL/LBL with recurrent genetic abnormalities:
-Abnormalities with GOOD prognosis (2)
- t(12;21) ETV6-RUNX1
- Hyperdiploid (>50 copies)
T/F: Hypodiploidy (<46 chromosomes) portends a worse prognosis in B-ALL/LBL.
True
General characteristics of Burkitt-like Lymphoma.
- Location
- Population
- Nodal
- Immunocompromised
Burkitt Lymphoma Morphology:
- Proliferation
- Nuclei
- Numerous (cell type)
- Mitosis/Apoptosis
- Diffuse Proliferation
- Medium sized, round, 2-5 nucleoli
- Tingible body macrophages
- High rate of Mitosis/Apoptosis
*Starry Sky
Burkitt’s Vs. B-ALL IHC. (3)
Burkitt is:
- Tdt Neg
- CD20 Pos
- sIg Pos
B-ALL/LBL IHC:
-CD10 Negativity suggests what?
-MLL gene anomaly
Burkitt’s Molecular/Cytogenetics.
C-MYC gene on chr8 (Rearrangement)
-t(8;14) is MC
ALL/LBL morphology. (3)
- Undifferentiated Blasts
- Cytochemically Negative for MPO and SBB
- PAS+ in blocklike/coarse granular pattern
ALL Vs. LBL:
-Cell lineage
ALL - B-cell (80%)
LBL - T-cell (80%)
Lymphoblastic Leukemia (ALL) Vs Lymphoblastic Lymphoma (LBL): -ALL
Marked involvement of BM (>25%) and Blood (>20%), regardless of tissue
T-LBL clinical presentation. (2)
- Anterior Mediastinal Mass
- Hypercalcemia common
