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Boards.CP.Heme > Burkitt, ALL, B-ALL, T-ALL > Flashcards

Burkitt, ALL, B-ALL, T-ALL Flashcards

1
Q

Burkitt Lymphoma Morphology:

-Wright stained blood or Cytologic Preps

A

Deep blue cytoplasm w/

-Lipid vacuoles

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2
Q

B-ALL clinical presentation.

A

MC malignancy of Children

-Peaks at 3 years of age

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3
Q

T-ALL Molecular abnormality.

A

TCR rearrangement in nearly ALL cases

-IgH rearrangement in 10-20%

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4
Q 
Lymphoblastic Leukemia (ALL) Vs Lymphoblastic Lymphoma (LBL):
-Lesions involving tissue and sparing blood and BM.
A

LBL

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5
Q

General characteristics of African (endemic) BL.

  • Location
  • Age
  • EBV association
A
  • Jaw mass
  • Kids
  • EBV Positive
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6
Q

T-LBL vs. Thymoma is best distinguished by what?

A

Epithelial Markers

-EMA

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7
Q

B-ALL/LBL favorable prognosis findings:

  • WBC count
  • Ages
  • M/F
  • Chemo response
  • Chromosome number
A

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)
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8
Q

B-ALL/LBL IHC:

-Negative for (2)

A
  • CD20

- sIg

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9
Q

B-ALL/LBL with recurrent genetic abnormalities:

  • Most common structural abnormality
  • Good or Poor prognosis
A

t(9;22) BCR/ABL1

  • minor breakpoint (m-bcr) rearrangement
  • chimeric protein of 190kD

Poor prognosis

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10
Q

B-ALL/LBL molecular/cytogenetic findings.

A

6q, 9p, 12p abnormalities

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11
Q

B-ALL/LBL IHC:

-Positive for (7)

A
  • CD10
  • CD19
  • CD34
  • CD99
  • PAX-5
  • TdT (nuclear)
  • HLA-DR
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12
Q

T/F: PCNA (Ki67) is positive in >99% of cells in BL.

A

True

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13
Q

Burkitt Lymphoma IHC:

-Negative for (5)

A
  • CD5
  • CD23
  • CD34
  • Tdt
  • bcl-2
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14
Q

T-ALL IHC:

  • Positive for (7)
  • Variable (1)
  • Negative (1)
A

Positive for:

  • CD2
  • CD3 (cytoplasmic)
  • CD5
  • CD7
  • CD99
  • TdT (nuclear)
  • CD13/CD33 in some cases (myeloid markers)

Variable for: CD34

Negative for: HLA-DR

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15
Q

Burkitt Lymphoma IHC:

-Positive for (7)

A
  • CD10
  • CD19
  • CD20
  • CD22
  • bcl-6
  • C-myc
  • Surface Ig (sIg)
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16
Q

What are the 3 clinicopathologic types of Burkitt Lymphoma (BL)?

A
  • African (endemic)
  • Western (sporadic)
  • Burkitt-like lymphoma
17
Q

T-ALL expression of CD4 and CD8?

A

Both Positive or Both Negative

18
Q

By Flow Cytometry, Hematogones display a range of expression of what markers? (5)

A
  • CD10
  • CD20
  • CD34
  • Tdt
  • sIg
19
Q

General characteristics of Western (sporadic) BL.

  • Location
  • Age
  • EBV association
A
  • Nodal or Extranodal (often intraabdominal)
  • Children/Young Adults
  • EBV Negative
20
Q

What IHC markers make Burkitt UNLIKELY (vs. DLBCL)? (3)

A
  • CD10 Neg
  • bcl-6 Neg
  • bcl-2 Pos

*Also - BCL2 or BCL6 rearrangements (NOT in BL)

21
Q

T/F: Sometimes C-MYC is rearranged with Ig(kappa)(2p12) or Ig(lambda)(22q11).

A

True

22
Q

30-50% of B-ALL/LBL express at least one what?

A

myeloid antigen

-CD13 or CD33

23
Q

B-ALL/LBL with recurrent genetic abnormalities:

-Abnormalities with GOOD prognosis (2)

A
  • t(12;21) ETV6-RUNX1

- Hyperdiploid (>50 copies)

24
Q

T/F: Hypodiploidy (<46 chromosomes) portends a worse prognosis in B-ALL/LBL.

A

True

25
Q

General characteristics of Burkitt-like Lymphoma.

  • Location
  • Population
A
  • Nodal

- Immunocompromised

26
Q

Burkitt Lymphoma Morphology:

  • Proliferation
  • Nuclei
  • Numerous (cell type)
  • Mitosis/Apoptosis
A
  • Diffuse Proliferation
  • Medium sized, round, 2-5 nucleoli
  • Tingible body macrophages
  • High rate of Mitosis/Apoptosis

*Starry Sky

27
Q

Burkitt’s Vs. B-ALL IHC. (3)

A

Burkitt is:

  • Tdt Neg
  • CD20 Pos
  • sIg Pos
28
Q

B-ALL/LBL IHC:

-CD10 Negativity suggests what?

A

-MLL gene anomaly

29
Q

Burkitt’s Molecular/Cytogenetics.

A

C-MYC gene on chr8 (Rearrangement)

-t(8;14) is MC

30
Q

ALL/LBL morphology. (3)

A
  • Undifferentiated Blasts
  • Cytochemically Negative for MPO and SBB
  • PAS+ in blocklike/coarse granular pattern
31
Q

ALL Vs. LBL:

-Cell lineage

A

ALL - B-cell (80%)

LBL - T-cell (80%)

32
Q 
Lymphoblastic Leukemia (ALL) Vs Lymphoblastic Lymphoma (LBL):
-ALL
A

Marked involvement of BM (>25%) and Blood (>20%), regardless of tissue

33
Q

T-LBL clinical presentation. (2)

A
  • Anterior Mediastinal Mass

- Hypercalcemia common

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