Chronic Leukemia Flashcards
What is chronic lymphocytic leukemia. What is seen on blood smear? What does lymph node involvement cause?
Neoplastic proliferation of naive B cells that co express CD5 and CD20. Increased lymphocytes and smudge cells are seen on blood smear. Involvement of lymph nodes leads to generalized lymphadenopathy and is called small lymphocytic lymphoma.
What is chronic leukemia,when does it present and what are the four subtypes?
Neoplastic proliferation of mature circulating lymphocytes, characterized by a high WBC count. Usually insidious in onset and seen on older adults.
Chronic lymphocytic leukemia (CML), hairy cell leukemia, adult t-cell leukemia/lymphoma (ATLL) and mycosis fungoides
What are three complications of chronic lymphocytic leukemia?
- Hypogammaglobulinemia a causes infection and death
- Autoimmune hemolytic anemia
- Richter transformation to diffuse large B cell lymphoma observed by enlarging lymph node or spleen
What is hairy cell leukemia? What are cells positive for? Why is there splenomegaly and dry tap on bone marrow aspiration? Is there lymphadenopathy? How is it treated and what is the mechanism of this drug?
Neoplastic proliferation of mature B cells characterized by hairy cytoplasmic processes. Cells are positive for tartrate-resistant acid phosphotase (TRAP). Splenomegaly due to accumulation of hairy cells in red pulp and dry tap due to marrow fibrosis.
Lymphadenopathy is absent. Excellent response to 2-CDA (cladribine) which is an adenosine deaminase inhibitor. Adenosine accumulates to toxic levels in neoplastic B cells.
A fashion model with Japan and Caribbean ancestry comes to your clinic complaining of rashes on her skin. PE shows generalized lymphadenopathy with hepatosplenomegaly. Blood work is notable for what? What does she have? Which virus is it associated with? What will X ray show?
She has adult t-cell leukemia/lymphoma which is associated with the human t-lymphotropic virus (HTLV-1 virus). Blood work will show hypercalcemia and x ray will show lytic (punched out) bone lesions.
What is mycosis fungoides? What does it cause? What special structures does it form? What can be seen on blood smear?
Neoplastic proliferation of mature CD4+ T cells that infiltrate the skin producing localized skin rash, plaques and nodules. Aggregates of neoplastic cells in the epidermis are a called Pautrier micro abscesses.
Sezary cells which are characteristic lymphocytes with cerebriform nuclei are seen in blood smear. When these cells spread to involve the blood, you have Sezary syndrome.
