FOR THE TRULY BRAVE: Leukemia, Lymphoma, and PCD Integration Flashcards
follicular small cleaved lymphoma affects which population
- middle-aged to elderly adults
prognosis of high white blood count in ALL (good/bad)
- bad
bone marrow aspirate for ALL
- large cells- open chromatin- prominent nucleoli
70% of patients with MM present with
- bone pain
follicular small cleaved lymphoma - patients present with
- high stage disease
prognosis of abnormal(11q23) in ALL
- bad
which is the most common adult leukemia
- CLL
ALL is a malignancy of
- committed lymphoid progenitor cell- pre-T or pre-B
curability of small lymphocytic lymphoma
- incurable
liver or bone marrow involvement or extensive involvement of another extralymphatic organ is what stage
IV
light chains expressed by flow cytometry of normal lymph nodes
- B cells express both kappa and lambda light chains
small lymphocytic lymphoma is the essentially the same disease as
- CLL
- which can manifest clinically over months to years
- CLL- CML
intermediate grade lymphomas
- diffuse large cell lymphoma
CD 1-8 is which cell?
- T cell
mediastinal or soft tissue mass presents in which cell line
- T cell
paracortical hyperplasia is the proliferation of
- T lymphocytes
prognosis of hyperdiploidy in ALL (good/bad)
- good
what kind of disorder is CML classified as
- myeloproliferative
which is the most common cancer in children
- ALL
prognosis of (4;11) in what condition?
What is the prognosis?
- ALL
- poor
prognosis of >10 years of age in ALL (good/bad)
- bad
follicular small cleaved lymphoma flow cytometry light chain
- light chain restricted
- only kappa or lambda
Hodgkin lymphoma flow immunochemistry
- positive for CD30 and CD15
- negative for CD45
bone disease associated with abnormal proliferation of plasma cells in the bone marrow
- lytic lesions/pathologic features- hypercalcemia
small lymphocytic lymphoma affects what cell
- mature B cell
familial syndromes seen in what condition?
what are these syndromes?
- ALL
- down syndrome - neurofibromatosis - bloom syndrome - ataxia telangiectasia
deletions of chromosomes 5 and 7 in AML (good/bad)
- bad
Burkitt’s lymphoma translocation
- t(8;14)
- t(2;8)
- t(8:22)
- c-myc
follicular small cleaved lymphoma translocation
- t(14;18)
- BCL2
FAUX LICK. IT’S A FAUX PAS FOR A 14 YEAR OLD TO LICK AN 18 YEAR OLD. SHIT, ITS PROBABLY ILLEGAL TOO. AND YOU KNOW WHAT COMES AFTER LICKING, 2 BASTARD CHILDREN (BCL2)
diffuse large B-cell lymphoma curability of low stage
- low stage can be cured
lymphoblastic lymphoma flow cytometry
- positive for CD4 and CD8
blast crisis can lead to
- AML- ALL
markers for ALL
- CD19- CD10- TdT- no surface light chain
prognosis of t(12;21) in ALL (good/bad)
- good
JUST THINK THAT 12;21 IS HAPPY NUMBER BECAUSE IT GOES THE SAME WAY FORWARDS AS BACKWARDS
stage 2 of Rai classification
- lymphocytosis- splenomegaly
which cell line of ALL has the worst prognosis
- T cell
case symptoms of Waldenstrom’s macrogammaglobulinemia
- headache- blurred vision- hyperviscosity
AML is a malignancy of
- committed myeloid progenitor cell
which population is impacted by PCD
- adults
t(15;17) in cytogenetics with AML (good/bad)
- good
follicular hyperplasia is the proliferation of
- B lymphocytes
race most impacted by multiple myeloma
- African Americans
what condition is also common in CLL
- autoimmune hemolytic anemia
in ALL malignant cells lose
- ability to differentiate
CD 34 is which cell?
- stem cell
- blast cell
what test do you do after CML is identified?
- quantitative PCR for the bcr/abl transcript
clinical presentation of amyloidosis
- raccoon eyes- enlarged tongue- proteinuria
definition of leukemias
- neoplasms of hematopoietic cells
CLL is a malignancy of
- mature B cells
follicular hyperplasia example
- neck nodes in a patient with strep throat
follicular hyperplasia has a need for
- antibody production
Reed-Sternberg cell is what kind of cell
- activated B cell
bone marrow aspirate of CLL
- variable involvement- loss of heterogeneity
paracortical hyperplasia example
- neck nodes in patients with infectious mono
treatment of APL
- all-trans retinoic acid (ALTRA)- induction chemo
sinus histiocytosis example
- lymph nodes draining a carcinoma
stage 3 of Rai classification
- lymphocytosis- anemia
Abl tyrosine kinase inhibitor of choice
- imatinib
lymphoblastic lymphoma affects which cell
- immature T cells expressing CD3
- coexpressing CD4 and CD8
- and TdT
median survival of stage 4
- 2 years
stage 0 of Rai classification
- lymphocytosis only
Hodgkin lymphoma diagnosis based on
- finding Reed-sternberg cells
stage 1 of Rai classification
- lymphocytosis- lymphadenopathy
what is the median age of diagnosis of ALL
- 11
ALTRA moa
- differentiating agent
is AML curable
- yes
clinical manifestation of ALL
- tumor lysis syndrome- lymph node involvement- mediastinal mass- CNS involvement- testicular involvement in males
multiple myeloma malignant plasma cells interact with
- bone marrow microenvironment
which are composed of myeloid origin
- AML- CML
what is the most common cause of enlarged lymph nodes?
- benign reactive lymphadenopathy
which are composed of lymphoid origin
- ALL- CLL
median survival of stage 1
- 8 years
AML arising from history of MDS or myeloproliferative disorder (good/bad)
- bad
lymphoblastic lymphoma affects which population
- children
gender most impacted by multiple myeloma
- males
most non-hodgkin lymphoma is what type of cell
- B cells
forward scatter in flow cytometry separates based on
- size
steps of multiple myeloma
- MGUS -> smoldering -> myeloma
findings associated with abnormal immunoglobulins and other factors secreted by malignant plasma cells
- renal disease - rouleaux- amyloid- hyperviscosity- cryoglobulins- coagulation abnormalities CCRRAH
what are myeloma defining events
- hypercalcemia- renal disease- anemia- bone diseaseCRAB
non-hodgkin lymphoma risk factors
- age
- infections
- immune disorders
- toxins
median survival of stage 3
- 3 years
treatment for AML
- 7 days cytarabine- 3 days daunorubicin, idarubicin
age most impacted by multiple myeloma
- 65-70
bone marrow aspirate in CML
- hypercellular- increased M:E
which chromosome is the Philadelphia chromosome?
- t(9;22)- 22 BCR/ABL is Ph
Waldenstrom’s macrogammaglobulinemia related to cancer?
- low grade lymphoma- involving bone marrow and spleen
sinus histiocytosis stimulation of
- antigen-presenting cells
follicular small cleaved lymphoma affects which cell
- mature B cell
clinical and pathology findings associated with multiple myeloma are a consequence of
- tumor mass effect of the malignant plasma cells - abnormal secretory products from the malignant plasma cells - monoclonal immunoglobulins and cytokines
follicular small cleaved lymphoma curability
- incurable
amyloidosis present with which stain?
- congo red staining of bone marrow biopsy
in AML, malignant cells lose
- the ability to differentiate
Waldenstrom’s macrogammaglobulinemia associated with which immunoglobulin
- IgM
diagnosis test for Waldenstrom’s macrogammaglobulinemia
- SPEP showing IgM monoclonal spike- serum viscosity
side scatter in flow cytometry separates based on
- complexity
diffuse large B-cell lymphoma cytogenetic abnormalities? molecular abnormalities?
- no cytogenetic abnormalities
- abnormal Bcl-6
risk factors for multiple myeloma
- age- gender- race- family history- radiation exposure- chronic antigenic stimulation
bone marrow biopsy of AML
- monotonous population of mononuclear cells
what percent of CML patients are asymptomatic
- 20-40%
importance of malignant cells in chronic phase of CML
- maintain ability to differentiate
Waldenstrom’s macrogammaglobulinemia more common in which gender
- men
which can manifest clinically over weeks to months
- AML- ALL
mantle cell lymphoma flow cytometry
- CD5 and CD19 positive
- CD10 and CD23 negative
MY BOY CORCH ROCKED NUMBER 5 FOR STATE AT 19 YEARS OLD. HE WOULD GO ON MY MANTLE ABOVE MJ AND HIS 10+ CHAMPIONSHIPS BECAUSE WE ARE STATE FANS.
CD 19 and early 20s are which cell?
- B cell
risk factors of most patients with non-hodgkin lymphoma
- most patients have no identifiable risk factors
diagnosis of multiple myeloma
- monoclonal plasma cells of >10%AND- Myeloma Defining event
risk factors for ALL
- prior radiation- prior chemo- familial syndromes
prognosis of <1 year of age in ALL (good/bad)
- bad
Waldenstrom’s macrogammaglobulinemia is a disease of which population
- adults
CD 15 is which cell?
- granulocytic
median survival of stage 0
- > 15 years
treatment of CLL
- not a curable diseases- treat only if symptoms present
risk of developing myeloma from MGUS
- 1% per year
CML tends to choose which pathway
- myeloid
petechiae are present in
- AML- ALL
median survival of stage 2
- 6 years
lymphatic involvement on both sides of the diaphragm is what stage?
III
lymph nodes in Hodgkin’s lymphoma
- continuous lymph node group to contiguous lymph node group
t(9;22) in ALL
- bad but does not independently drive disease
CLL is an incidental lab finding in what percentage of cases
- 20%
ALL most commonly of which cell line
- B cell
B symptoms
- fever > 38 degrees
- drenching night sweats
- weight loss > 10% over 6 months
multiple myeloma is a tumor of
- plasma cells
risk of developing myeloma from smoldering
- 10% per year
what does MGUS stand for
- monoclonal gammopathy of undetermined significance
prognosis of hypodiploidy in ALL (good/bad)
- bad
leukemias have what kind of involvement
- significant peripheral blood and bone marrow involvement
biomarkers for multiple myeloma
- extreme bone marrow clonal plasmacytosis- elevated free serum light chain level- more than one focal lesion on MRI
small lymphocytic lymphoma affects what population
- adults
bence jones protein
- kappa light chains in urine protein electrophoresis
Hodgkin lymphoma flow cytometry nor cytogenetics
- not diagnostic
Burkitt’s lymphoma affects which cell
- mature B cell
Burkitt’s lymphoma closely related to
- ALL FAB L3
result of the Philadelphia chromosome
- fusion protein with constitutive tyrosine kinase activity
median age of diagnosis for CLL
- 72
Waldenstrom’s macrogammaglobulinemia cell morphology
- >10% lymphoplasmacytic
best screening test for CML
- fish
Waldenstrom’s macrogammaglobulinemia most symptoms caused by
- elevated IgM
prognosis of t(9;22) in ALL (good/bad)
- bad
single nodal region or a single extra nodal site is what stage
I
small lymphocytic lymphoma flow cytometry
- CD5 and CD23 present
- light chain restricted
what is the most frequent molecular abnormality in AML
- FLT3
paracortical hyperplasia has an increased need for
- cell-mediated immunityq
non-hodgkin lymphoma associated toxic chemicals
- pesticides- herbicides- benzenes
follicular small cleaved lymphoma grade
- low grade
two or more nodal regions of an extra nodal site on the same side of the diagraphragm is what stage
II
being older and being diagnosed with AML (good/bad)
- bad
labs for amyloidosis
- < 10% clonal plasma cells in bone marrow- <3% g/dl monoclonal protein
peripheral blood in CML
- numerous immature granulocytes- increased basophils
treatment related AML mostly due to
- radiation therapy- chemo
lab findings for CLL
- leukocytosis- lymphocytosis- hypogammaglobulinemia- smudge cells
most common type of non-hodgkin’s lymphoma
- diffuse large B-cell lymphoma
how do you distinguish A stage from B stage?
A stage is the absence of the B stage symptoms
low CD numbers are which cell?
- T cell
13q14 small lymphocytic lymphoma prognosis
- good
diffuse large B-cell lymphoma can be associated with
- immune dysfunctional
CD 33 is which cell?
- myeloid
PCD are diseases associated with
- monoclonal proliferation of immunoglobulin producing plasma cells
flow cytometry of normal lymph nodes
- mixture of B and T cells
- T cells express either CD4 or CD8
CD 13 is which cell?
- granulocyte
what genetic abnormality is most seen in APL
- t(15;17) PML/RARa
morphology of cells in ALL
- homogenous lymphoblasts
sinus histiocytosis expansion of
- subcapsular/medullary sinus
immunophenotyping
- identifying phenotype using fluorescently labelled antibodies
result of malignant plasma cells interacting with bone marrow microenvironment
- activation of osteoclasts- suppression of osteoblasts- leads to lytic bone disease
morphology of the cells in CLL
- homogenous mature lymphocytes- smudge cells on smear
mantle cell lymphoma occurs in which population
- middle aged to elderly adults
is multiple myeloma curable?
- no
sinus histiocytosis is proliferation of
- histiocytes
- tissue macrophages
Hodgkin lymphoma peak incidence
- 20s
what is the acute presentation of ALL in teens?
- mediastinal or soft tissue mass
treatment related AML (good/bad)
- bad
morphology of cells in AML
- homogenous myeloblasts- Auer rod
follicular hyperplasia enlargement of
- germinal center
- tangible-body macrophages
- increased mitotic activity
non-hodgkin lymphoma associated infections
- HIV
- EBV
- H.pylori
- Hep B and C
- HTLV-1
- HHV-8
pathogenesis of CML
- Philadelphia chromosome
Burkitt’s lymphoma affects which population
- children
CML stands for
- chronic myelogenous leukemia
CD 14 is which cell?
- monocytic
what is an Aeur rod
- pink needle in the cell
Hodgkin lymphoma characterized by presence of
- Reed-sternberg cell
lab values for MGUS
- < 3.0 g/dL serum monoclonal proteinAND- < 10% monoclonal plasma cells in bone marrow- no end organ damage
paracortical hyperplasia expansion of
- paracortical activity
- increased mitotic activity
- activated lymphocytes
diffuse large B-cell lymphoma occurs in which population
- children
- adults
smoldering myeloma labs
- > 3.0 g/dL serum monoclonal proteinOR> 10-60% bone marrow plasma cellsOR- urinary monoclonal proteinAND- no myeloma defining events
morphology of the cells in CML
- heterogenous
mantle cell lymphoma expresses high levels of
- cyclin D1
Hodgkin lymphoma smaller peak incidence
- >50s
acute DIC and coagulopathy most commonly seen in
- APL
precursor protein in amyloidosis
- secreted in a soluble state- becomes insoluble at some tissue sites and compromises organ function
immunoglobulins most often found in MM
- IgG - IgA- light chains only
CLL stands for
- chronic lymphocytic leukemia
mantle cell lymphoma translocation
- t(11;14)
- cyclin D1 gene
lymphoma pathology classification schemes
- working formulation
- WHO
follicular small cleaved lymphoma may progress to
- large cell lymphoma
light chains in amyloidosis
- lambda light chains
clonality of AML
- clonal expansion of myeloid blasts
Waldenstrom’s macrogammaglobulinemia phenotype
- mature B cell
Amyloid light chain amyloidosis associated with
- multiple myeloma- abnormal light chains
trisomy 12 small lymphocytic lymphoma prognosis
- bad
high grade lymphomas
- burkitt’s lymphoma
- lymphoblastic lymphoma
findings associated with abnormal proliferation of plasma cells in the bone marrow
- impaired hematopoiesis- hypogammaglobulinemia- bone disease- nerve root compression
leukemias are diagnosed according to
- prominent cell type involved- stage of maturation
lymphoblastic lymphoma presents with what symptom
- mediastinal mass
typical pattern on flow cytometry for CLL
- mature B cell phenotype with CD5 and CD23- light chain restricted
therapeutic options for CML
- Abl tyrosine kinase inhibitors- allogenic stem cell transplantation
% of bone marrow blasts in AML
- >20%
low grade lymphomas
- small lymphocytic lymphoma
- follicular small cleaved lymphoma
symptoms of smoldering multiple myeloma
- asymptomatic
common lab finding of CML
- leukocytosis- neutrophilia- basophilia- eosinophilia
stage 4 of Rai classification
- lymphocytosis- thrombocytopenia
