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Pathology > Hematopathology II > Flashcards

Hematopathology II Flashcards

1
Q

What are the 3 classes of chronic lymphoid neoplasms?

A
  • Chronic Leukemias
  • Lymphomas
  • Plasma Cell Disorders
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2
Q

What are the most common chronic leukemias?

A
  • Chronic lymphocytic leukemia (CLL)

- Small lymphocytic lymphoma (SLL)

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3
Q

What are the rarer types of chronic leukemias?

A

Hairy cell leukemia

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4
Q

What do B-cell neoplasms tend to express as biomarkers?

A

CD20, CD5 (pan T-cell marker) and CD23

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5
Q

What is the most common leukemia of adults in the Western world?

A

CLL

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6
Q

What is the typical patient of CLL/SLL?

A

Older patients - around 60 years of age

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7
Q

What mutation indicates a favorable outcome for CLL/SLL?

A

IGH

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8
Q

What is seen on microscopic evaluation of CLL and SLL?

A

Peripheral blood shows typical small lymphocytes with scant cytoplasm some smear may show disrupted tumor cells (smudge cells)

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9
Q

Why are there smudge cells on blood smear of CLL?

A

CLL cells are more fragile and will be smudged in the process of the smear

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10
Q

What is seen under the microscope in hairy cell leukemia?

A

Cells have cytoplasmic projections (hair like)

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11
Q

What is the most common patient population for hairy cell leukemia and what is their typical presentation?

A

Usually middle aged men presenting with pancytopenia, monocytopenia, splenomegaly(most common), hepatomegaly, infections

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12
Q

What does staining for hairy cell leukemia show?

A

Tartrate resistant acid phosphatase (TRAP)

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13
Q

What is the prognosis for hairy cell leukemia?

A

Excellent response to gentle chemotherapy

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14
Q

Where is Adult T-cell leukemia/lymphoma often seen?

A

Seen frequently in southern Japan , West Africa, and Caribbean

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15
Q

What is the typical presentation of Adult T-cell leukemia/lymphoma seen frequently in southern Japan , West Africa, and Caribbean?

A

Skin lesions, hepatosplenomegaly, lymphocytosis and hypercalcemia

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16
Q

What virus is associated with Adult T-cell leukemia/lymphoma?

A

HTLV-1

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17
Q

What cells are seen in the blood in Adult T-cell leukemia/lymphoma?

A

Floret cells (CD4+ lymphocytes)

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18
Q

What are the different classes of lymphomas?

A

Hodgkin

Non-Hodgkin

19
Q

What are some examples of the etiologies of lymphomas?

A
  • 􏰁Chromosomal abnormalities
    􏰁- Immune deficiencies: AIDS, Post-transplant, rheumatoid arthritis,
  • SLE, Sjogren’s syndrome
    􏰁- Viruses: HTLV-I, EBV, HHV-8, Hepatitis C
    􏰁- Bacteria: Helicobacter pylori in gastric MALT lymphoma 􏰁
  • Iatrogenic (radiation)
20
Q

Endemic Burkitt lymphoma Location

A

Africa

21
Q

MALT lymphoma

A

Mediterranean

22
Q

Adult T-cell leukemia lymphoma (HTLV-I positive)

A

Japan and Caribbean Islands

23
Q

T-cell lymphoma leukemia

A

Asia and Japan

24
Q

What is usually needed for the diagnosis of lymphoma?

A

Tissue or lymph node biopsy

25
Q

What should be negative for lymphoma?

A

MPO

26
Q

What are the main B cell markers?

A

CD19, CD20

27
Q

What are the main T cell markers?

A

CD3

28
Q

What are the main myeloid markers?

A

MPO

29
Q

What does follicular lymphoma present with and who is typically affected?

A

􏰁Constitutes 40% of adult NHLs and it presents with painless lymphadenopathy (generalized)

30
Q

What is seen in follicular lymphoma under microscopy?

A

Small cells with cleaved or irregular nuclei (centrocytes) and larger cells with open nuclear chromatin and several nucleoli (centroblasts)

31
Q

Translocation of Follicular Lymphoma

A

t(14;18) [BCL2/IGH fusion]

32
Q

What does the t(14;18) [BCL2/IGH fusion] in follicular lymphoma cause?

A

Causes BCL2 over-amplification (anti-apoptotic)

33
Q

What are benign reactive follicles?

A

Where B cells normally mature and are selected for

34
Q

How does follicular lymphoma alter the benign reactive follicles?

A

Follicles are all over the lymph nodes - back to back rather than having a lot of space

35
Q

What does the detection of BCL2 show up as in the stain?

A

The follicles will stain a brown color

36
Q

Who is mantle cell lymphoma typically seen in?

A

Older males

37
Q

What biomarkers will be seen in mantle cell lymphoma?

A

CD19, CD20, CD5 positive

38
Q

Translocation of Mantle Cell Lymphoma

A

t(11;14) [Cyclin D1–IGH fusion]

39
Q

What does the t(11;14) [Cyclin D1–IGH fusion] translocation cause?

A

Causing Cyclin D1 over-amplification (increased proliferation)

40
Q

Who is the patient population of Burkitt’s lymphoma?

A

• Children or young adults; aggressive disease

41
Q

What are the sites of the tumors in Burkitt’s lymphoma?

A

• Mandible (endemic-African), abdomen (non-endemic)

42
Q

What is the microscopy of Burkitt’s lymphoma described as?

A

“Starry sky pattern”

43
Q

Translocation of Burkitt’s lymphoma

A

t(8;14) [MYC- IGH fusion]

44
Q

What is the result of the t(8;14)[MYC-IGH fusion]?

A

􏰁Causes MYC over-amplification (increased proliferation)

Pathology (203 decks)

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