Hematopoetic Pathology - WBC Disorders, Lymphoid, Myeloid Neoplasm Flashcards
Which is the utility of leukocyte alkaline phosphatase?
⬆️ ▶️ benign reactions
⬇️ ▶️ chronic myelocytic leukemia
What situations can lead in monocytosis? Value.
- autoimmune disease (RA, inflammatory bowel disease)
- chronic Infections ▶️ Tuberculosis
- malignancy
*>800 cells/mm3
In what cases can you find eosinophilia? What type of infections can lead on it? Value.
- Type I hypersensibility reaction (asthma, penicillin reaction)
- Protozoal disease ▶️ Dientamoeba fragilis (only protozoal infection with eosinophilia)
- Invasive helminthic infection ▶️ strongyloidiasis, hookworm
*>400 cells/mm3
⏺ Pinworms and adult ascariasis are not accompanied by eosinophilia (noninvasive)
What cells in infectious mononucleosis are enlarged, with abundant cytoplasm condensed at periphery (“ballerina skirt” appearance)?
Cytotoxic (CD8) T-lymphocytes ▶️ form atypical lymphocytes (Downey cells)
Heterophile-negative infectious mononucleosis is most likely caused by
CMV
B-cell lineage marker of acute lymphoblastic leukemia
CD19, CD10
Most common type of B-cell lineage of ALL. Age group affected.
Early pre-B-ALL
Children
Common sites of infiltration of ALL
CNS and testes ▶️ sanctuary sites
What does the smudge cells (“parachute cells”) suggest?
T-chronic lymphocytic leukemia
Most common form of non-Hodgking lymphoma, typical translocation found on it
Follicular lymphoma
Translocation (14;18)
Most common bone marrow primary tumor in adults
Multiple myeloma
M spike of IgM in protein electrophoresis suggests
Lymphoplasmacitic lymphoma
Infectious agent associated with adult T-cell leukemia/lymphoma (ATLL)
HTLV-1
Most common finding that is diagnostic of Hodgkin lymphoma. Surface markers of most subtypes, which subtype is negative for them?
Reed-Sternberg cells
CD15, CD30
Lymphocyte-predominant type
Distinctive and pathognomonic finding of acute myelogenous leukemia. Which is the most common form and characteristics translocation?
Myeloblasts with Auer rods
M3
t(15;17)
Genetic finding of chronic myelogenous leukemia and its implication
Philadelphia chromosome: t(9;22)
Protein P210 ▶️ tyrosine kinase activity
Why does pruritus and gastric ulcers occur in polycythemia vera? Complication.
Basophils ▶️ ⬆️ histamine
Bleeding gastric ulcer ▶️ iron deficiency
Finding of essential thrombocythemia at bone marrow and peripheral blood smear. Important clinical feature.
BM: ⬆️ megakaryocytes, PB: >1.000.000 platelets
Excessive bleeding, occlusion of small vessels
Findings of myelofibrosis at bone marrow aspiration and blood smear
BM: “dry tap”, hypocellular + fibrosis (⬆️ reticulin), fibroblast proliferation (no neoplastic)
BS: leukoerythroblastosis, tear drop RBC
What surface marker is reduced in neutrophilic leukocytosis? Why?
Fc receptor (CD16) Bacterial infection or tissue necrosis ▶️ Immature forms (left shift)
Classically what suggests basophilia?
Chronic myeloid leukemia
What bacteria is the exception since that it causes lymphocytic leukocytosis? Why?
Bordetella pertussis
Lymphocytic promoting factor
What neoplasia is associated with eosinophilia? Which mechanism allows that?
Lymphoma Hodgkin (Mixed cellularity type) ⬆️ IL-5
What region of the lymph node is enlarged in infectious mononucleosis leading in generalized lymphadenopathy?
Paracortex
Splenomegaly in infectious mononucleosis is caused by enlarge of which zone?
Periarterial lymphatic sheath (PALS) of the white pulp
What are the risks if dormancy of EBV in B lymphocytes occurs?
Recurrence of infectious mononucleosis
B-cell lymphoma (specially in immunodeficiency)
Based on clinical presentation if there is bone lytic lesions how do you differentiate multiple myeloma from adult T cell leukemia/lymphoma?
Skin rash in ATLL (HTLV-1 virus associated)
What type of myeloproliferative disorder doesn’t have hyperuricemia and then risk of gout associated?
Essential thrombocythemia
Why does multiple myeloma cause bone pain, hypercalcemia and lytic lesions on x-ray commonly in skull and vertebrae? What risk does it confer?
Proliferation of plasma cells ▶️ ⬆️ osteoclast activating factor + ⬆️ RANK receptor on osteoclasts
⬆️ risk of fracture
Most common cause of death in multiple myeloma?
Infections
*monoclonal antibodies lack antigenic diversity
