Hematopoietic Malignancies Flashcards
what’s the big difference between leukemia and lymphoma?
both are malignant diseases of hematopoietic cells
the big defining characteristic that separates leukemia and lymphoma is their place of origin
leukemia starts in the bone marrow, and lymphoma starts in lymph nodes
but they can look similar clinically because they can involve a lot of the same parts of the body
what type of cells does leukemia involve?
leukemias may arise from either myeloid or lymphoid cells
what type of cells does lymphoma involve?
lymphomas arise only from lymphoid cells
what is leukemia?
arises from lymphoid or myeloid stem cells
starts in bone marrow then spreads to the blood stream
can be acute or chronic
what is lymphoma?
arises from lymphoid cells only
starts in lymphatics tissues but can spread to bone marrow or blood
can be Hodgkin or non-Hodgkin
what are the two basic types of lymphomas?
Hodgkin lymphoma (HL)
no-Hodgkin lymphoma (NHL)
what’s the most important difference between HL and NHL?
Hodgkin lymphoma has a better prognosis than non-Hodgkin lymphoma
this is due in large to the way that lymphomas behave
HL starts in a single node and progresses in a predictable fashion to the next node in that particular chain, and then to the next lymph node region, and so on
NHL starts in a single node, but may next appear in a lymph node in a distant part of the body
what population in HL most common in?
HL occurs most commonly in young men between the ages of 15 and 34
also has a second, smaller peak of incidence in patients over the age of 55
what is HL?
defined by the presence of Reed-Sternberg cells
there are five subtypes of HL, each with its own morphologic appearance and prognosis
what are Reed-Sternberg cells?
they have a very unusual morphology
they are gigantic and they have at least two big nuclei with single nucleoli, giving the cell an “owl’s eye” appearance
what is NHL?
no Reed-Sternberg cells
it’s actually a big group of very different types of lymphoma
some NHLs grow very slowly and have a good prognosis while others grow in an explosive fashion and have a high mortality rate
what are the two categories of NHL?
two big categories according to whether the malignant cells are B cells or T cells
what are some of the more important and common NHLs?
- follicular lymphoma
- chronic lymphocytic lymphoma/small lymphocytic leukemia
- mantle cell lymphoma
- mycosis fungoides/Sézary syndrome
- Burkitt lymphoma
- acute lymphoblastic leukemia/lymphoma
- large cell lymphoma
what’s the defining cell of Hodgkin lymphoma?
the Reed-Sternberg cell, which is a very large cell with big nuclei and an “owl’s-eye” appearance
what is leukemia?
all leukemias are malignant proliferations of hematopoietic cells in the bone marrow
what are the two main types of leukemia?
acute
chronic
both types can be composed of either lymphoid or myeloid cells
what are acute leukemias?
they come on suddenly and have a devastating clinical course
acute leukemias are composed of very immature hematopoietic cells
what are chronic leukemias?
they appear more insidiously and progress at a slower pace
may persist for years even without treatment
chronic leukemias are composed of cells at a more mature stage of development
explain myeloid vs. lymphoid leukemias
leukemias may be composed of lymphoid cells or myeloid cells
myeloid means basically any cell outside the lymphoid lineage (so neutrophils, basophils, eosinophils, monocytes, red blood cells, and megakaryocytes)
what are the four main groups of leukemias?
based on whether it’s acute/chronic and if it’s lymphoid/myeloid
- Acute myeloid leukemia
- Chronic myeloproliferative disorders
- Acute lymphoblastic leukemia
- Chronic lymphoproliferative disorders
What are the first two questions you need to ask yourself when you’re looking at a leukemia?
ss it acute or chronic?
And, is it myeloid or lymphoid?
A 50-year-old female presents with a 3-week history of worsening fatigue, fevers, and weight loss. A blood smear and bone marrow biopsy are performed, and the bone marrow and blood are full of immature myeloid cells. what’s the most likely diagnosis?
acute myeloid leukemia
On
predominance. The peripheral smear shows mostly mature cells, as does the bone marrow biopsy. A biopsy of an inguinal lymph node shows evidence of malignant and mature cells. whats the most likely diagnosis?
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)
the patient has mature-appearing, malignant cells of lymphoid origin in his blood, bone marrow, and lymph nodes
Myeloid malignancies are malignant proliferations of cells arising from myeloid stem cells. Which of the following cells would NOT be classified as myeloid?
A. Basophil
B. Erythrocyte
C. Megakaryocyte
D. Plasma Cell
plasma cell
