Heme neoplasms

Question 1

what are 3 main hematolyhoid tissues involved

Answer 1

1. marrow
2. lymph nodes
3. spleen
   less so
   - tonsils
   - liver
   - GI mucosa

Question 2

2 main types of heme cells

Answer 2

1. lymphoid

2. myloid

Question 3

3 main mechs behind neoplams

Answer 3

1. genetic changes
2. unreg. proliferation
3. outgrowth of other cells

Question 4

3 things by which WHO classifies

Answer 4

1. cell lineage
   - resemblance to normal cell type
   - morphology
   - immunophenotyping
2. genetic abberatiokns
3. clinical behavior

Question 5

2 main types of neosplams

Answer 5

1. leukemia - widespread in marrow and ussually peripheral blood
2. lymphoma - discrete masses and not peripheral blood

Question 6

2 major classes of leukemia

Answer 6

1. chronic - insidious and less aggressive

2. acute - rapid onset and aggressive

Question 7

what is further classification of leukemia

Answer 7

1. myloid

2. lymphocytic

Question 8

4 types of leukemia

Answer 8

1. ALL
2. AML
3. CLL
4. CML

Question 9

what are features of lymphoma

Answer 9

• in nodes mostly

- often features of a single lineage stuck in a stage of dev.

Question 10

what are 2 main subtypes of lymphoma

Answer 10

1. hodgkins
2. non-hodgkins
   - further subdivided into 35 subtypes

Question 11

2 ways to diagnose and diff. heme neoplasms

Answer 11

1. clinical presentation

2. diagnostic tests

Question 12

5 major lab evaluations of heme malig.

Answer 12

1. morphology
2. cytochem
3. immunocytochem
4. cytogenetics
5. molecular genetics

Question 13

what is examined on morphology

Answer 13

1. what cells look like

2. architecture

Question 14

what is cytochemisty

Answer 14

special stains to help classify lineage of specific cells

Question 15

2 tests in immunohistochemistry

Answer 15

1. immunophenotypes - cell surface markers

2. flow cytometry - tool to detect cellsurface proteins

Question 16

2 tests in cytogenetics

Answer 16

1. karyotype

2. FISH

Question 17

what is important on cytogenetics

Answer 17

50% will have aquired somatic recurrent chromosomal translocations
- mostly activate oncogenes

Question 18

how to chromo abberations arise

Answer 18

• likely random alterations

- genotoxic agents

Question 19

3 important pieces of info given by genetics

Answer 19

1. diagnosis
2. prognosis
3. response to therapy

Question 20

what cells are needed for cytogenetics

Answer 20

live bone marrow cells

Question 21

4 types of chromo abberatiosn

Answer 21

1. deleltion
2. translocaitions
3. aneuploidy
   4, amplifications

Question 22

what is common problem with translocaitons

Answer 22

results in activation of cell proliferation gene by bringing it under control of a constituatively active gene in cell type (eg. immunoglobin gene)

Question 23

what is clonality of hematologic neoplasm

Answer 23

all cells are monoclonal - arise from single cell

- if found, can help determine malig, from reactive

Question 24

3 ways to prove monoclonality

Answer 24

1. aquired clonal cytogenetic abnormality
2. new fusion gene
3. for lymphoid
   - kappa or B light chain restriction
   - Ig gene rearragnement for B cells or T cell -r in T-cells

Question 25

what is use of protein electrophoresis

Answer 25

normal population has a variety of different Ig and will get a spread
- in malig you get a single clone, and thus a single band