Heme neoplasms Flashcards
what are 3 main hematolyhoid tissues involved
- marrow
- lymph nodes
- spleen
less so
- tonsils
- liver
- GI mucosa
2 main types of heme cells
- lymphoid
2. myloid
3 main mechs behind neoplams
- genetic changes
- unreg. proliferation
- outgrowth of other cells
3 things by which WHO classifies
- cell lineage
- resemblance to normal cell type
- morphology
- immunophenotyping - genetic abberatiokns
- clinical behavior
2 main types of neosplams
- leukemia - widespread in marrow and ussually peripheral blood
- lymphoma - discrete masses and not peripheral blood
2 major classes of leukemia
- chronic - insidious and less aggressive
2. acute - rapid onset and aggressive
what is further classification of leukemia
- myloid
2. lymphocytic
4 types of leukemia
- ALL
- AML
- CLL
- CML
what are features of lymphoma
- in nodes mostly
- often features of a single lineage stuck in a stage of dev.
what are 2 main subtypes of lymphoma
- hodgkins
- non-hodgkins
- further subdivided into 35 subtypes
2 ways to diagnose and diff. heme neoplasms
- clinical presentation
2. diagnostic tests
5 major lab evaluations of heme malig.
- morphology
- cytochem
- immunocytochem
- cytogenetics
- molecular genetics
what is examined on morphology
- what cells look like
2. architecture
what is cytochemisty
special stains to help classify lineage of specific cells
2 tests in immunohistochemistry
- immunophenotypes - cell surface markers
2. flow cytometry - tool to detect cellsurface proteins
2 tests in cytogenetics
- karyotype
2. FISH
what is important on cytogenetics
50% will have aquired somatic recurrent chromosomal translocations
- mostly activate oncogenes
how to chromo abberations arise
- likely random alterations
- genotoxic agents
3 important pieces of info given by genetics
- diagnosis
- prognosis
- response to therapy
what cells are needed for cytogenetics
live bone marrow cells
4 types of chromo abberatiosn
- deleltion
- translocaitions
- aneuploidy
4, amplifications
what is common problem with translocaitons
results in activation of cell proliferation gene by bringing it under control of a constituatively active gene in cell type (eg. immunoglobin gene)
what is clonality of hematologic neoplasm
all cells are monoclonal - arise from single cell
- if found, can help determine malig, from reactive
3 ways to prove monoclonality
- aquired clonal cytogenetic abnormality
- new fusion gene
- for lymphoid
- kappa or B light chain restriction
- Ig gene rearragnement for B cells or T cell -r in T-cells
what is use of protein electrophoresis
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
