Heme/Onc Flashcards
1
Q
Aflatoxins
A
aspergillus
HCC
2
Q
vinyl chloride
A
liver
angiosarcoma
3
Q
carbon tetrachlordie
A
liver
centrilobular necrosis, fatty change
4
Q
nitrosamines
A
smoked foods
gastric cancer
5
Q
arsenic
A
cutaneous squamous cell
liver angiosarcoma
6
Q
naphthalene dyes
A
bladder transitional cell carcinoma
7
Q
Alkylating agents
A
leukemia
8
Q
Psammoma bodies
A
laminated, concentric calcific spherules Papillary adenocarcinoma of thyroid Serous papillary cystadenocarcinoma of ovary Meningioma Mesothelioma
9
Q
CEA
A
CRC, pancreatic
10
Q
CA 19-9
A
pancreatic
11
Q
CA 125
A
Ovarian
12
Q
Mycosis fungoides
A
Chronic T cell leukemia
CD4+
Pautrier microabscesses (skin)
–> sezary syndrome (blood) – cerebroform nuclei
13
Q
CLL
A
chronic lymphoid leukemia Small lymphocytic lymphoma (when in LNs) Naive B Cells 60+ CD5, CD20 Smudge cells hypo-IgG AIHA (bad IgG) Can --> DLBCL (p/w enlarging spleen)
14
Q
Hairy cell
A
chronic lymphoid leukemia Mature B Cells TRAP + Red pulp of spleen, no LAD, dry BM tap Tx: 2-CDA (cladribine) -- adenosine deaminase inhibitor
15
Q
ATLL
A
Adult T cell Leukemia/Lymphoma HTLV-1 Japan, Caribbean Rash, HSM, LAD Lytic Bone Lesions **
16
Q
CML
A
30-60yrs Granulocytes, basophils* (vs leukemoid) t(9; 22) -- BCR-abl Tx: imatinib chronic phase: large spleen Accelerating phase: enlarging spleen. can transform to AML or ALL (b/c mutx in HSCs, not myeloblasts) LAP (-) (or v low) vs leukemoid rxn
17
Q
PV
A
RBCs JAK2 hyperurecemia/gout thrombosis, itching, hyperviscosity can --> acute leukemia Tx: phlebotomy, hydroxyurea
18
Q
ET
A
PLTs JAK2 incr bleeding or incr thrombosis no hyperuricemia/gout no transformation
19
Q
Myelofibrosis
A
megakaryocytes JAK2 incr PDGF --> myelofibrosis extra-medullary hematopoesis infection, thrombosis, bleeding leuko-erythroblastic smear, tear drop cells
20
Q
Acute monocytc AML
A
AML: BM blasts >20%. Can arise from myelodysplasia. MPO+. 55yrs
subset of AML with gum involvement
21
Q
Acute megakaryoblastic AML
A
AML: BM blasts >20%. Can arise from myelodysplasia. 55yrs
MPO -
Down’s before 5
22
Q
APML (M3)
A
AML: BM blasts >20%. Can arise from myelodysplasia. MPO+. 55yrs t(15;17) --> RAR disruption Auer rods DIC! Tx: ATRA
23
Q
B ALL
A
ALL: tdt+, Down's after 5 CD 19, 20, 10 Tx: Chemo with ppx to brain, scrotum t (12;21) = kids, good prognosis t (9;22) (Phil) = adults, poor prognosis
24
Q
T ALL
A
ALL: tdt+, Down's after 5 CD2 - CD8 + no CD10 Thymic mass Teenager
25
DLBCL
```
large cell lymphoma
CD20+
Older adults, sometimes kids
diffuse sheets of cells
sporadic vs transformed
clinically aggressive
```
26
Burkitt's
```
intermediate B Cell lymphoma
CD20
Adolescents/young adults
EBV
African --> jaw
sporadic --> abdomen
c-myc* (varied translocations eg t (8; 14))
Starry-sky (due to apoptosis from rapid cell growth
```
27
Marginal zone
small B cell lymphoma
CD20
2/2 chronic inflammation
Hashimoto's, Sjogren's --> parotid. H Pylori --> MALT
28
Small lymphocytic lymphoma
CLL involving LNs
29
Follicular lymphoma
```
small B cell
CD20
late adulthood
LAD --> lots of follicles
t(14; 18) = IgH- bcl2
Can --> DLBCL
vs reactive: bcl2+, loss of architecture, monoclonal, no tingible body MPhages
Tx: CTX or rituximab
```
30
Mantle cell
small B cell lymphoma
CD20
t(11;14) = IgH - Cyclin D (G1/S phase)
31
Hodgkin's lymphoma
Bimodal: young adults; > 55yo
rare neoplastic cells (R-S)
CD15, CD30
CD20 (-) (Although it is B cell lymphoma)
cytokine production --> B Sx, reactive infiltrate, fibrosis
localized, contiguous vs multiple peripheral
50% EBV
32
Nodular sclerosing
hodgkin's subtype
cervical, mediastinal with broad fibrosis
young female
33
Lymphocyte rich
hodgkin's subtype
| best prognosis
34
lymphocyte depleted
hodgkin's subtype
worst prognosis
elderly/HIV
35
Mixed hodgkin's
Eosinophils! 2/2 IL-5
| Can have peripheral eosinophilia
36
Waldenstrom's
B cell lymphoma producing IgM
Generalized LAD, incr serum protein with M spike 2/2 IgM (not IgG or A, as in MM)
Hyperviscosity --> bleeding, stroke, retinal hemorrhage, NO lytic bone lesions (vs MM)
Tx: pheresis
37
Langerhans cell histiocytosis
Proliferative d/o of dendritic cells from monocyte lineage
Kids
Lytic bone lesions and rash
S-100 and CD1a
"tennis rackets" on EM (looks like C Tetani spore)
38
multiple myeloma
IgG > IgA
Incr IL-6, osteoclast activating factor --> clast stimulation via RANK
infection (most common cause of death)
AL amyloidosis, reulauex formation
Bence Jones, myeloma kidney
M spike on SPEP
"punched out" lesions =/= ratty lesions of Paget's
