Heme Onc

Question 1

Pancytopenia characterized by severe anemia, leukopenia, and thrombocytopenia. Normal cell morphology, but hypocellular bone marrow with fatty infiltration (dry bone marrow tap). Absence of splenomegaly.

Answer 1

Aplastic anemia

Question 2

Aplastic anemia (cause)

Answer 2

Destruction of myeloid stem cells from 1) Radiation and drugs (benzene, chloramphenicol, alkylating agents, antimetabolites) 2) Viral agents (parvovirus B19), EBV, HIV, HCV 3) Fanconi anemia (DNA repair defect) 4) Idiopathic (immune mediated, primary stem cell defect), may follow acute hepatitis.

Question 3

Hypercellular marrow with megaloblastic hematopoeisis

Answer 3

Mylodysplastic syndrome

Question 4

Presence of promyelocytes with rod-shaped cytoplasmic inclusions. Cell cytoplasm has azurophilic granules. Hypergranular promyelocytes with multiple Auer rods.

Answer 4

Promyelocytic (FAB M3) Leukemia. Characterized by hypercoagulability and bleeding (DIC).

Question 5

Recurrent epistaxis, echymoses, marked thrombocytopenia. No signs/sxn of pancytopenia, marrow failure, or splenomegaly.

Answer 5

Immune Thrombocytopenic Purpura