Heme/Onco IV Flashcards
leukemia vs. lymphoma
leukemia - bone marrow involvement
-cells in peripheral blood
lymphoma - lymph node
leukemoid rxn
inflammatory response to infection
WBC elevated with neutro and band cells - left shift
increased leukocyte alk phos
leukemoid rxn vs. CML
WBC elevated with band cells - left shift - in both
CML - no LAP
LR - elevated LAP - leukocyte alk phos
hodgkin lymphoma
local group nodes
prognosis - stage - better than NHL
reed sternberg cells
bimodal distribution
EBV association
non-hodgkin lymphoma
multiple peripheral nodes
extranodal involvement
majority B cells
incidence peak 20-40yo
HIV and autoimmune association
reed stern berg cells
owl eyes
hodgkin lymphoma
CD15 and CD30 positive
better prognosis - stromal or lymph rxn to RS cells
-lympho rich - best prognosis
burkitt lymphoma
t (8;14)
c-myc on 8 with heavy chain (14)
starry scar
endemic - jaw - african
associated with EBV
diffuse large B cell lymphoma
older adults
MC type NHL in adults
follicular lymphoma
t (14;18)
BCL2 and heavy chain
Bcl2 inhibit apoptosis
wax and wain painless lymphadenopathy
mantle cell lymphoma
older males
t (11;14)
translocation cyclin D1 with heavy chain
CD5 positive
sezary syndrome
mycosis fungoides
skin patch and plaque
cutaneous T cell lymphoma
atypical CD4 cells - cerebriform nuclei
multiple myeloma
plasma cell - fried egg
-clock face
lots of IgG
AL - primary amyloid
punched out bone lesion
M spike
Ig light chain - bence jones proteinuria
rouleaux formation
monoclonal gammopathy of undetermined significance
MGUS
monoclonal expansion of plasma cells
develop multiple myeloma at rate of 1-2% per year
waldenstrom macroglobulinemia
M spike - IgM - vs. IgG (MM)
hyperviscous syndrome
blurry vision
raynauds
pseudo pelger huet anomaly
neutrophil with bilobed nuclei
after chemo
T cell ALL
mediastinal mass
with dow syndrome
TdT
marker pre T and B cells
CD10
only pre-B cell
t(12;21)
better prognosis for ALL
CLL
elderly
MC adult leukemia
CD20 and CD5 positive - B cells
smudge cells
SLL - small lymphocytic leukemia
same as CLL
but CLL - higher peripheral blood lymphomcytosis
hairy cell leukemia
mature B cell tumor in elderly
dry tap on aspiration
TRAP positive
tartrate resistant acid phosphatase
TRAP
positive in hairy cell leukemia
tx hairy cell leukemia
cladribine
pentostatin
AML
65yo
auer rod - M3 subtype
t(15;17)
M3 AML
all trans retinoic acid - vit A
induce differentiation of myeloblasts
CML
t (9;22)
BCR-ABL fusion - philly
blast crisis
splenomegaly
low LAP - low activity mature granulocytes
imatinib
tx of CML
BCR-ABL tyrosine kinase inhibitor
all-trans retinoic acid
tx of M3 AML
t (15;17)
langerhans cell histiocytosis
disorder of dendrites
lytic bone lesion - in child
birbeck granule
S-100 positive - mesodermal origin
CD1a
JAK2 mutation
hematopoietic growth factor signaling
mutation in chronic myeloproliferative disorders (not CML)
polycythemia vera
increased hematocrit
JAK2 mutation
itching after shower
secondary - due to EPO level increase
essential thrombocytosis
overproduction of platelets - abnormal
bleeding and thrombosis
bone marrow - large megakaryocytes
myelofibrosis
obliteration of bone marrow
-fibroblast activity
teardrop RBCs - and dry tap
relative polycythemia
dehydration and burn - decreased plasma volume
appropriate absolute polycythemia
lung disease
heart disease
high altitude
see more RBC with low O2 sat and elevated EPO
inappropriate absolute polycythemia
see more RBC and no decreased O2 sat
and elevated EPO
renal cell carcinoma
hepatocellular carcinoma
hydronephrosis
ectopic EPO
