leukemia

Question 1

leukemia

Answer 1

-if myeloid (AML/CML)
-acute- myeloblast
-chronic- basophil, eosinophil, neutrophil (granulocytes)
-middle aged- 50-60

-if lymphocytic (CLL/ALL)
-acute- lymphoblast- young
-chronic- b lymphocytes, t lymphocyte, NKC- old
-really old or really young

Question 2

acute lymphocytic leukemia

Answer 2

-B cell MC subtype
-MC childhood malignancy!!

-hepatomegaly/splenomegaly
-lymphadenopathy
-fever
-hematologic ab - petechiae, purpura, fatigue, pallor
-MSK pain
-ALL = anemic, lumpy (megaly), limping (MSK)

-pancytopenia - CBC -> WBC can be high / normal/ low
-bone marrow bx- >20% lymphoblasts !!!

-chemo
-CNS preventative therapy - intrathecal methotrexate

Question 3

acute myeloid leukemia

Answer 3

-MC acute leukemia in adults
-acute promyelocytic leukemia (APL) (M3 variant):
-myeloperoxidase +
-AUER RODS - needle shape
-tx- vitamin A and chemo

-pancytopenia
-fatigue
-pallor/weak
-infection

-bone marrow bx- >20% myeloblasts

-chemo
-APL- vitamin A, all-trans-retinoic-acid

Question 4

chronic lymphocytic leukemia

Answer 4

-mature B cell neoplasm
-older adults!!- 70yo

-asymptomatic
-fatigue
-lymphadenopathy
-splenomegaly/hepatomegaly

-absolute lymphocytosis >5,000
-smudge cells!!!!!!- crushed little lymphocytes

-observe bc age and no sx
-chemo is sx or younger

Question 5

chronic myelogenous leukemia

Answer 5

-myeloproliferation neoplasm -> granulocytes
-philadelphia chromosome !!!! 9 and 22 translocation

-asymptomatic
-splenomegaly
-fatigue, wt loss, fever

-leukocytosis with neutrophil predominance

-tx-
-tyrosine kinase inhibitors (imatinib)

Question 6

hodgkin lymphoma

Answer 6

-mature B cells malignancy
-reed sternberg cells!!!!!- multinucleated cells
-bimodal age
-contiguous spread to local lymph nodes -> better prognosis
-epstein barr virus - RF

-MC- nodular sclerosing

-non-tender lymphadenopathy- neck MC
-mediastinal mass
-B-symptoms- fever, night sweats, wt loss

-excisional bx - (NOT FNA)
-PET/CT

-chemo/radiation

Question 7

non-hodgkin lymphoma

Answer 7

-B and T cells malignancies
-ABSENCE of reed sternberg cells
-hematogenous/non-contiguous spread -> poor prognosis

-diffuse large B-cell- MC

-burkitt lymphoma! - highly aggressive:
-starry sky appearance on bx
-epstein barr virus
-jaw or facial bone tumor

-non-tender lymphadenopathy
-extranodal involvement -GI

-excisional bx
-PET/CT

-chemo/radiation