Leukemia/Lymphoma Diagnostic Tools Flashcards
1
Q
What does a blood smear and/or BM aspirate tell you?
A
MORPHOLOGY
- RBCs - go from blue cytoplasm –> red as they gain Hb and then lose nucleus
- Blasts - generally have a more loose chromatin, nucleoli, basophilic cytoplasm
- If myeloid cells then go from myeloblast (no granules) –> promylelocyte (many primary granules)
- Normal lymphocytes are about the size of a RBC
- AML - Auer rods (primary granules clumped into needle-like crystals)
2
Q
What does a BM biopsy tell you?
A
cellularity / architecture
- Myeloid - more monotonous sheets
- Lymphoid - more variable sizes
- Aplastic anemia - lots of fat cells
- Rule - cellularity should be 100% - age
3
Q
What is flow cytometry?
A
- cells in fluid suspension thru laser; if larger then more forward scatter… if complex (many granules) than inc side scatter
- Diff antibody for specific surface proteins ea bound to diff fluorochromes
4
Q
CD45+
A
- leukocyte common antigen
5
Q
CD34+
A
progenitors to blast phase (immaturity)
6
Q
CD117+
A
HSC/ progenitors/ mast cells
7
Q
TdT
A
Lymphoblast
8
Q
T Cell Markers
A
CD3, CD4, CD5, CD8
9
Q
B Cell Markers
A
CD19, CD20, CD22
Often have abberant CD5
Can tell if monoclonal by all kappa or all lamda instead of 2:1 kappa
10
Q
Myeloid Cell Markers
A
CD13, CD33, MPO, CD15
11
Q
Reed-Sternberg Cell Markers
A
CD15+ CD30+
12
Q
Immunohistochemistry
A
- look at tissue sections not individual cells
- Primary antibody binds target of interest then secondary antibody w/ biotin to bind primary; then add enzyme complex w/ streptavidin and streptavidin will bind biotin; lastly add substrate for that enzyme which will cause colored product when enzyme acts on substrate to ID target of interest
13
Q
2 Cytogenetic Tests
A
- Karyotyping (examine while in metaphase)
- FISH (must know what mutation you are looking for)
