Leukemias

Question 1

acute promyelocytic leukemia (APL) bone marrow biopsy

Answer 1

complete replacement of bone marrow by similar promyelocytes (large cells with moderate amounts of cytoplasm and numerous violaceous cytoplasmic granules) 
Auer rods (intracytoplasmic azurophilic crystals seen within atypical promyelocytes)

Question 2

APL characteristic translocation

Answer 2

t(15;17) : PML - RARA

Question 3

APL epidemiology

Answer 3

early adulthood - 60 years

occur after cytotoxic therapy, especially with topoisomerase-II inhibitors

Question 4

APL symptoms

Answer 4

pancytopenia - weakness, fatigue, infections, epistaxis, gingival bleeding, menorrhagia, and ecchymoses

Question 5

APL laboratory findings

Answer 5

pancytopenia, rare circulating atypical promyelocytes within the peripheral blood, and often complete effacement of bone marrow with atypical promyelocytes

Question 6

APL treatment

Answer 6

all-trans retinoid acid essential

Question 7

acute myeloid leukemia genetics

Answer 7

mutation in FLT3

transmembrane tyrosine kinase receptor

Question 8

AML epidemiology

Answer 8

median age 65

Question 9

AML symptoms

Answer 9

pancytopenia with median WBC count of 15,000

Question 10

AML bone marrow biopsy

Answer 10

increased myeloblasts, which morphologically are small to large with scant cytoplasm and have fine chromatin with occasional nucleoli

Question 11

Burkitt lymphoma genetics

Answer 11

MYC oncogene, Ig heavy chain gene

Question 12

Burkitt lymphoma sporadic

Answer 12

US

Question 13

sporadic Burkitt lymphoma presentation

Answer 13

massive abdominal disease associated with ascites

Question 14

sporadic Burkitt lymphoma histology

Answer 14

monotonous, medium-sized lymphocytes with numerous tangible body macrophages and a high proliferative index

Question 15

AML genetics (another)

Answer 15

t(8;21) - RUNX1 - RUNX1T1

Question 16

AML t(8;21) epidemiology

Answer 16

older age

Question 17

AML t(8;21) presentation

Answer 17

extra medullary deposits of myeloblasts (granulocytic sarcoma)

Question 18

AML t(8;21) bone marrow biopsy

Answer 18

abundant cytoplasm, occasional Auer rods, and cytoplasmic vacuolization

Question 19

CML genetics

Answer 19

t(9;22) BCR-ABL1

philadelphia chromosome

Question 20

CML findings

Answer 20

myeloproliferative neoplasm with increased proliferation of all stages of differentiation of myeloid cells, with median WBC count 100,000, and increased myeloblasts (usually < 2%), promyelocytes, myelocytes, metamyelocytes, bands, and neutrophils

Question 21

CML epidemiology

Answer 21

males > 50