Leukemias and Lymphomas Flashcards
Rapid clonal proliferation in the bone marrow of lymphoblasts or myeloblasts caused by a malignant neoplasm which in turn causes high numbers in the peripheral blood
Acute Leukemias
- affects children, adolescents, people >50
- 2-5 is peak age
- Types: T and B cell
- Diagnosis is small and large lymphoblast
Acute Lymphoblastic Leukemia (ALL)
- a type of ALL
- symptoms: fatigue due to anemia, fever, mucocutaneous bleeding, bone pain, hepatosplenomegaly
B-cell ALL
- a type of ALL
- symptoms: large mass in mediastinum, anemia, thrombocytopenia, organomegaly, bone pain
T-cell ALL
- affects adults and increases with age
- diagnosis: WBC counts average 5 to 30x10^3 and can range greatly
- symptoms: anemia, thrombocytopenia, neutropenia
- has other lab tests for confirmation
Acute Myeloid Leukemia (AML)
hyperuricemia due to cell turnover
uric acid
hyperphosphatemia due to cell lysis and bone destruction
phosphorous
hypocalcemia due to bone destruction
calcium
hypokalemia due to tumor and external loss
potassium
- seen in granulocytic cells and small amounts in monocytes
- differs AML from ALL
Myeloperoxidase stain
- neutrophils show a positive reaction and lymphocytes a negative reaction
- differs AML from ALL
Sudan Black B
- affects 40’s
- diagnosis: small lymphoid cells and smudge cells
Chronic Lymphoid Leukemia
Reason for smudge cells and how you fix them
- due to weak cellular membrane
- make an albumin slide
- cause: neoplasms of lymph nodes
- types: T and B cell
Lymphomas
- age: elderly
- characteristics: all produce monoclonal light chain immunoglobulins, and/or clonal immunoglobulin gene rearrangement
- common types: follicular lymphoma and diffuse large B-cell lymphoma
Mature B-cell lymphoma
-based on location of origin
CLL and SLL
originated in the bone marrow and peripheral blood
CLL
originated in the lymph node and lymphoid organ
SLL
- age affected: middle age (55)
- small B-cells with abundant cytoplasm and fine (hairy) cytoplasmic projections
- cells originated post-germinal center stage
- symptoms: splenomegaly and pancytopenia
- Trap stain
Hairy Cell Leukemia
- lymphoproliferative disorder characterized by medium size lymphoid cells with irregular nuclear outlines derived from the follicular mantle zone
- indented nuclei reminiscent of the cleaved nuclei
Mantle Cell Lymphoma
- originate from the germinal center B-cells and in most cases, recapitulates follicular architecture
- numerous closely spaced follicles
- medium size cells with anglular or indented nuclei and a mix of large lymphoid cells
- butt cells
Follicular Lymphoma
- twice the size of normal lymphocytes
- have diffuse histologic growth pattern and can differ significantly in cytologic appearance
Diffuse Large B-cell Lymphoma
- characterized by medium sized, highly proliferating lymphoid cells with basophilic vacuolated cytoplasm
- starry-sky appearance
- tumor cells and macrophages
Burkitt Lymphoma
Two types of Hodgkin Lymphoma
- Nodular Lymphocyte-Predominant Hodgkin Lymphoma
- Classical Hodgkin Lymphoma
- age: males in their 30’s
- B-cell neoplasm composed of relatively rare neoplastic cells scattered within nodules of reactive lymphocytes
- popcorn cells
Nodular Lymphocyte-Predominant Hodgkin Lymphoma
- age: 15-34 and >54
- heterogenous group of lymphoid neoplasms derived from the germinal center with few diagnostic neoplastic cells
- Reed-Sternberg cells with a rich reactive background
Classical Hodgkin Lymphoma
large lymphoid cells with abundant cytoplasm and vesicular multilobed nuclei
Popcorn cells
large cells with bilobed nucleus with eosinophilic nucleoli and abundant cytoplasm, “owl eyes”
Reed-Sternberg cells
