lymphoid malignancies

Question 1

acute lymphocytic leukemia characteristics

Answer 1

stem cell disorder
malignant proliferation
peak age 2-5 yoa

Question 2

acute lymphocytic leukemia etiology

Answer 2

idiopathic
chromo ab (Downs syndrome)
leukemogenic factors

Question 3

acute lymphocytic leukemia clinical course

Answer 3

abrupt onset
fatigue, pallor, weight loss, fever, bruising, bone pain

Question 4

acute lymphocytic leukemia laboratory presentation

Answer 4

n/n anemia
thrombocytopenia
v wbc
diff: blasts (no auer rods)
cytochemistry: block + PAS
cell markers: CALLA, CD
classification: FAB
bm: hypercellular (increased blasts)

Question 5

ALL TREATMENT

Answer 5

chemo/ radiation
bm transplant
umbilical cord treatment
80% survival in children

Question 6

chronic lymphocytic leukemia laboratory presentation

Answer 6

n/n anemia
decreased plts
increased wbc
neutropenia
lymphocytosis
small lymphs
smudge cells

Question 7

CML treatment

Answer 7

supportive
chemo/ radiation as needed

Question 8

hairy cell leukemia characteristics

Answer 8

adult disease
male; female= 7:1

Question 9

hairy cell leukemia clinical presentation

Answer 9

splengomegaly
increased infection

Question 10

hairy cell leukemia laboratory presentation

Answer 10

pancytopenia
hairy cells
fibrosis in bm
TRAP stain +
immunophenotyping: B cells positive for CD 19, 20, 22, 25 etc.

Question 11

hairy cell leukemia therapy

Answer 11

supportive
splenectomy
chemo

Question 12

multiple myeloma charachteristics

Answer 12

adult median age 65
male predominance
malignant proliferation of plasma cells
monoclonal gammopathy (most IgG)

Question 13

multiple myeloma clinical presentation

Answer 13

bone pain
lytic bone lesions and fractures
symptoms related to abnormalities

Question 14

multiple myeloma laboratory presentation

Answer 14

increased plasma cells in bm
+/= plasma cells in peripheral blood
increased serium Ca
Bence Jones protein in urine
rouleaux
hazy smear
increased ESR
flame cells
ab. plasma cells with Dutcher bodies
immunophenotyping/ cytogenetics

Question 15

multiple myeloma therapy

Answer 15

poor prognosis
chemo
bm/ stem cell transplant
death due to infection, fractures, renal failure

Question 16

Waldenstrom’s Macroglobulnemia characteristics

Answer 16

malignant proliferation of plasma cells

Question 17

Waldenstrom’s Macroglobulinemia clinical/lab characteristics

Answer 17

lymphadenopathy
hepatosplenomegaly
monoclonal gammopathy (IgM)
hyperviscosity
NO bone lesions

Question 18

Waldenstrom’s Macroglobulinemia treatment

Answer 18

plasmapheresis: take unit of blood remove bad stuff give good back
median survival 4 yrs

Question 19

Sezary syndrome

Answer 19

T cell lymphoma

Question 20

Sezary Syndrome clinical/lab findings

Answer 20

erythrodema (skin infiltration and circulating Sezary cells)
sezary cell: t cell w/ irregular nuclear outline and fine chromatin (looks slightly immature)
treatment same as other lymphomas

Question 21

lymphomas characteristics

Answer 21

malignant neoplasm involving lymphoid organs
2 types: Hodgkins and Non Hodgkins
adult: peaks at 20-30/ >50 yoa
most common malignancy of young adults in US

Question 22

Hodgkin’s lymphoma characteristics

Answer 22

localized
central lymph nodes
contiguous spread
rare extra-nodal disease
peripheral blood not involved
bizarre cell apperance

Question 23

Non-Hodgkin’s lymphoma characteristics

Answer 23

widespread
peripheral lymph nodes
non-contiguous spread
extra-nodal disease common
peripheral blood may be involved
normal cell apperance (lymphs w/ clefts in nucleus but all look the same)

Question 24

lymphoma classification

Answer 24

based on cell types and spread of disease

Question 25

lymphoma treatment

Answer 25

chemo
radiation
2/3 hodgkin’s disease is curable- relapse possible

Question 26

Burkitt’s lymphoma

Answer 26

high incidence in Africa
often extra-nodal (facial bones, jaw, intestines, ovaries, kidney)
diagnosed by morphology and immunophenotyping (B cell in orgin)
typical cell= blue, vacuolated (L3) [big blue cells w/ vacuoles]
treatment: chemo