Lymphoma/ Leukemias Flashcards
What illness has
Low Hemoglobin (Hb) and platelets
High WBC count
auer rods
MPO+
AML
Patients with infectious _____ have flu-like symptoms, lymphadenopathy, and splenomegaly.
Atypical Lymphoblasts on smear
(weird shaped)
mononucleosis
Mucosal Pallor =
Anemia
This patient’s combination of pancytopenia, hypercoagulability (eg, hepatic vein thrombosis), and anemia are characteristic of
paroxysmal nocturnal hemoglobinuria (PNH).
Pancytopenia
N-emia
Hypercoagulability
PNH is caused by an acquired mutation of the ___ gene within a clonal population of multipotent hematopoietic stem cells.
This gene is involved in the synthesis of the _______ anchor, a glycolipid necessary for the attachment of several cell-surface proteins, including _____ (decay-accelerating factor) and _____ (MAC inhibitory protein). These proteins help inactivate complement and prevent the membrane attack complex from forming on normal cells.
COOMBS Negative Hemolysis
PIG-A
glycosylphosphatidylinositol (GPI)
CD55
CD59
Patients with ______ mutation are at increased risk of thrombotic events
factor V Leiden
Easy bruising =
impaired platelet plug formation
vWF deficiency
Hemophilia
Head and neck squamous cell carcinomas typically spread first to the ____ lymph nodes via the lymphatics.
anterior cervical
The involvement of anterior cervical lymph nodes affects the staging of the disease.
____ reactions are usually mild, hemolytic reactions that occur >24 hours after blood transfusion (recent hospital visit).
Occurs in patients previously exposed to a minor RBC antigen (eg, previous blood transfusion, pregnancy).
(+ Coombs)
(+/– ↑ indirect bilirubin or ↑ lactate dehydrogenase)
Delayed hemolytic transfusion
They are a type of anamnestic response (delayed immunologic response
Additional laboratory findings include anemia with compensatory reticulocytosis and evidence of hemolysis
(+/– ↑ indirect bilirubin, ↑ lactate dehydrogenase).
____ reactions occur within minutes of transfusion initiation and present with wheezing, angioedema, and hypotension, findings not seen in this patient.
This reaction can occur in patients with IgA deficiency due to the reaction of recipient anti-IgA antibodies against donor IgA.
Anaphylactic transfusion
Rifampin, phenobarbital, and phenytoin are potent enhancers of the cytochrome P-450 pathway; concurrent use of warfarin with these medications results in _______ efficacy of warfarin.
decreased efficacy
(Low INR)
The presence of rod-shaped intracytoplasmic inclusions known as Auer rods is characteristic of many forms of acute myeloblastic leukemia (AML). The ___ variant of AML, acute promyelocytic leukemia, is associated with the cytogenetic abnormality t(__;__).
M3
t(15;17)
Deletion of ____ is one of the molecular defects seen in chronic lymphocytic leukemia.
13q
Mantle cell lymphoma is a B-cell malignancy associated with
t(__;__)
This translocation results in activation of the _____ gene.
t(11;14)
cyclin D
(Clock on the Mantle 11:14)
With t(__;__), associated with Burkitt lymphoma, t
t(8;14)
In Burkitt’s Lymphoma there is a translocation between the ___ protooncogene on chromosome 8 and the _____ region on chromosome 14. This leads to increased production of the oncogene due to the frequency with which the Ig gene is transcribed.
cMyc
Ig heavy chain
Translocation of the ABL gene from chromosome 9 to chromosome 22 is characteristic of _______. t(9;22) forms the “Philadelphia chromosome” and results in the formation of a new gene, BCR-ABL, whose product has constitutively active ______.
chronic myelogenous leukemia
tyrosine kinase activity
t(9,22) is associated with
CML
t(15,17) cytogenetic change represents a translocation between the _____ gene on chromosome 17 and the _______ gene on chromosome 15.
Fusion of these 2 genes produces a chimeric gene product, ____ which codes for an abnormal ____ receptor.
This abnormal fusion gene inhibits promyelocyte differentiation and triggers the development of APML.
Management is with ______.
retinoic acid receptor alpha (RARα)
promyelocytic leukemia (PML)
PML/RARα
retinoic acid
all-trans retinoic acid
Associated with CD15 and CD30 markers
Hodgkins Lymphoma
Associated with EBV
or Jaw Lesion
burkitt’s Lymphoma
Non-Hodkins
Associated with waxing/waning Lympoadenopathy
(indolent) Follicular lymphoma
Associated with t(11;14)
Mantle Cell Lymphoma
Associated with t(11;18)
Marginal Zone lymphoma
Associated with Sjrogrens
Chronic Inflammatory illnesses
Marginal Zone Lymphoma
Associated with HIV/AIDS or EBV
AIDS defining illness
Ring Enhancing Lesion
Primary CNS lymphoma
Associated with HTLV or IVDU
Adult T-cell lymphoma
Associated with skin patches/ plaques
cerebrifrom nuclei
pautrier microabscess (tumor cell aggregates in skin)
Mycosis Fungosis
Sezary
B Cell Leukemias (2)
CLL (B)
Hairy Cell (B)
T cell Leukemias (1)
Granulocyte Leukemias (2)
ALL (T)
AML, CML (Granulocytes)
NHL Neoplasms of Mature B cells (6)
Burkitt
Diffuse Large B cell
Follicular
Mantle
Marginal Zone
Primary CNA lymphoma
NHL Neoplasms of Mature T cells (2)
Adult T cell (tokyo) Lymphoma
Sezary Syndrome (M. Fungioides)
Most common Hodkin Lymphoma
Women > Men
Nodular Sclerosis
Hodkins lymphoma
Eosinophilia
Immunocompromised
Mixed Cellularity
Hodkins Lymphoma
Seen in immunocompromised
NO eosionphils
Lymphocyte depleted
Hodkins lymphoma with best prognosis
Lymphocyte rich
