Malignancy Introduction

Question 1

How are mature non-lymphoid cells identified?

Answer 1

Morphology (i.e. blood count and film)

Question 2

Though morphology is mainly used to identify mature non-lymphoid cells, what are some other options that can be used?

Answer 2

Cell surface antigens and enzyme expression

Question 3

Glycophorin A antigen on a cell suggests which type of cell?

Answer 3

Erythrocyte

Question 4

Myeloperoxidase enzyme expression on a cell suggests what type of cell?

Answer 4

Neutrophils

Question 5

Stem cells and early progenitors cannot be identified by morphology. What is done instead?

Answer 5

Immunophenotyping for cell surface antigens

Question 6

What normally characterises malignant haemopoiesis?

Answer 6

Increased numbers of abnormal and dysfunctional cells, with loss of normal activity

Question 7

In malignant haemopoiesis, there is loss of normal activity. An example of this would be abnormal haemopoiesis - what type of tumour would generally cause this and where would it be found?

Answer 7

Acute leukaemia, in the bone marrow

Question 8

In malignant haemopoiesis, there is loss of normal activity. An example of this would be abnormal immune function - what type of tumour would generally cause this and where would it be found?

Answer 8

Certain lymphomas, in the lymph nodes

Question 9

Abnormalities in malignant haemopoiesis are due to one or more of what 4 causes?

Answer 9

Increased proliferation, lack of differentiation, maturation or apoptosis

Question 10

Describe the abnormality in haemopoiesis which is seen in acute leukaemias?

Answer 10

Proliferation of abnormal progenitors with a block in further differentiation/maturation

Question 11

How will the cells in acute myeloid leukaemia look and why?

Answer 11

They will all look the same since there is no differentiation

Question 12

Describe the abnormality in haemopoiesis which is seen in chronic leukaemias?

Answer 12

Proliferation of abnormal progenitors, but no block in differentiation or maturation

Question 13

What is the main cause of haematological malignancies?

Answer 13

Genetic, epigenetic and environmental interaction

Question 14

What is a clone?

Answer 14

A population of cells which have derived from a single parent cell

Question 15

Describe the clonage in a) normal haemopoiesis? b) abnormal haemopoiesis?

Answer 15

a) polyclonal b) monoclonal

Question 16

Types of haematological malignancy can be based on lineage. What are the two broad types?

Answer 16

Myeloid and lymphoid

Question 17

Types of haematological malignancy can be based on the developmental stage within the lineage. Give an example of the cancer that would arise at each stage: a) pro-B cell? b) B cell? c) plasma cell?

Answer 17

a) acute lymphoblastic leukaemia b) chronic lymphocytic leukaemia c) myeloma

Question 18

What is a myeloma?

Answer 18

Plasma cell malignancy in the marrow

Question 19

Types of haematological malignancy can be based on the anatomical site involved. Where are each of the following types of cancers found: a) leukaemias? b) lymphomas?

Answer 19

a) blood b) lymph nodes

Question 20

What is a type of malignancy which can involve the blood and bone marrow? This is why it is important to check what blood test in someone presenting with lymphadenopathy?

Answer 20

Chronic lymphocytic leukaemia / FBC

Question 21

What is significant about acute leukaemias/high grade lymphomas compared with chronic leukaemias/low grade lymphomas?

Answer 21

They are more histologically and clinically aggressive

Question 22

What are some features of histological aggression?

Answer 22

Large cells with a high nuclear: cytoplasmic ratio, prominent nucleoli, rapid proliferation, open chromatin

Question 23

What is the main feature of clinical aggression?

Answer 23

Rapid progression of symptoms

Question 24

Which type of cancers present with failure of normal bone marrow function?

Answer 24

Acute leukaemias