Malignant disorders of leukocytes: ALL + Flashcards
what stain(s)/identifiers are pos or neg in lymphoblasts?
PAS positive, TdT positive!!;
MPO and SBB neg
what gene translocation/fusion gene is found in CML and also often in B-cell lymphoblastic leukemia/lymphoma?
t(9;22)/ BCR-ABL gene
Is B-cell or T-cell ALL more common?
B-cell
Give the 4 classifications by FAB of acute lymphoblastic leukemias with brief description
L0- more common in children/young; small homogenous lymphoblasts; best prognosis; most T-cell ALl is L0
L1- more common in adults; large HETerogenous lymphoblasts
L3- the leukemic phase of Burkitt lymphoma, always B-cell lineage. Lymphoblasts large, uniform, prominent nucleoli, deep basophilic cytoplasm; poor prognosis
Burkitt Lymphoma- the high grade NHL phase of L3
what virus is associated with Burkitt’s lymphoma and how is presentation different on different continents?
EBV; In Africa where it is endemic, presents mainly with facial bone tumors; In U.S. with abdominal mass
CD markers of a progenitor B-cell ALL:
CD19, CD34 (ALL WBCs), TdT. CD10 is negative bc this comes with maturation
CD markers of Early-pre-B-cell ALL
CD10, CD19, CD34, & TdT
CD MARKERS OF Pre-B-cell ALL and then B-cell ALL
Pre: CD10/CALLA, CD19, CD20, TdT POS
B-cell ALL: CD19 AND 20 ONLY, no TdT
List the progression in maturity of B-cell ALL categories and the markers that are associated
Progenitor: CD19, CD34, TdT
Early-pre-B: CD10, CD19, CD34, TdT
Pre-B: Cd10, CD19, CD20, TdT
B-cell: CD19 and CD20 only
Markers that help ID T-cell lineage in ALL:
Also what is positive in immature T-cells that is positive for all immature lymphocytes?
CD2, 3, 5 & 7
TdT
Give the genetic translocation associated, and oncogene if were given:
FAB L3/Burkitt lymphoma
T-cell ALL
Pre-B cell ALL (this one is in CML too)
- t(8:14)
- t(7;11)
- t(9;22)
In what ALL is a mediastinal mass due to thymus enlargement commonly presents especially in adolescents?
T-cell ALL
are cells of ALL mature or precursor type? what about CLL?
precursor; mature or maturing in CLL
*the acute leukemias of either origin are of less mature cell stages, and chronic leukemias of mature cells
What kind of leukemia: Patient is 65, had lymphocytosis at 6.0 x 109/L WBCs, with homogenous small hyperclumped lymphocytes predominating; Flow showed CD19 and Cd20 ……patient had no symptoms.
What can this progress to?
CLL, B-cell type; the lymphoma stage is SLL, small lymphocyte leukemia
What kind of leukemia: patient presented with massive splenomegaly and a dry bone marrow tap; with pancytopenia of PB; TRAP positive cells with hairlike projections, CD19 and 20 positive
Hairy Cell, HCL: a B-cell malignancy more common in males over 50
Possible diagnosis?
pt presented with massive splenomegaly, elevated WBC count over 100 x 109/L; with many prolymphocytes on peripheral smear
PLL: Prolymphocytic leukemia which is usually B-cell but not always
this is a general description of what leukemia? lymphocytosis > 5 x 109/L; WBC btw 20 - 200; normo-normo anemia; mature-appearing lymphocytes without nucleoli and checkerboard appearance of clumping, and many smudge cells
CLL
In what type of CLL do the abnormal cells have large lymphs w/ moderate cytoplasm, moderately condensed chromatin and one prominent nucleoli usually?
Prolymphocytic
This leukemia is associated with HTLV-1 (human T-cell lymphotropic virus); where is it endemic and what is unique about the leukemic cells? How does it present?
ATLL: adult T-cell leukemia/lymphoma; endemic in Japan, some of S. Pacific; flower-like or clover-like nuclei (lobulated); widespread lymphadenopathy/liver enlarged
Thisis a description of what syndrome:
malignant mature T-cells with cerebriform/convluted nucleoli, scant cytoplasm; Cutaneous lesions, erythroderma, lymphadenopathy,
Sezary syndrome (look at images on p 203 of compendium)
what condition is related to Sezary syndrome>
mycosis fungoides, a T-cell malignancy of the skin
