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Heme/Lymph 2 > Morphology - Ch. 13 > Flashcards

Morphology - Ch. 13 Flashcards

1
Q

Neutrophils with abnormally dark and coarse granules

A

Toxic granules (abnormal azurophilic granules) - due to sepsis or inflammatory disease

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2
Q

Sky-blue cytoplasmic puddles w/in neutrophils

A

Döhle bodies - due to sepsis or inflammatory disease

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3
Q

Many immature granulocytes appearing in blood during severe infection

A

Leukemoid reaction - reactive leukocytosis

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4
Q

Swollen, painful LNs with prominent reactive germinal centers w/ numerous mitotic figures, macrophages w/ particulate debris, many neutrophils, and follicular necrosis in the centers

A

Acute lymphadenitits - due to infection

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5
Q

LNs w/ large oblong germinal centers surrounded by collar of small naive B cells, polarized germinal centers with centroblasts and centrocytes w/in a network of follicular dendritic cells and debris-containing macrophages

A

Follicular hyperplasia

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6
Q

Causes of follicular hyperplasia

A

RA, toxo, early HIV

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7
Q

Telling reactive hyperplasia instead of neoplastic (5)

A
  • Preserved LN architecture
  • Varied shape/size of follicles
  • Mitotic figures
  • Macrophages
  • Light and dark zones
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8
Q

Large T cells with round nuclei, open chromatin, prominent nucleoli, and pale cytoplasm in the paracortical LN region

A

Immunoblasts (immature T cells) - normal

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9
Q

Expanded T-cell zones, diminished follicles, hypertrophy of sinusoidal and vascular endothelial cells, and infiltrating macrophages and eosinophils

A

Paracortical hyperplasia

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10
Q

Causes of paracortical hyperplasia

A

Acute viral infections (ex. mono)

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11
Q

Increased number and size of cells lining lymphatic sinusoids (LNs), increased macrophages, expanded/distended sinuses

A

Sinus histiocytosis

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12
Q

Causes of sinus histiocytosis

A

Reactive hyperplasia OR cancers draining into the LN (based on other findings)

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13
Q

Hypercellular marrow packed w/ lymphoblasts that have scant basophilic cytoplasm, nuclei larger than normal and convoluted, stippled chromatin, and rimmed nucleoli. Marcophages ingesting dead tumor cells give “starry sky”

A

Acute lymphoblastic leukemia/lymphoma (ALL)

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14
Q

Myeloblasts (AML) vs. Lymphoblasts (ALL)

A

Lymphoblasts - TdT

Myeloblasts - MPO

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15
Q

Small lymphocytes w/ round or slightly irregular nuclei, condensed chromatin, and scant cytoplasm in the LNs, blood, BM, spleen, portal tracts. Smudge cells in blood.

A

Chronic lymphocytic leukemia / Small lymphocytic lymphoma (CLL/SLL)

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16
Q

Areas of small inactive lymphocytes and large active lymphocytes w/in LNs

A

Proliferation centers - CLL/SLL (always)

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17
Q

CLL/SLL –> rapidly enlarging mass w/in LN or spleen

A

Richter syndrome - transformation to diffuse large B-cell lymphoma

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18
Q

Small cells in LN w/ irregular/cleaved nuclear contours and scant cytoplasm

A

Centrocytes - follicular hyperplasia or follicular lymphoma

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19
Q

Large cells in LN w/ open nuclear chromatin, several nucleoli, and modest cytoplasm

A

Centroblasts - follicular hyperplasia or follicular lymphoma

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20
Q

LNs - nodular/diffuse pattern w/ centrocytes and centroblasts w/in reactive follicular dendritic cells and macrophages and T cells

Blood - modest increased WBC

A

Follicular lymphoma

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21
Q

Large B cells w/ either round/oval nucleus appearing vesicular or multilobed/cleaved nuclei, open chromatin, prominent nucleoli, abundant cytoplasm

A

Diffuse large B-cell lymphoma

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22
Q

Diffuse infiltrate or intermediate-sized lymphoid cells with round/oval nuclei, coarse chromatin, several nucleoli, and moderate cytoplasm. High mitotic index, many apoptotic cells, and interspersed phagocytes causing “starry sky”

A

Burkitt lymphoma

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23
Q

BM - tumor cells w/ slightly clumped chromatin, 2-5 nucleoli, and royal blue cytoplasm w/ clear vacuoles

A

Burkitt lymphoma

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24
Q

Punched-out defects of soft, gelatinous, red tumor tissue within vertebral column, ribs, skull pelvis, etc. Excess plasma cells w/ perinuclear clearing and eccentrically placed nucleus w/in the BM.

A

Multiple myeloma

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25
Q

Plasma cells w/ vesicular chromatin and prominent single nucleolus

A

Plasmablasts - multiple myeloma (maybe)

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26
Q

Multinucleated plasma cells

A

Multiple myeloma (maybe)

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27
Q

Plasma cells w/ fiery red cytoplasm

A

Flame cells - multiple myeloma (maybe)

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28
Q

Plasma cells w/ multiple grapelike cytoplasmic droplets

A

Mott cells - multiple myeloma (maybe)

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29
Q

Plasma cells w/ globular inclusions of globules

A

Russell bodies (cytoplasm) or Dutcher bodies (nucleus) - multiple myeloma (maybe)

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30
Q

Red cells in blood to stick together in linear arrays

A

Rouleaux formation - multiple myeloma (and others)

31
Q

BM - infiltrate of lymphocytes, plasma cells, plasmacytoid lymphocytes, and mast cell hyperplasia. PAS-positive inclusions of Ig in cytoplasm (Russel) or nucleus (Dutcher) of some plasma cells. Dissemination to LNs, spleen, liver.

A

Lymphoplasmacytic lymphoma

32
Q

LNs - Homogenous population of small lymphocytes with irregular/clefted nuclear contours surround reactive germinal centers

Other - polyp-like lesions in bowel

A

Mantle cell lymphoma

33
Q

Blood - Leukemic cells with various nuclei, moderate pale blue cytoplasm w/ threadlike/bleblike extensions

Marrow - Diffuse infiltrate of similar cells enmeshed in extracellular matrix of reticulin fibers

Spleen - enlarged, beefy red, heavily infiltrated red pulp

A

Hairy cell leukemia

34
Q

LNs - Pleomorphic mixture of variably sized malignant T cells, infiltrate of eosinophils and macrophages, and neoangiogenesis

A

Peripheral T-cell lymphoma - unspecified

35
Q

Large anaplastic cells that cluster about venules and infiltrate lymphoid sinuses (like carcinoma)

A

Anaplastic Large-Cell Lymphoma

36
Q

Horseshoe-shaped (embryoid) nuclei and voluminous cytoplasm

A

Hallmark cells - Anaplastic Large-Cell Lymphoma

37
Q

Tumor cells w/ multilobed nuclei in “cloverleaf” or “flower” appearance

A

Adult T-Cell Leukemia/Lymphoma

38
Q

CLA+, CCR4+, CCR10+ cells w/ marked infolding of nuclear membrane (cerebriform appearance) w/in skin –> LNs, BM, blood

A

Mycosis Fungoides

39
Q

Blood - Large CD3+ or CD56+ lymphocytes w/ abundant blue cytoplasm and few coarse azurophilic granules

BM - sparse interstitial lymphocytic infiltrates

A

Large Granular Lymphocytic Leukemia

40
Q

Destructive nasopharyngeal mass w/ CD56+ (or CD3+) tumor cells w/ large azurophilic granules in cytoplasm; cells invade small vessels causing ischemic necrosis

A

Extranodal NK/T-Cell Lymphoma

41
Q

Large cells w/ multiple nuclei or single nucleus w/ multiple lobes, each w/ a large inclusion-like nucleolus, abundant cytoplasm

A

Reed-Sternberg cells (classical) - HL

42
Q

Large cells w/ single nuclei w/ large inclusion-like nucleolus and abundant cytoplasm

A

RS cell, mononuclear variant

43
Q

Large cell, folded or multilobate nuclei and abundant pale cytoplasm w/ nucleus sitting in empty hole

A

Lacunar cell (RS cell variant) - Nodular Sclerosis HL

44
Q

Large cell, polypoid nuclei, minimal nucleoli, abundant cytoplasm

A

Lymphohistiocytic cell (RS cell variant) - Lymphocyte-predominance HL

45
Q

RS cells in background of non-neoplastic inflammatory cells

A

Hodgkin lymphoma

46
Q

Lacunar RS cells + eosinophils, plasma cells, and macrophages; deposition of collagen bands that divide LNs into nodules

A

Nodular Sclerosis HL

47
Q

RS cells w/ mononuclear variants mixed w/ T cells, eosinophils, plasma cells, and macrophages

A

Mixed-Cellularity HL

48
Q

RS cells w/ mononuclear variants mixed w/ many reactive T cells

A

Lymphocyte-Rich HL

49
Q

RS cells and variants, few background cells

A

Lymphocyte Depletion HL

50
Q

L&H RS cells, CD20+, CD15-, CD30-, background of follicular dendritic cells and reactive B cells

A

Lymphocyte Predominance HL

51
Q

> 20% myeloid blasts in the bone marrow

A

AMLs

52
Q

Delicate nuclear chromatin, 2-4 nucleoli, and voluminous cytoplasm with fine, peroxidase-positive azurophilic granules

A

Myeloblasts

53
Q

Needle-like azurophilic granules of MPO

A

Auer rods

54
Q

Folded or lobulated nuclei, no auer rods, nonspecific esterase-positive

A

Monoblasts

55
Q

Megakaryocytic differentiation in AMLs is accompanied by marrow ____ due to cytokine release

A

Fibrosis

56
Q

BM - disordered (dysplastic) differentiation affecting the erythroid, granulocytic, monocytic, and megakaryocytic lineages to varying degrees

A

Myelodysplastic syndromes

57
Q

Erythroblasts with iron-laden mitochondria visible as perinuclear granules in Prussian-blue stained aspirates/biopsies

A

Ring sideroblasts - myelodysplastic RBCs

58
Q

Erythroblasts w/ iron-laden mitochondria as perinuclear granules in Prussian Blue stain

A

Ring sideroblasts

59
Q

Nuclei w/ misshapen, often polypoid, outlines

A

Nuclear budding abnormalities

60
Q

Neutrophils w/ only 2 nuclear lobes

A

Pseudo-Pelger-Hüet cells

61
Q

Megakaryocytes w/ multiple separate nuclei

A

Pawn ball megakaryocytes

62
Q

Blood - pseudo-PGH cells, giant platelets, macrocytes, poikilocytes, and excess monocytes

A

Myelodysplastic syndromes

63
Q

BM - ring sideroblasts, pseudo-PGH cells, pawn ball megakaryocytes, etc.

A

Myelodysplastic syndromes

64
Q

BM - neoplastic promyelocytes with abnormally coarse and numerous azurophilic granules, several cells with bilobed nuclei and auer rods

A

Acute promyelocytic leukemia - t(15;17)

65
Q

Blood - monoblasts and promonocytes w/ folded nuclear membranes

A

AML with monocytic maturation

66
Q

AML w/ full range of myelocytic maturation, many auer rods, abnormal cytoplasmic granules

A

AML w/ myelocytic maturation - t(8;21)

67
Q

AML w/ myelocytic and monocytic differentiation, abnormal eosinophilic precursors w/ abnormal basophilic granules

A

Acute myelomonocytic leukemia - inv(16)

68
Q

AML w/ numerous auer rods in bundles w/ individual progranulocytes; primary granules are prominent; high incidence of DIC

A

Acute promyelocytic leukemia - t(15;17)

69
Q

Most common AML in Down Syndrome

A

AML w/ megakaryocytic maturation

70
Q

Hypercellular marrow w/ massively increased numbers of maturing granulocytic precursors. Sea-blue histiocytes. MAJOR blood leukocytosis (>100,000). Greatly-enlarged spleen red pulp, w/ infarcts.

A

Chronic myelogenous leukemia (CML)

71
Q

Hypercellular marrow w/ slightly increased RBC progenitors, granulocytic precursors, and megakaryocytes. Mild organomegaly. Increased basophils and large platelets in blood.

A

Polycythemia vera

72
Q

BM - mildly hypercellular with markedly increased megakaryocytes with some abnormally large forms, delicate reticulin fibrils, but no overt fibrosis. Blood shows abnormally large platelets and mild leukocytosis

A

Essential thrombocytosis

73
Q

Hypercellular marrow w/ cells of all lineages, especially large dysplastic clustered megakaryocytes. Later, marrow becomes more hypercellular and diffusely fibrotic w/ cloud-like nuclear-shaped megakaryocytes and hematopoietic elements in dilated sinusoids. Extensive splenomegaly w/ subcapsular infarcts. Blood shows early release of nucleated erythroid and granulocyte progenitors. Teardrop cells in blood.

A

Primary myelofibrosis

Heme/Lymph 2 (16 decks)

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