MTAP W3 (Hematology W15: Chronic Leukemia)

Question 1

LYMPHOPROLIFERATIVE DISORDERS

When neoplastic cells involve mainly the bone marrow and blood, the disorder is known as a -

Answer 1

leukemia

Question 2

LYMPHOPROLIFERATIVE DISORDERS

When the disease is limited mainly to lymph nodes or organs, the disease is known as a -

Answer 2

lymphoma

Question 3

Occasionally, a lymphoma develops into -

Answer 3

leukemia

Question 4

LYMPHOPROLIFERATIVE DISORDERS

most common chronic leukemia in adult

Answer 4

CHRONIC LYMPHOCYTIC LEUKEMIA

Question 5

LYMPHOPROLIFERATIVE DISORDERS

is a slowly progressing clonal malignancy of
lymphocytes in an arrested stage of maturation.

Answer 5

CHRONIC LYMPHOCYTIC LEUKEMIA

Question 6

LYMPHOPROLIFERATIVE DISORDERS

commonly seen in adults with a mean age of occurrence at 55 years

Twice as common to men compared to women

enlarged lymph nodes, and abdominal discomfort caused by liver and spleen enlargement

Answer 6

CHRONIC LYMPHOCYTIC LEUKEMIA

Question 7

LYMPHOPROLIFERATIVE DISORDERS

Patients have a leukocytosis ranging from 10,000 to 150,000/mm3 with 80% to 90% lymphocytes persistent over a period of weeks to
months.

Answer 7

CHRONIC LYMPHOCYTIC LEUKEMIA

Question 8

LYMPHOPROLIFERATIVE DISORDERS

CLL
- are commonly found on blood smears.

Answer 8

smudge cells

Question 9

remnants of cells that lacks any
dentcytoplasmicmembrane membrane or nuclear
structures

Answer 9

smudge cells

Question 9

May pathologic in case of CLL, or can be an artifact

Answer 9

smudge cells

Question 10

clover leaf or flower appearance: pathogenic in CLL

Answer 10

rieder cell

Question 11

cytogenetic abnormalies can be detected by WHO, involves 12,14

Answer 11

CHRONIC LYMPHOCYTIC LEUKEMIA

Question 12

develops in 10% of patients who have CLL. The patient’s blood smear
demonstrates spherocytes and reticulocytosis.

Answer 12

AIHA

Question 13

CHRONIC LYMPHOCYTIC LEUKEMIA

95% of CLL have - cell leukemia

Answer 13

B cell

Question 14

CHRONIC LYMPHOCYTIC LEUKEMIA

Cluster designation markers for B lymphocytes

• positive in B-lymphocyte CLLs and some lymphomas

Answer 14

CD5

Question 15

CHRONIC LYMPHOCYTIC LEUKEMIA

Cluster designation markers for B lymphocytes

positive for late B cells and hairy-cell leukemia

Answer 15

CD22

Question 16

CHRONIC LYMPHOCYTIC LEUKEMIA

Cluster designation markers for B lymphocytes

positive in all stages of B-lymphocyte development (i.e., Pan-B)

Answer 16

CD24

Question 17

CHRONIC LYMPHOCYTIC LEUKEMIA

Immunologic markers for T-cell leukemia include

E-rosette marker (i.e., sheep RBCs)

Answer 17

CD2

Question 18

CHRONIC LYMPHOCYTIC LEUKEMIA

Immunologic markers for T-cell leukemia include

positive for T-lymphocyte CLL, T-cell prolymphocytic leukemia, and infectious mononucleosis

Answer 18

CD3

Question 19

CHRONIC LYMPHOCYTIC LEUKEMIA

Immunologic markers for T-cell leukemia include

positive for T-lymphocyte CLL

Answer 19

CD8

Question 20

CHRONIC LYMPHOCYTIC LEUKEMIA
Treatment of CLL includes one or a combination of the following agents: (3)

Answer 20

1. chemotherapy with alkylating drugs
2. glucocorticoid
3. radiotherapy

Question 21

Clinical staging systems (-) for assessing prognosis in CLL were developed in the early
1980s, based on easily obtainable biological and clinical parameters.

Answer 21

Rai and Binet

Question 22

Rai and Binet

Stage -: Bone marrow and blood lymphocytosis

Answer 22

0

Question 23

Rai and Binet

Stage -: Lymphocytosis with enlarged nodes/ Lymphadenopathy

Answer 23

1

Question 24

Rai and Binet Stage -: Lymphocytosis with enlarged spleen or liver or both

Answer 24

2

Question 25

Rai and Binet Stage -: Lymphocytosis with anemia

Answer 25

3

Question 26

Rai and Binet Stage -: Lymphocytosis with thrombocytopenia

Answer 26

4

Question 27

LYMPHOPROLIFERATIVE DISORDERS is a variation of CLL in which there is a high number of morphologically immature larger lymphocytes, which appear as prolymphocytes.

Answer 27

Prolymphocytic leukemia (PLL)

Question 28

LYMPHOPROLIFERATIVE DISORDERS The prognosis is usually subacute and more resistant to treatment than is common CLL. Patients have a mean survival of 1 year.

Answer 28

B-CELL PROLYMPHOCYTIC LEUKEMIA

Question 29

LYMPHOPROLIFERATIVE DISORDERS PLL prolymphocytes commonly type positive with the membrane markers -

Answer 29

CD 19, CD 20, CD 22, CD 24

Question 30

LYMPHOPROLIFERATIVE DISORDERS PLL prolymphocytes commonly type positive with the membrane markers and strong expression of -

Answer 30

sIg/ surface immunoglobulin

Question 31

LYMPHOPROLIFERATIVE DISORDERS small B lymphocytes with abundant cytoplasm and fine (“hairy”) cytoplasmic projections.

Answer 31

HAIRY CELL LEUKEMIA

Question 32

LYMPHOPROLIFERATIVE DISORDERS TRAP + The cytochemical features of HCL include a strong acid phosphatase reaction that is not inhibited by tartaric acid or tartrate-resistant acid phosphatase (TRAP) stain.

Answer 32

HAIRY CELL LEUKEMIA

Question 33

(leukemic reticuloendotheliosis)

Answer 33

HAIRY CELL LEUKEMIA

Question 34

LYMPHOPROLIFERATIVE DISORDERS Splenomegaly is a common physical finding B cell malignancy (CD19, CD20 positive) CD25! IL2 receptor unique to px with -

Answer 34

HAIRY CELL LEUKEMIA

Question 35

LYMPHOPROLIFERATIVE DISORDERS Monoclonal gammopathy causes B cell production of excessive -

Answer 35

IgG, IgA

Question 36

LYMPHOPROLIFERATIVE DISORDERS Multiple skeletal system tumors of plasma cells (myeloma cells) cause - and -

Answer 36

1. lytic bone lesions 2. hypercalcemia

Question 37

LYMPHOPROLIFERATIVE DISORDERS Identified on serum protein electrophoresis by an "M"-spike in the gamma-globulin region;

Answer 37

multiple myeloma

Question 38

LYMPHOPROLIFERATIVE DISORDERS Laboratory Findings: Marked rouleaux Bence jones proteins

Answer 38

multiple myeloma

Question 39

- (free light chains—kappa or lambda) found in the urine; toxic to tubular epithelial cells; cause kidney damage

Answer 39

bence jones proteins

Question 40

LYMPHOPROLIFERATIVE DISORDERS a hypergammaglobulinemia variant of chronic lymphocytic leukemia, increase of monoclonal IgM in the serum

Answer 40

WALDENSTROM’S MACROGLOBULINEMIA

Question 41

LYMPHOPROLIFERATIVE DISORDERS Marked roleaux formation and increased ESR BENCE jones proteins + coombs test

Answer 41

WALDENSTROM’S MACROGLOBULINEMIA

Question 42

LYMPHOPROLIFERATIVE DISORDERS Lab dx: lymphophilia and monocytosis

Answer 42

lymphoma

Question 43

are the hallmark of Hodgkin’s lymphoma, may be found in the lymph nodes and marrow of a patient who has this disease.

Answer 43

Reed-Sternberg cells

Question 44

owls eyes appearance, giant binucleated or multi-nucleated cells with acidophilic nuclei.

Answer 44

Reed-Sternberg cells

Question 45

Hodgkin lymphoma (classical) -of lymphomas; seen in patients between 15 and 35 years of age and over 55 years of age

Answer 45

40%

Question 46

Hodgkin lymphoma (classical) seen more frequently in males; certain subtypes have an - association

Answer 46

EBV

Question 47

Hodgkin lymphoma (classical) —70% are this subtype; lowest EBV association

Answer 47

nodular sclerosis

Question 48

Hodgkin lymphoma (classical) —20% are this subtype; highest EBV association MALIGNANT LEUKOCYTE DISORDERS

Answer 48

mixed cellularity

Question 49

Non-Hodgkin lymphoma associated with EBV, has a strong affinity for B cells; this affinity causes B-cell proliferation. When the cytolytic killer T lymphocytes’ response is deficient, an unchecked B-cell proliferation can result in lymphoma.

Answer 49

Burkitt's

Question 50

Non-Hodgkin lymphoma (i.e., Mycosis Fungoides) is an HTLV1-promoted helper-inducer T- cell malignancy. This lymphoma is associated with a lymphocytosis of Sezary cells.

Answer 50

Cutaneous T-cell lymphoma

Question 51

smudgey poorly defined patches and plaques

Answer 51

cutaneous T-cell lymphoma M. fungoides

Question 52

is the most common cutaneous lymphoma.

Answer 52

M. fungoides

Question 53

characteristic cerebriform nuclei

Answer 53

Sezary cells