Neoplastic disorders part 1 Flashcards
Overproduction of various types of immature or mature leukocytes in the bone marrow and/or peripheral blood, in most types of leukemias
Leukemias
Solid malignant tumors of the lymph nodes
Lymphomas
Overproduction of plasma cells in the bones marrow with concurrent production of abnormal proteins
Myelomas
Cells involves in Leukemias:
- myelogenous or lymphocytic cell types
Cells involves in Lymphomas:
- Lymphocyte (Reed-Sternberg cells) which are diagnostic of Hodgkin-type lymphoma
Cells involves in Myeloma:
Plasma cells
Site of malignant cells for Leukemia:
Malignant cells freely pass the blood-brain barrier (BBB)
Site of malignant cells for Lymphomas:
- Reticuloendothelial organs that houses mononuclear phagocytes (lymph nodes, spleen, liver and bone marrow)
- may spill over into the circulating blood and present a leukemic appearing picture on peripheral blood smear
Site of malignant cells for Myelomas:
Bone marrow (plasma cells form mass or tumors)
*Umbrella term which refers to neoplastic disorders involving your WBC; in the blood and bone marrow
Leukemia
two (2) natures of leukemia
either myelogenous or lymphocytic in nature
M:E Ratio for leukemia
M:E ratio is 10:1
general term for malignancy that starts in the lymph system, mainly the lymph nodes
Lymphomas
Two types of lymphomas
Hodgkin and Non-Hodgkin
form of cancer of the plasma cells
Myelomas
Differences between Acute and Chronic Leukemia
Age:
Onset:
Median survival time, untreated:
WBC
Acute Leukemia:
- All ages, with peaks in 1st decade & after 50 yr
- Sudden
- Weeks to months
- ↑, N, or ↓
Chronic Leukemia:
- Adults
- Insidious
- Months to year
- ↑ (may be > 50,000
Differences between Acute and Chronic Leukemia
Differential:
Anemia :
Platelets :
Others aged lymphoid:
Methods used to diagnose:
Acute Leukemia:
- Blasts usually present
- Mild to severe
- Mild to severe ↓
- Usually lymphoid in children, myeloid in adults
- Peripheral blood smear, bone marrow Same but less use of cytochemical stains examination, cytochemical stains, immunophenotyping, cytogenetics, molecular genetics
Chronic Leukemia:
- More mature cells
- Mild
- Usually N
- Myeloid mostly in young to middle-in older adults. Most go into blast crisis
- Same but less use of cytochemical stains
Classify leukemias (acute):
Acute Myeloproliferative Leukemia (AML)
- M0
- M1
- M2
- M3, M3m
- M4
- M5, M5a
- M6
- M7
Classify leukemias (acute):
Acute Lymphoproliferative Leukemia (ALL)
- L1
- L2
- L3 (Burkitt type)
Classify leukemias (Chronic)
Chronic Myeloproliferative leukemia (CML)
- CML
_ PV - ET
- Chronic neutrophilic leukemia
- Myeloid Metaplasia
Classify leukemias (Chronic)
Chronic Lymphoproliferative leukemia (CLL)
- CLL
- Prolymphocyte leukemia
- Hairy cell leukemia
Classifications of refractory anemia under Dysmyelopoietic or Myelodysplastic disorders:
- Refractory anemia / refractory cytopenia
- Refractory anemia w/ ringed sideroblasts
- Refractory anemia with excess blasts
- Refractory anemia with excess blasts in transformatino
- Chronic Myelomonocytic leukemia
Classifications of Lymphomas:
- Hodgkin’s lymphoma
- Non-Hodgkin’s lymphoma
- Mycosis fungoides
- Sezary syndrome
Classifications of Plasma cell dyscrasia:
- Multiple myeloma
- Waldenstrom’s macroglubinemia
- Plasma cell leukemia
- Heavy chain diseases
- Amyloidosis
What is the criteria of FAB diagnosing AML?
> 30% blasts
What is the criteria of WHO diagnosing AML?
> 20% blast
FAB (1976) classifications
M0
M1
M2
M3, M3m
M4
- undifferentiated AML
- AML without maturation
- AML with maturation (AMLS with t(8;21)
- Acute Promyelocytic leukemia
-Microgranular, promyelocytic leukemia - Acute Myelomonocytic leukemia
FAB (1976) classifications
M4Eo
M5, M5a, M5b,
M6
M7
- Acute Myelomonocytic leukemia with eosinophilia
- Acute Monocytic leukemia
- Acute monocytic leukemia with poor differentiation
- Acute Monocytic leukemia with differentiation
- Acute Erythroleukemia (DI Gulielmo’s)
- Megakaryoblastic leukemia
*most common type of leukemia in children younger than 18 months of age
*typically occurs in middle-aged adults with a median age of 46 years.
Acute Myelogenous Leukemia
*Localized tumor masses consisting of myeloblasts
*May arise in bone or soft tissues
*Presence of large quantities of the enzyme MPO
*Produces a green appearance if the tissue is cut
Chloroma
*Eosinophilic rod–like cytoplasmic inclusions derived from myeloperoxidase-positive primary granules
Auer rods
This means “bunch of sticks”
Faggot cells (Auer rods)
Auer rods can be found in what FAB classifications?
- M2
- M3
- M4
*most aggressive of acute leukemia
*severe bleeding tendency and a fatal course, if untreated, of only weeks
*Disseminated intravascular coagulation (DIC) is most often associated
Acute Promyelocytic Leukemia (FAB M3)
what is the equivalent classification of FAB M3 in WHO classification?
- AML with t(15;17)
Acute Myelomonocytic Leukemia (FAB M4) is referred to as?
Naeglitype monocyticle leukemia
what is the equivalent classification of FAB M4 in WHO classification?
AML with inv(16)
*pathological finding of slightly dilated, thin- walled vessels filled with leukemic cells.
*plug of leukocytes within the microvasculature
Leukostasis
Common organs involved in leukostasis?
Brain and lungs
what is the equivalent classification of FAB M6 in WHO classification?
Acute erythroid leukemia
other term for Erythemicmyelosis?
Di Gulielmo’s syndrome
*proliferation of both immature granulocytic and erythrocytic cell types
Erythroleukemia (FAB M6)
most common cancer in children (L1)
Acute Lymphoblastic leukemia
Enzyme associated with ALL?
Terminal deoxynucleotidyl transferase (Tdt)
FAB classifications of ALL
L1:
L2:
L3:
- Small homogeneous blasts; mostly in children
- Large heterogeneous blasts; mostly in adults
- : “Burkitt type ” large basophilic B-cell blasts with vacuoles, t(8;14) alteration is common.
Frequently a “starry-sky” pattern of admixed histiocytes
Mature B-Cell Neoplasm Classification
- CLL/SLL
- B-cell prolymphocytic leukemia
- Hairy cell leukemia (HCL)
- Plasma cell neoplasm
*most common form of leukemia in adults
*usually a B-cell disorder
*Commonly exhibit up to 80% or 90% small lymphocytes
CLL
*mature B-cell malignancy
*Pancytopenia
*strong acid phosphatase reaction that is not inhibited by tartaric acid or tartrate-resistant acid phosphatase (TRAP) stain
Hairy Cell leukemia
*occurring primarily in the BM
*Produce multiple tumors, which appear on a radiograph as multiple punched-out osteoporotic lesions
*marked degree of rouleaux formation
Multiple Myeloma
Associated conditions of Multiple Myeloma
- Monoclonal gammopathy,
- Hyper viscosity of the blood,
- Bence–Jones protein in the urine
B-cell neoplasm characterized by lymphoplasmo proliferative disorder with infiltration of the bone marrow and a monoclonal immunoglobulin M (IgM) protein.
Waldenstrom Macroglobulinemia
Which malignancy of WM is associated with which manufactures IgM
lymphoplasmacytoid cells
Hodgkin type lymphoma is differentiated by presence of what cell?
Reed-Sternberg cells
mononuclear (Hodgkin) cell with each nucleus bearing a very large inclusion-like nucleolus
Reed-Sternberg cells
Reed-Sternberg cells are large multinucleated cell resembling which characteristic?
Owl’s eye
leukemic phase of cutaneous T-cell lymphoma, mycosis fungoides
Sezary syndrome
Rare atypical mononuclear cells with cerebriform nuclei
Sezary cells
