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HEMATOLOGY HEMATOPOIESIS > Neoplastic disorders part 2 > Flashcards

Neoplastic disorders part 2 Flashcards

1
Q

What conditions are included in Myeloproliferative Neoplasms?

A
  • Chronic myelogenous Leukemia
  • Polycythemia Vera
  • Primary myelofibrosis
  • Essential Thrombocytosis/Thrombocythemia
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2
Q

*an MPN that originates in an abnormal pluripotent bone marrow stem cell
*and is consistently associated with the BCR-ABL 1 fusion gene located in the Philadelphia chromosome

A

Chronic Myelogenous Leukemia (CML)

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3
Q

reciprocal translocation of DNA between chromosomes 9 and 22 (t9q:22q)

A

Philadelphia chromosome

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4
Q

*an absolute increase in red cell mass, leukocytosis, and thrombocytosis. *Panhyperplasia of the bone marrow
*Pancytosis in peripheral blood

A

Polycythemia vera

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5
Q

Polycythemia vera is characterized by what mutation?

A

JAK2 V617F

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6
Q

both are increased in PV

A

Serum and urine Erythropoietin

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7
Q

systemic bone marrow fibrosis and extramedullary hematopoiesis

A

Primary fibrosis

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8
Q

caused by infiltrative disorders, including malignancies and infections, or exposure to chemical toxins or

A

Secondary myelofibrosis

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9
Q

__________ - replaced by abnormal cells
__________ - fibrotic tissue

A
  • myelopthisic
  • myelofibrosis
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10
Q

a clonal myeloproliferative disorder primarily affecting the megakaryocytic lineage with the principal manifestation of sustained thrombocytosis

A

Essential thrombocythemia

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11
Q

the ‘millionaires’

A

Essential thrombocythemia

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12
Q

*disorders in which apoptosis predominates, hematopoiesis is ineffective, and cytopenias occur
*chronic myelomonocyticleukemia (CMML),
*atypical chronic myeloid leukemia (aCML),

A

Myelodysplastic syndromes

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13
Q

Dysgranulopoiesis

A
  • Pseudo Pelger Huet
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14
Q

Dysmegakaryocytopoiesis

A

giant hypogranular platelets

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15
Q

cytochemicals in order to identify a particular or differentiate leukemias

A

cytochemistry

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16
Q

To differentiate a myelogenous or monocytic leukemia from acute lymphocytic leukemia

A

Myeloperoxidase Reaction

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17
Q

___________ is present in the primary azurophilic granules of neutrophil, eosinophil and monocyte

A

Peroxidase

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18
Q

interpretations for myeloperoxidase reaction
Red brown peroxidase:
Auer rods:
Monocytes:
Lymphoblast and lymphoid cells:

A

– present in neutrophil and eosinophil
- strongly positive
- negative to diffusely +
- negative

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19
Q

interpretations for myeloperoxidase reaction
Acute leukemia infection & myelodysplasia:
Basophils:
Peroxidase:

A
  • show negative stain
  • increase in CML
  • may stain positive in granulocytic leukemia
  • may show results similar to those of sudan black B
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20
Q

if Myeloperoxidase (MPO) or Sudan Black B (SBB) stain is used, which type of leukemia would show positive ad negative stain?

A

Positive:
AML

Negative:
M6, Mixed

21
Q

Show positive stain if Chloroacetate Esterase (CAE) is used

A

Myelocytic:
M1, M2, M3, M4

22
Q

Show positive stain if Non-specific Esterase is used (NSE)

A

Monocytic:
M4, M5

23
Q

Show positive stain in Periodic Acid Schiff is used (PAS)

A

ALL, M6, M7

24
Q

To distinguish acute myelogenous and monocytic leukemia from lymphocytic leukemia.

A

Sudan Black B (SBB)

25
Q

Principle of Sudan Black B (SBB)

A
  • Sudan black B dye is fat soluble,then it stains fat particles which present in the primary and secondary granules of myelocytic and monocytic cells.
26
Q

interpretations for SBB

A
  • Positive stain in patients with AML
  • not black staining cytoplasmic granules in myeloblasts
  • Myelogenous cells show coarse staining (faint staining pattern for myeloblast and increases staining with maturation)
  • Auer rods = positively stained
  • Monocytic cells show finely scattered granules
  • negative lymphocytic stain
  • L3 Burkitt type shows positive staining vacuoles
27
Q

Differentiate myelocytic and monocytic leukemia

A

Non-specific Esterases (w/ fluoride inhibition)

28
Q

principle of this test is WBCS contain esterases, a group of lysosomal enzymes
*show positive black red stain in megakaryocytes, platelets, histiosyte macrophage monocyte & lymphoblast of ALL
*negative for granulocytes

A

Non-specific Exterase

29
Q

with the addition of this reagent to incubation solution, it inhibits the staining reaction in monocytes but not in granulocytes

A

Sodium fluoride

30
Q

principle of this test is when naphthol AS-D chloroacetate is used as a substrate, the reaction is positive in the granulocytic cells and negative to weak in the monocytic cells

A

Specific Esterase or Chloroacetate

31
Q

interpretations for Specific esterase Choloroacetate

Myeloid cells:
Monocyte and Basophils:
Other cells (lymph-plasma-megakaryocyte-nrbc):
Auer rods:

A
  • positive
  • negative to weakly positive
  • negative
  • positive
32
Q

Cytochemical stains for differentiation of Acute leukemia for AML and ALL

Myeloperoxidase:
Sudan Black:
Napthol-AS-D Chloroactetate esterase (specific esterase):
Periodic Acid Schiff (PAS):

A

AML
- Pos
- Pos
- Pos
- Neg or diffusely pos

ALL
- Neg
- Neg
- Neg
- Pos (coarsely granular or block like)

33
Q

*Diagnosis of some acute lymphocytic leukemia
*subtypes of AML

A

Periodic Acid Schiff (PAS) Reaction

34
Q

principle for Periodic Acid Schiff

A

the stain indicates the presence of mucoproteins, glycoproteins and high molecular weight carbohydrates in blood cells.

35
Q

Interpretations for PAS
Neutrophils:
Myeloblasts:
Eosinophils:
Monocytes:
Lymphocytes:
NRBC:
Megakaryocytes:

A
  • positive at most stages of development (strongly in mature stage)
  • weakly positive or negative
  • positive in stages of development
  • weakly positive (fine granules)
  • may contain few positive granules
  • negative (positive in abnormal erythroid precursors of erythroleukemia
  • positive
36
Q

which malignant cell has presence of increased number of PAS-positive granules in a focal or block-like positivity?

A

malignant lymphocytes in lymphoblastic leukemia

37
Q

Distinguishing the cells of leukemoid reactions with increase activity from these of (CML)with decreased activity.

A

Leukocyte Alkaline phosphatase (LAP)

38
Q

principle for Leukocyte Alkaline Phophatase

A

Alkaline phosphatase -
Activity is present in varying degrees in the neutrophil and band form of the granulocytes/sometimes in B lymphocytes

39
Q

how to perform LAP score?

A

Count 100 neutrophils and score them (0/+4), then multiply the score by the number of cells with that score , then calculate the final score by adding the total scores.

40
Q

Normal range for LAP score

A

30-185

41
Q

LAP score grading
No stain:
Faint and diffuse staining:
Pale with a moderate amount of blue staining:
Strong blue precipitated stain:
deep blue or brilliant staining with no visible cytoplasm:

A
  • 0
  • +1
  • +2
  • +3
  • +4
42
Q

LAP is elevated in

A
  • Leukemoid reaction
  • Pregnancy (3rd trimester)
  • Polycythemia vera
  • Aplastic anemia
  • Mutilple myeloma
  • Obstructive jaundice
  • Hodgkins’ disease
43
Q

LAP decreased in

A
  • CML
  • Paroxysmal Nocturnal Hemoglobinuria
  • Sickle Cell anemia
  • Hypophosphatasia
  • Sideroblastic anemia
  • Myelodysplastic anemia
44
Q

CML has a LAP score of?

A

<10

45
Q

Will not affect LAP result:

A

1.Untreated hemolytic anemia.
2.Lymphosarcoma.
3.Viral hepatitis.
4.Secondary polycythemia.

46
Q

Siderotic granules are found in the cytoplasm of developing cells in [BM] in the form of Ferric[Fe+3]

A

Prussian Blue Reaction

47
Q

Siderotic granules are found in?

A

NRBCs and some Reticulocytes

48
Q

___________ hydrolyzes the substrate napthol AS-BI phosphoric acid. When hydrolyzed,
*this substrate couples with a dye such as fast garnet GBC and produces red precipitate at the site of enzyme activity

A

Acid Phosphatase

HEMATOLOGY HEMATOPOIESIS (7 decks)

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