Pan-CP 2

Question 1

Adult T-cell leukemia/lymphoma (ATLL)

• characteristic cell?
• casuative agent?
• geographic distribution?
• disease caused by the same agent?

Answer 1

• flower cell
• HTLV-1, a retrovirus endemic to southern Japan, Brazil, South Africa, and the Caribbean. Spread thru sex, breastfeeding, blood
• 1:40 people infection w/ HTLV will develop ATLL
• tropical spastic paraparesis – characterized by myelopathy/neuropathy, which progresses to lead to irreversible neurologic impairments

Question 2

Burkitt:

• characteristic translocation (hint: multiple partners)

Answer 2

c-Myc (8) translocates to:

• IgH (14)
• Ig-lambda light chain (2)
• Ig-kappa light chain (22)

Question 3

What blood components do the following stains stain?

1. Chloroacetate esterase
2. Napthyl esterase (non-specific esterase)
3. Myeloperoxidase
4. Sudan Black
5. Period acid-Schiff (PAS): ALL vs. AML

Answer 3

1. granulocytes
2. monocytes >>>> other lineages
3. immature and mature neutrophils; mature monocytes
4. myeloblasts/myelocytes; lipid vacuoles in Burkitt lymphoma
5. ALL: rosary beads; AML: diffuse granular hue

Question 4

Dohle bodies

• found in?
• composed of?

Answer 4

infective and inflammatory states (especially burns)

normal pregnancy

congenital anomolies like May-Hegglin (MYH9)

composed of piled up RER – high RNA content. Can be destroyed w/ ribonuclease rx.

Question 5

Follicular lymphoma

• translocation?
• characteristic stain? is it always +?
• grading?
• bone marrow involvement?

Answer 5

• t(14;18) IgH:bcl-2
• bcl-2 – however can be bcl-2 (especially in peds cases)
• grade 1: 0-5 centroblasts/hpf
• grade 2: 6-15 centroblasts/hpf
• grade 3a: >15 centroblasts/hpf
• grade 3b: all centroblasts
• BM invovlement in 40-70%, usually paratrabecular