Showinsky Intro

Question 1

List the 3 main manners in which hematologic malignancies manifest.

Answer 1

Leukemia, lymphoma, extramedullary myeloid tumor/granulocytic sarcoma

Question 2

In what ways do hematologic malignancies overlap?

Answer 2

A hematologic malignancy may have characteristics of other malignancies, but the diagnosis is based on which is most prevalent.

Question 3

How is the severity of a lymphoma classified?

Answer 3

By grade, high or low

Question 4

How is the severity of a leukemia classified?

Answer 4

By acute or chronic onset

Question 5

What is the presentation of high grade lymphoma.

Answer 5

Usually rapid onset, often seen with a high WBC and marrow takeover

Question 6

What is the presentation of low grade lymphoma.

Answer 6

Often presents with enlarged lymph nodes and mildly elevated WBC count

Question 7

What is the presentation of acute leukemia.

Answer 7

Rapidly progressing often with failed production of normal marrow. Will see low production of other blood cells. Most prevalent cells are often blasts

Question 8

T or F: The prognosis of acute leukemia is often favorable even without therapy.

Answer 8

False. Poor prognosis without therapy.

Question 9

What is the presentation of chronic leukemia.

Answer 9

Both CML and CLL have a slow onset with no symptoms at time of diagnosis, increased WBC count due to accumulation of normal mature blood cells

Question 10

Why do lymphomas contain balanced translocations involving immunoglobulin and T cell receptor genes?

Answer 10

B and T cells undergo genetic recombination during development that may predispose them to translocations.

Question 11

What is meant by a balanced translocation?

Answer 11

No genetic material is added or lost in translocation.

Question 12

What is the importance of a translocation in a hematologic malignancy?

Answer 12

This can be a diagnostic of the particular type of cancer.

Question 13

List 3 viruses known to have oncogenic roles in some cases of lymphoma.

Answer 13

EBV, HTLV-1 (human T cell leukemia virus), Kaposi sarcoma/human herpes virus 8

Question 14

What type of cancers do EBV predispose a person towards?

Answer 14

Hodgkin, some cases of Burkitt, B-cell NHLs

Question 15

What type of cancers do HTLV-1 predispose a person towards?

Answer 15

Adult T cell leukemia/lymphoma

Question 16

What type of cancers do Kaposi/Human herpes virus 8 predispose a person towards?

Answer 16

Primary effusion lymphoma

Question 17

What is the incidence of leukemias and lymphomas in adults?

Answer 17

Leukemia - 6th most common; NHL - 7th most common; Myeloma - 15th most common

Question 18

What is the incidence of leukemias and lymphomas in children?

Answer 18

Leukemia - 1st most common; Brain/CNS cancer - 2nd most common; Lymphoma - 3rd most common

Question 19

What are the 5 classification categories for hematologic malignancies?

Answer 19

1.) Cell morphology 2.) Histologic growth pattern 3.) Cytogenetic findings 4.) Relative amounts of malignant cells 5.) Phenotype of malignant cells

Question 20

What are the basic functional categories of hematologic malignancies (7 of them)

Answer 20

1.) Acute leukemias 2.) Myelodysplastic syndrome 3.) Myeloproliferative neoplasms 4.) Hodgkin lymphoma 5.) Non-Hodgkin lymphoma 6.) Plasma Cell Neoplasms 7.) Other?

Question 21

What are the expected findings for an acute leukemia?

Answer 21

Block in maturation that results in accumulation of immature cells in the bone marrow.

Question 22

What are the expected findings for myelodysplastic syndrome?

Answer 22

Bone marrow is taken over by a neoplastic clone that is incapable of making normal cells of one or more myeloid lineage

Question 23

What are the expected findings for an myeloproliferative syndrome

Answer 23

Bone marrow is taken over by neoplastic cell that make too many of one or more myeloid lineages

Question 24

What are the expected findings for classic Hodgkin lymphoma?

Answer 24

A very unique B cell lymphoma

Question 25

What are the expected findings for an non-Hodgkin lymphoma?

Answer 25

All of the different mature lymphocyte malignancies that are not Hodgkin lymphoma

Question 26

What are the expected findings for an plasma cell neoplasma?

Answer 26

includes MGUS, plasmacytoma, and multiple myeloma

Question 27

What other hematologic cells can get cancer (other than T, B, or myeloid cells)?

Answer 27

Histiocytes, dendritic cells and others, but these are very rare

Question 28

What are the predisposing factors for hematologic malignancies?

Answer 28

1.) Primary or acquired immunodeficiency 2.) DNA damage due to chemicals or radiation or benzene 3.) Inherited condition of hematologic instability

Question 29

T or F: There is such thing as a benign hematologic malignancy.

Answer 29

FALSE