WBC, LN, Spleen, Thymus Flashcards
Most common cause of agranulocytosis
Drug toxicity
Clinically significant neutropenia <500/mm3
Agranulocytosis
What type of infections is the patient highly susceptible to when he has agranulocytosis?
Candida and Aspergillus
Most common cancer of children
ALL
Most common leukemia of adults in Western world
CLL/ SLL
Most common indolent lymphoma of adults
Follicular lymphoma
Most common lymphoma of adults
Most common form of Non Hodgkins lymphoma
Diffuse large B cell lymphoma
Fastest growing human tumor
Burkitt lymphoma
Early childhood
Bone marrow failure
T 12:22, t 9:22 mutation
Large hypercellular marrow with lymphoblasts
B-cell Acute Lymphoblastic leukemia
Adolescent males
Thymic masses
NOTCH-1 mutation
Hypercellular marrow with lymphoblasts
T cell ALL
Favorable prognostic factors for ALL
Age 2-10 Low WBC count Hyperdiploidy Trisomy 4,7,10 T 12;21
Age ~60 years Hypogammaglobulinemia Constitutional symptoms Hepatosplenomegaly Lymphadenopathy Small lymphocytes with SMUDGE CELLS
Chronic lymphocytic leukemia
Prognostic factor in CLL that may lead into progression to DLBCL
Richter syndrome
Middle age Painless generalized lymphadenopathy BCL 2, t 14;18 Lymphocytosis Paratrabecular lymphoid aggregates Indolent course No cure
Follicular lymphoma
60 years old male> female
Rapidly enlarging mass at nodal or extranodal site
BCL6, BCL2, myc
Diffuse pattern of growth, large cells pale to basophilic cytoplasm
Aggressive
Diffuse large B cell lymphoma
Mandibular mass, kidneys, ovaries, adrenals Latent infection with EBV MYC gene (t8;14) Starry sky pattern Aggressive but responsive to chemo
Burkitt Lymphoma
Most important plasma cell neoplasm
Multiple myeloma
65-70 years old
Multiple lytic punched out bone lesions, hypercalcemia, renal failure, dec humoral immunity
PAS positive nuclear (Russell bodies) or cytoplasmic (Ductcher bodies) inclusions
Multiple myeloma
Most common laboratory findings in Multiple Myeloma
M protein
IgG
Hypercalcemia
Bence Jones proteinuria
Key cytokine to proliferation and survival in Multiple Myeloma
High levels mean poor prognosis
IL-6
Naive B cell origin
Small lymphocytes with irregular to occasionally deeply clefted nuclear contours
Painless lymphadenopathy
Poor prognosis
Mantle cell lymphoma
Memory B cell origin
Arises in tissues on chronic inflammation
Regress when inciting agent removed
Marginal zone lymphoma
B cell origin
Leukemic cells with fine hairy projections
Splenomegaly, cytopenias
Excellent prognosis
Hairy cell leukemia
T cell origin
ALK (Ch2) rearrangements
Large anaplastic cells with abundant cytoplasm and horseshoe shaped nucleus
CD 30+ like hodgkin’s
Anaplastic large cell lymphoma
Cd4 origin
HTLV 1
Cloverleaf cells
Poor prognosis
Adult T cell lymphoma
Generalized exfoliative erythroderma + leukemia of T cells with cerebriform nuclei
Sezary syndrome
Mycosis fungoides
Diagnostic of Hodgkin lymphoma
Large, multiple nuclei or single with multiple lobes; each with nucleolus about a size of small lymphocyte
Popcorn cells
Owl eye nuclei
Reed- Sternberg cell
CD15 CD30 positive
More common ni males except Nodular sclerosis
Adults
Hodgkin lymphoma
Most common type of Hodgkin lymphoma
Nodular sclerosis
T(15;17) FAB M3 Best prognosis Adults Large myeloblasts with abundant cytoplasm (+) Auer rods Rare CNS spread
AML
Cells with numerous Auer rods in Acute promyelocytic leukemia
Faggot cell
Adults
BCR ABL t(9;22) Philadelphia chromosome
Hypercellular marrow with abundant green blue wrinkled cytoplasm
Treatment: tyrosine kinase inhibitors
CML
Proliferativr disorder of dendritic cells
HLA - DR, S-100, CD1a positive
Birbeck granules
Langerhans cell histiocytosis
