WBC Part 2 Flashcards
what is the most common cancer of children (accounting for 80% of childhood leukemias)
Acute Lymphoblastic Leukemia/Lymphoma (ALL)
ALL is a neoplastic population of what
immature lymphocytes aka lymphoblasts
incidence of Pre-B ALL is highest when
age of 4 (peak population of immature lymphoblasts in BM at this time)
incidence of Pre-T ALL is highest when
adolescence (when thymus reaches is maximal size)
ALL shows with what clinical features (in general)
abrupt “stormy” onset
Bone Pain
generalized adenopathy
hepatosplenomegaly
what flow cytometry results are expected in Pre-B ALL
CD10, CD19, CD79a
surface light chain negative
TdT
which ALL (T or B) is usually leukemic
B-ALL
which ALL (T or B) is usually lymphomic
T-ALL
CD10, CD19, CD79a
surface light chain negative
TdT
Pre-B ALL
what flow cytometry results are expected in Pre-T ALL
cCD3, CD4, CD8
CD1a, CD2, CD5, CD7
TdT
Pre-B ALL is due to what (both good and poor prognosis)
Good prognosis: hyperdiploidy, t(12;21)
Poor prognosis: t(9;22)
Pre-T ALL is due to what translation
TCR loci on chromosomes 7 and 14
what is the most common leukemia of adults in the western world
chronic lymphocytic leukemia (CLL)
CLL presents how
a leukemic process (leukocytosis) with absolute lymphocytosis, often times includes the marrow
smudge cells and lymphocyte that looks like a soccer ball (small mature lymphs with hyper clumped nuclear chromatin) are classically seen in what cancer?
chronic lymphocytic leukemia (CLL)/ small lymphocytic lymphoma (SLL)
what are the clinical feature of Chronic Lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)
over 50 years old
most patients are asymptomatic
immune disruption- autoimmune hemolytic anemia
cCD3, CD4, CD8
CD1a, CD2, CD5, CD7
TdT
Pre-T ALL
SLL and CLL are the same except
CLL has increased peripheral blood lymphocytosis or bone marrow involvement
All T-Cell ALL can present with what clinical findings
mediastinal mass (airway compression) testicular involvement
under what conditions would one see nucleated RBCs
marrow stress
extramedullary hematopoiesis
something is in the bone marrow taking up space kicking out immature cells
what spleen and liver changes are seen in SLL/CLL
white pulp expansion and portal tract expansion
what is Richter syndrome (aka Richter transformation)
transformation from CLL to diffuse large B cell lymphoma
what flow cytometry results would one expect from CLL/SLL
CD5, CD19, CD23
CD20 (dim)
surface light chain (dim)
bcl-2 translocation are often associated with what cancer(s)
follicular lymphoma: t(14;18)
synovial sarcoma: t(X;18)
CD5, CD19, CD23
CD20 (dim)
surface light chain (dim)
CLL/SLL
follicular lymphoma presents with what
painless “waxing and waning” lymphadenopathy
BM almost always involved and peripheral blood rarely involved
germinal center B cells that mimic the normal lymphoid follicles are seen in what
follicular lymphoma
in follicular lymphoma the number of centroblasts correlates with what
grade (the more centroblasts the higher the grade)
what is the morphology seen in follicular lymphoma
nodular, small cells
cleaved (folded) nucleus centrocytes
centroblasts (for grading)
what flow cytometry results would one expect in follicular lymphoma
CD10, CD19, CD20
surface light chain (bright)
bcl-2
bcl-6
in what two cancers would one see CD10 in flow cytometry and how can one tell the difference
Follicular Lymphoma
Pre-B ALL
(Pre-B ALL doesn’t have a surface light chain present since its an immature B cell, also bcl-2 is present in follicular lymphoma)
what does bcl-6+ mean
it indicates that the cells have passed through germinal center stage of mutation
mantle cell lymphoma (MCL) is associated with what translocation
t(11;14)- Cyclin D1
what cancer has tumor cells that closely resemble the normal mantle zone cells that surround the germinal centers of secondary follicles
mantle cell lymphoma (MCL)
lymphomatoid polyposis is what and is associated with what cancer
GI involvement- multifocal mucosal involvement of small and large bowel
associated with mantle cell lymphoma (MCL)
tumor cell that overly expresses cyclin D1 and is CD5+ is most likely what
mantle cell lymphoma (MCL)
how is increased cyclin D1 detected
FISH, PCR, immunohistochemistry
what flow cytometry results would one see in mantle cell lymphoma (MCL)
CD5, CD19
CD20 (bright)
surface light chain (bright)
CD5+ and bright CD20 and surface light chain is most likely what cancer
mantle cell lymphoma (MCL)
CD5+ and dim CD20 and surface light chain is most likely what cancer
CLL/SLL
CD10+ and surface light chain negative is most likely what cancer
Pre-B ALL
CD10+ and surface light chain positive is most likely what cancer
Follicular Lymphoma (also should see bcl-2)
name one drug (monoclonal antibody we have learned) that can be used to treat mantle cell lymphoma
rituximab (anti-CD20)