Wednesday Groupings/Definitions/Presentations Flashcards by Karina Katchko

Lymphocytosis count

> 4000

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Lymphocytoses causes

infectious-EBV, CMV, hepatitis, etc

transient stress-trauma, MI, seizures

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List the 5 neoplastic proliferations of mature lymphocytes

CLL
Hairy Cell Leukemia
Splenic marginal zone lymphoma
ATLL
Sezary syndrome

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List the 7 lymphoid neoplasms we need to know

B-ALL
T-ALL
CLL/SLL
Hairy Cell
Large Granular lymphocytic leukemia
Mycosis fungoides/Sezary syndrome
ATLL

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Name the precursor B-cell neoplasm

B-ALL

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Name the 2 peripheral B-cell neoplasms

CLL/SLL

Hairy Cell

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Name the precursor T-cell neoplasm

T-ALL

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Name the peripheral T-cell and NK-cell neoplasms

large granular lymphocytic leukemia
mycosis fungoides/sezary syndrome
Adult T-cell leukemia/lymphoma

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Key features of B-ALL

precursor B cells
kids
pancytopenia
aggressive

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Key features of T-ALL

precursor T cells
adolescent males
thymic masses
aggressive
variable BM involvement

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Key features of hairy cell

memory B cells
older males
pancytopenia
splenomegaly
indolent

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Key features of CLL/SLL

naive B or memory B
older adults
BM, LN, spleen and liver disease
autoimmune hemolysis 
thrombocytopenia (minority)
indolent

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Key features of ATLL

caused by HTLV-1 
helper T cells
adults with cutaneous lesions
BM involved
hypercalcemia
Japan, West Africa, Caribbean
aggressive (fatal months to a year)

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Mycosis Fungoides/Sezary syndrome key features

helper t cells
adults
cutaneous patches/plaques/ etc
indolent

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Large Granular lymphocytic leukemia

cytotoxic T and NK cell types
RARE
adults
splenomegaly
neutropenia
anemia
sometimes with AI diseases (Rheumatologic)

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“starry sky appearance”

burkitt lymphoma

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Are tumors with mutated or unmutated IG segments more aggresse?

those w/unmutated IG segments

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What is MBUS?

monoclonal B cells of undetermined significance

asymptomatic that have CD5+Bcells inthe PB but too few to be CLL

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Are tumors with mutated or unmutated IG segments more aggresse?

those w/unmutated IG segments

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What is MBUS?

monoclonal B cells of undetermined significance

asymptomatic that have CD5+Bcells inthe PB but too few to be CLL

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Factors the make CLL/SLL prognosis worse

11q/17p deletions
lack of somatic hypermutation
expression of ZAP70

What does ZAP-70 do?

augments signals produced by the Ig receptor

What is richter syndrome?

transformation from CLL/SLL to large B cell lymphoma/other more aggressive tumor

Lab findings of hairy cell leukemia?

hairlike projections

BM can’t be aspirated “dry tap”

Sezary syndrome blood smear finding?

Cerebriform nuclei

What can HTLV-1 give rise to besides ATLL?

demyelinating disease of CNS and thoraco lumbar spinal cord

What type of genetic material do all retroviruses contain?

2 copies of single stranded +RNA

ATLL histology

flower cells | abnormally lobulated nuclei

What is TSP/HAM? Cause

Tropic spastic paraparesis/HTLV_1 associated myelopathy | HTLV-1

What is TSP/HAM? Cause

Tropic spastic paraparesis/HTLV_1 associated myelopathy | HTLV-1

Multiple Myeloma Key features

``` most common plasma cell neoplasm malignant osteolytic lesions/pathologic fractures end organ damage amyloidosis ```

What types of end organ damage are seen in multiple myeloma?

``` (CRAB) hyperCalcemia Renal insufficiency Anema Bone disease ```

What are the most common locations for lytic bone lesions in multiple myeloma?

``` vertebrae ribs skull pelvis femur ```

What is rouleaux and when is it seen?

red cells coining up on top of each other because there's too much protein around seen in multiple myeloma

Main complication of multiple myeloma? Cause of death?

immunosuppression | recurrent infections COD

Multiple myeloma prognosis?

incurable | 3yrs

What is MGUS?

monoclonal gammopathy of undetermined significance | benign but, precursor to multiple myeloma

What are plasmacytomas?

localized growth of monoclonal plasma cells | seen in Multiple Myeloma or as distinct entity

Where are most common plasmacytomas as distinct entities located?

upper respiratory tract

What is amyloid?

an extracellular proteinaceous misfolded substance

What is amyloidosis? most common forms?

disease characterized by deposition of amyloid | amyloid light chain, amyloid associated, beta amyloid

Lab finding for amyloidosis?

apple green birefringence on congo red stain

What does Primary amyloidosis produce? causes?

``` light chains (bence jones proteins) plasma cell dyscrasia (MM or MGUS) ```

What gene is on 17p?

p53

Which age groups have worst prognosis with B-ALL?

<2 | adults

Good genetic prognostics for B-ALL

hyperdiploidy | t(12,21)

Bad genetic prognostics for B-ALL

hypodiploidy | t(9,22)

Bad clinical prognostics for B-ALL

100,000 CSF involvement marrow involvement by day 15

Good prognostic indicators CLL/SLL

mutated IG gene (post germinal) | deletion 13q

Bad prognostic indicators CLL/SLL

``` unmutated IG (pregerminal) CD38/ZAP-70 deletion 11q, 17p ```

List the causes of atypical lymphocytes +/- lymphocytoses

``` CLL/SLL Leukemic Lymphoma Hairy Cell ATLL Sezary ```