Week 4: Hematology overview Flashcards
Where does leukemia start?
starts in bone marrow, can spread to blood and nodes
Where does lymphoma start?
starts in lymph nodes, can spread to blood, marrow
Can leukemia be from myeloid of lymphoid origin?
both
What are clinical features of acute leukemia?
Sudden onset, symptoms of BM failure (fatigue, infections, bleeding), bone pain, organ infiltration
Acute myeloid leukemia
Malignant proliferation of myeloid blasts in blood and BM, 20% CUTOFF FOR DIAGNOSIS, many subtimes, bad prognosis
What are classifications for AML?
genetic abnormalities, FLT-3 mutation, multilinage dysplasia, therapy-related, not otherwise classified
What are genetic mutations of AML?
Good: t(8;21), inv(16), t(15;17), Bad: 11q23
What is a diagnostic finding of AML M3?
Faggot cells (lots of auer rods)
What is a finding of myeloid origin?
auer rods
What is a classic finding of AML M4?
gum involvement of the mouth
Acute lymphoblastic leukemia
Malignant proliferation of lymphoid blasts in blood, BM, classified by immunophenotype (B vs. T), more common in children, prognosis often good
What is proliferating the most in CML?
neutrophils
What is proliferating the most in polycythemia vera?
red cells
What is proliferating the most in essential thrombocytopenia?
platelets
What is proliferating the most in myelofibrosis?
everything
Chronic myeloid leukemia
Neutrophilic leukocytosis, basophilia, Philadelphia chromosome t(9;22), three phases
Chronic myelofibrosis
panmyelosis then marrow fibrosis, extramedullary hematopoiesis, TEARDROP RED CELLS
Polycythemia vera
High RBC in blood (makes blood sludgy), different from secondary polycythemia, thrombosis and hemorrhage, Jak-2 mutation
Essential thrombocytopenia
very high platelet count in blood, can occur in young women, diagnosis of exclusion, hemorrhage and thrombosis
Chronic lymphocytic leukemia
small, mature B cell lymphocytes, same thing as small lymphocytic lymphoma, CD5+, long but inexorable course, hypogammaglobulinemia, AIHA
Hairy cell leukemia
Hairy cells, big spleen, pancytopenia, TRAP+
Non-hodgkin lymphoma
malignant proliferation of lymphoid cells (blasts or mature cells) in lymph nodes, skips around to random lymph nodes, many subtypes, mostly B cell disease
Small lymphocytic lymphoma
Small, mature B cells, same thing as CLL, CD5+, long course, death from infection
Marginal zone lyphoma
actually a bunch of lymphomas, marginal zone pattern, MALT lymphoma, can be caused by H. pylori infection
Mantle cell lymphoma
t(11;14) Bcl-1/Cyclin D1 and IgH, mantle zone pattern, small, angulated B cell lymphocytes, more aggressive
Follicular lymphoma
Follicular pattern (can turn diffuse), small cleaved, mixed or large cell B cells, grades 1, 2 or 3, t(14;18) Bcl-2 and IgH, AVOIDS APOPTOSIS WITH BCL-2
Mycosis fungoides/Sézary syndrome
Skin lesions, blood involvement, cerebriform lymphocytes, T-cell immunophenotype
Diffuse large-cell lymphoma
Large B cells, extranodal involvement, grows rapidly, poor prognosis
Lymphoblastic lymphoma
Typical patient: teenage male with mediastinal mass (The T’s, T-ALL, thymus, teenage), diffuse pattern, lymphoblasts, Same as T-ALL
Burkitt lymphoma
t(8;14), child with fast-growing, extranodal mass, starry-sky pattern
Adult T-cell leukemia/Lymphoma
Japan/caribbean basin, HTLV-1, skin lesions, hypercalcemia, very aggressive
Hodgkin lymphoma
younger patients, good prognosis, contiguous spread, 5 subtypes, Reed-Sternberg cell
What are the prognostic indicators of ALL?
Immunophenotype (T is bad), Age (1-10 is good), WBC (
