White Blood Cell Disorders 3

Question 1

what is the clinical presentation of ALL?

Answer 1

• onset is abrupt and sever so there will be a short history of symptoms
• symptoms related to BM replacement: bone pain, cytopenias, enlargement of LN, liver and spleen, thymic enlargement (T-ALL), testicular enlargement (B-ALL)
  CNS involvement (B-ALL) such as headaches, blurred vision and vomiting

Question 2

lacunar reed Sternberg cells are seen in ______

Answer 2

classical HL: nodular sclerosing subtype

Question 3

Reed Sternberg cells are altered germinal center B lymphocytes are the minority/majority in Hodgkin’s lymphoma

Answer 3

minority;

non neoplastic inflammatory cells (lymphocytes, plasma cells and eosinophils) are the majority

Question 4

which translocation is associated with an adverse prognosis for ALL?

Answer 4

t(9.22)

high WBC count in PB

Question 5

what are some clinical presentation of Hodgkin’s lymphoma

Answer 5

• painless rubbery enlarged lymph node
• pain in node after drinking
• itching

Question 6

what translocation is associated with a good prognosis in ALL

Answer 6

t(12,21)
has low WBC in PB, Pre B cell immunophenotype
hyperdiploidy
palindrome = good

Question 7

CNS involvement with headaches, blurred vision and vomiting is indicative of what class of ALL?

Answer 7

B-ALL

Question 8

which subclass of Hodgkin’s lymphoma is CD45+

Answer 8

Variant

Question 9

clinical features of multiple myeloma

Answer 9

• pathologic bone fractures
• bacterial infections secondary to hypogammaglobulinemia
• renal insufficiency secondary to hypercalcemia, Bence Jones proteins, amyloid
• organomegaly: spleen, liver, LN, lung

Question 10

what age group do you see nodular sclerosis Hodgkin’s lymphoma?

Answer 10

adolescents or young adults (12-30)

Question 11

what are the subclassifications of Hodgkin’s lymphoma which are based on the immunophenotype of the Reed Sternberg cell

Answer 11

1. classical: CD15+ CD30+ CD45-

2. Variant: CD20+, CD45+ CD15- CD30-

Question 12

how can you distinguish ALL from AML?

treatment regiments and responses are different for both

Answer 12

• morphology: granules and auer rods seen in AML
• stains: MPO and Sudan black in AML; PAS in some ALL
• cryogenics: 90% of ALL are abnormal with hyperdiploidy or translocations

Question 13

what are the subtypes in the classical group of Hodgkins lymphoma

Answer 13

• Nodular sclerosis (most common)
• mixed cellularity
• lymphocyte rich
• lymphocyte depleted (worst)

Question 14

granules and Auer rods is seen in ______

Answer 14

AML

Question 15

lytic lesions on x ray is indicative of what plasma cell neoplasm

Answer 15

Multiple myeloma

Question 16

most of all ALL (acute lymphoblastic leukemia/lymphoma) are precursor _____ cell types

Answer 16

B cell types

Question 17

ALL type that is a precursor T cell neoplasm presents as ______

Answer 17

mediastinal (thymic) mass in adolescent male

presents as a lymphoma while the B cell precursor type presents as a leukemia

Question 18

what stage is nodular sclerosis HL usually found in?

Answer 18

Stage I/II

Question 19

which bone structures are most commonly affected in multiple myeloma?

Answer 19

• axial skeleton: vertebrae > ribs > skull)

Question 20

pain in nodes after drinking is seen in Hodgkin’s/ non Hodgkin’s lymphoma

Answer 20

Hodgkin’s lymphoma