White Blood Cell Quiz

Question 1

• Pro-lymphocytes (mitotically active) aggregate together forming proliferation centers
• Smudge Celll
• CD19, 20, 23, and 5 (T-cell marker)
• Location: Blood and marrow

Answer 1

CLL

Question 2

• Pro-lymphocytes (mitotically active) aggregate together forming proliferation centers
• Smudge Celll
• CD19, 20, 23, and 5 (T-cell marker)
• Location: Lymph nodes

Answer 2

SLL

Question 3

• CD10, 18, 22, and TdT
• Invade bone marrow
• t(9;22) or (12;21)

Answer 3

Precursor B cell ALL

Question 4

• CD3, 7, and TdT
• Thymic tumor
• t(9;22) or (12;21)

Answer 4

Pre T cell ALL

Question 5

• Nodular pattern of infiltration of tissue
• sIg, CD 19, 20, and CD79a (CD5 is not expressed)
• Stain for bcl-2 is (+)
• T(14;18)

Answer 5

Follicular Lymphoma

Question 6

• CD19, 20, 22, 79a, sIg
• Cells overexpress bcl-6
• Large cells

Answer 6

Diffuse Large B cell Lymphoma

Question 7

• CD10, 19, 20, 22, 79a, sIg, and bcl-6
• Translocation involves c-myc on chromosome 8
• Marophages with ingested debris
• Small cells

Answer 7

Burkitt Lymphoma

Question 8

• Mott cell (perinuclear clearning)
• cIg (+)
• Punched out bone lesions

Answer 8

Multiple Myeloma

Question 9

• CD19, 20, 22, 79a, surface IgM
• NOT CD5 or CD23 (distinguishes from B-CLL)
• Intranuclear inclusion, IgM
• Secretes M protein
• NO L-chains

Answer 9

Lymphoplasmacytic Lymphoma

Question 10

• Resemble normal B cells
• CD5, 19, 20, 22 and sIg (IgM)
• NO CD10 or 23
• Over expression of cyclin D1
• Painless lymphadenopathy

Answer 10

Mantle Cell Lymphoma

Question 11

• CD19, 20, 22, 79a, sIgM
• Associated with H. pylori infxn

Answer 11

Extranodal Marginal Cell Lymphoma

Question 12

• CD19, 20, 22, 79a, sIgM
• Replaces white pulp germinal centers

Answer 12

Splenic Marginal cell lymphoma

Question 13

• Thin membrane protrusions (looks like hair)
• CD103
• Marrow fibrosis
• Massive splenomegaly and pancytopenia

Answer 13

Hairy Cell Leukemia

Question 14

• CD4, 30
• Anaplastic lymphoma kinase
• Infiltration of dermis and generalized lymphadenopathy

Answer 14

Anaplastic Large Cell Lymphoma

Question 15

• HTLV-1 Provirus Positive
• CD2, 3, 5
• Hyperlobated nuclei
• Bone and cutaneous lesions

Answer 15

Adult T cell Leukemia / Lymphoma

Question 16

• CD4, 2, 3, 45RO, 5
• Cells form bands thru tissue
• Symptoms
  
  • Inflammatory preneoplastic phase: like eczema
  • Plaque phase
  • Tumor phase: with ulcerations

Answer 16

Mycosis Fungoides

Question 17

• CD4, 2, 3, 45RO, 5
• cell with cerebriform shaped nucleus
• Erythroderma
• Lymphadenopathy

Answer 17

Seazary Syndrome

Question 18

• TCR, CD3, CD8
• Lymphocytosis
• Anemia
• Neutropenia

Answer 18

T cell variant Large Granular Lymphocytic Leukemia

Question 19

• CD56
• B symptoms
• Hepatosplenomegaly
• Anemia / Thrombocytopenia

Answer 19

NK cell variant Large Granular Lymphocytic Leukemia

Question 20

• CD2 and CD56
• Associated with EBV
• Invade small vessels
• ischemic necrosis
• Most commonly affects nose and sinuses

Answer 20

Extranodal NK / T cell Lymphoma

Question 21

• HRS Lacunar cells
• CD15+, CD30+, EBV-, CD20-
• Bands of collagen divide tissue into nodules

Answer 21

Nodular Sclerosis Hodgkins Lymphoma

Presents in Stage 1 or 2

Question 22

• Classic HRS and Mononuclear variants
• CD15+, CD30+, EBV+

Answer 22

Mixed Cellular HL

Presents in stage 3 or 4

Question 23

• Classic HRS cell and Mononuclear variants
• CD15+, CD30+
• 40% EBV+
• Infiltrate mostly T cells

Answer 23

Lymphocyte Rich HL

Question 24

• Hypocellular infiltrate
• CD15+, CD30+, EBV+
• Non-collagenous fibrosis

Answer 24

Lymphocyte Depletion HL

Presents in Stage 3 or 4

Question 25

* Popcorn cell * CD20+ * Able to produce Ig * Inguinal node involvement * Inflammatory infiltrate mostly B cells

Answer 25

Nodular Lymphocyte Predominant HL Presents in stage 1 or 2

Question 26

* Myeloid blasts \> 20% of bone marrow cells * CD34, 33, some with CD15 * large nucleus with clear cytoplasm

Answer 26

AML, M1

Question 27

* Myeloid blasts \> 20% of bone marrow cells * CD34, 33, some with CD15 * large nucleus with fine, azurophilic peroxidase positive granules

Answer 27

AML, M2

Question 28

* Myeloid blasts \> 20% of bone marrow cells * CD34, 33, some with CD15 * large nucleus with Hypergranular, azurophilic peroxidase positive granules and Auer rods

Answer 28

AML, M3

Question 29

* Myeloid blasts \> 20% of bone marrow cells * CD34, 33, some with CD15 * large nucleus with basophilic granules in cytoplasm

Answer 29

AML, M4

Question 30

* Myeloid blasts \> 20% of bone marrow cells * CD34, 33, some with CD15 * large, folded or lobulated nucleus * Peroxidase negative * Esterase positive

Answer 30

AML, M5

Question 31

* Circulating neutrophils, metamyelocytes, and myelocytes * Marrow is ~100% cellular * bcr-abl fusion gene

Answer 31

CML

Question 32

* Hypercellular bone marrow * erythrocytosis, granulocytosis, and thrombocytosis in periphery * Increased red cell mass and hematocrit * Low lvls of EPO * Erythromelalgia

Answer 32

Polycythemia Vera

Question 33

* Thrombocytosis with giant platelets * Erythromelalgia * Characteristics of other myeloproliferative diseases are absent

Answer 33

Essential thrombocytosis Must be diagnosed by excluding other diseases

Question 34

* Marrow fibrosis * In marrow, megakaryocytes are large and clustered * Peripheral blood shows nucleated erythroid progenitors, granulocytic progenitors, and teardrop shaped RBCs

Answer 34

Primary Myelofibrosis Marrow converted to bone late in disease

Question 35

* Cells express CD1, S-100, HLA-DR * Birbeck granules with areas of dilation

Answer 35

Langerhans cell histiocytosis

Question 36

What is the Hand Schuller Christian triad?

Answer 36

* In Langerhans Cell Histiocytosis * Diabetes insipidus * Exophthalmos * Involvement of calvaria