WHO Chapter 1

Question 1

Number of cells on a peripheral blood manual differential count

Answer 1

200

Question 2

Number of cells on a marrow aspirate manual differential count

Answer 2

500

Question 3

Cells included in marrow aspirate differential

Answer 3

blasts, promonocytes, promyelocytes, myelocytes, metamyelocytes, bands, segmented neutrophils, eosinophils, basophils, monocytes, lymphocytes, plasma cells, erythroid precursors, mast cells (megas are not included)

Question 4

Core biopsy should be…

Answer 4

1.5 cm in length, at a right angle to cortical bone, ≥10 partially preserved intertrabecular areas

Question 5

Cells included in blast count

Answer 5

myeloblasts, monoblasts, megakaryoblasts

Question 6

Answer 6

Myeloblast

Question 7

Answer 7

1. Myeloblast
2. Promyelocyte

Question 8

Answer 8

1. Promyelocyte
2. Myelocyte
3. Metamyelocyte
4. Polychromatic erytoblast

Question 9

Answer 9

Myelocyte

Question 10

Answer 10

1. Myelocyte
2. PMN

Question 11

Answer 11

Metamyelocyte

Question 12

Answer 12

PMNs with toxic granulation

Question 13

Answer 13

1. Toxic granulation, cytoplasmic vacuoles, Dohle bodies
2. Monocyte

Question 14

Answer 14

1. Proerythroblast
2. Myeloblast
3. Promyelocyte
4. Metamyelocyte
5. PMN

Question 15

Answer 15

1. Polychromatic erythroblast
2. Orthochromic erythroblast

Question 16

Answer 16

1. Lymphocyte
2. Orthochromatic erythroblast

Question 17

Answer 17

PMN with peroxidase reaction

Question 18

Answer 18

PMN with alkaline leukocyte phosphatase (ALP)

Question 19

Answer 19

Hypersegmented (>/= 6) PMN

Question 20

Answer 20

Drumstick as an appendage with thin filament bridge to the nucleus (associated with X-chromosome)

Question 21

Answer 21

Very large PMN following chemotherapy

Question 22

Answer 22

PMN after prolonged (>8 hours) storage

Question 23

Answer 23

Monocyte

Question 24

Answer 24

Monocyte

Question 25

Answer 25

Monocyte

Question 26

Answer 26

Monocyte with esterase stain

Question 27

Answer 27

Phagocytic monocyte

Question 28

Answer 28

Neonatal lymphocyte

Question 29

Answer 29

Lymphocyte

Question 30

Answer 30

Osteoclast

Question 31

Question 32

Answer 32

Fibroblasts

Question 33

Answer 33

Monoblast, promonocytes

Question 34

Answer 34

Megakaryoblast

Question 35

Monoblasts and promonocytes count in which leukemias?

Answer 35

Acute monoblastic leukemia Acute monocytic leukemia Acute myelomonocytic leukemia

Question 36

Monoblasts

Answer 36

NSE+ MPO+/- May have pseudopod formation Abundant cytoplasm Round nucleus Prominent nucleoli

Question 37

Promonocyte

Answer 37

NSE+ MPO+ Finely dispersed chromatin Folded/grooved nucleus Indistinct/absent nucleolus Finely granulated cytoplasm

Question 38

Abnormal monocyte

Answer 38

Clumped chromatin Variably indented, folded nucleus Grey cytoplasm with more liliac granules Absent/indistinct nucleoli

Question 39

Blast equivalents in: 1. APL 2. Pure eythroid leukemia

Answer 39

1. Promyelocyte 2. Proerythroblasts

Question 40

MPO

Answer 40

Myeloid differentiation Absence doesn't exclude (early myelo/mono-blasts may lack) Often granular/Golgi staining Monoblasts/promonocytes show fine, scattered granules Negative in erythroid blasts, megakaryoblats, lymphoblasts

Question 41

Sudan Black

Answer 41

Parallels MPO staining, less specific Occasional lymphoblastic leukemias show + (light grey granules rather than deeply black characteristis of myeloblasts)

Question 42

NSE

Answer 42

1. α-napthyl butyrate (ANB) 2. α-napthyl acetate (ANA) Diffuse cytoplasmic activity in monoblasts and monocytes Lymphoblasts mya have focal punctate activity with NSE Negative in PMNs Megakaryoblasts & erythroblasts may have some mulitfocal, punctate ANA+ but it is partially resistant to NaF inhibition (monocyte NSE is totally inhibited by NaF)

Question 43

CAE

Answer 43

naphthol-ASD-chloroacetate esterase stains cells of neutrophil lineage and mast cells negative in normal eos, may be + in neoplastic eos

Question 44

CAE + NSE

Answer 44

permits ID of monos and immature/mature PMNs simultaneously myelomonocytic leukemias particularly express both

Question 45

PAS

Answer 45

+ in cytoplasm of leukemic proerythroblasts in erythroid leukemia (large globules)

Question 46

Ring Sideroblast

Answer 46

\>/= 5 granules encircling \>/= 1/3 nucleus 15% of cells in BM for RARS