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29 Cards in this Set
- Front
- Back
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Leukemia
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– – a malignant neoplasm of the hematopoietic cells – – characterized by diffuse replacement of the bone marrow by neoplastic cells.
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Acute leukemia - characterized by marrow
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replacement by immature cells (blasts). – the course of acute leukemia, when untreated, is rapidly fatal.
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Chronic leukemia
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- associated with well-differentiated or more mature eukocytes. – a relatively indolent course.
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Clinical Features of Acute Leukemia
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abrupt stormy onset - most patients present within three months of symptoms. symptoms of acute leukemia are usually related to depression of normal marrow function, i.e. anemia, fever, bleeding
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Precursor B-cell ALL immuno, prognosis
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CD19 and CD10 positive; sIg negative and Tdt positive; 90% disease free survival
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diagnosis of Acute Myelogenous Leukemia•
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The diagnosis of this leukemia, based on the WHO classification is defined when blasts represent 20% of the cells of the marrow.
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Acute promyelocytic leukemia, MAB classifaction M3 Clinical Features
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A disease of the third decade, but has been described in children; incidence equal in both sexes• Bleeding diathesis 50 percent; leukemia Hepatosplenomegaly infrequent
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Chronic Myeloid Leukemia epidemiology
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adults between the ages of 25 and 60 years and accounts for 15-20% of leukemia. The peak incidence is in the fourth and fifth decades of life.
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Chronic Myeloid leukemia clinical features•
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The onset is slow The initial symptoms include: fatigue, weakness, weight loss, or abdominal discomfort due to splenomegaly. Laboratory findings. The WBC count is usually greater than 100,000 cells per µL. The circulating cells are neutrophils and monocytes, basophils and eosinophils.
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Chronic Lymphocytic Leukemia epidemiology
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Chronic lymphocytic leukemia (CLL) is the most indolent leukemia Accounts for 30% of acute leukemia CLL is a disease of the older individuals and occurs in patients usually 50 years or older.
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Clinical Course chronic lymphocytic leukemia•
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Many patients live for greater than 10 years after diagnosis with a median survival of 4-6 years. Patients often die of unrelated causes. Transformation to acute leukemia is rare, however, the patients can undergo a transformation to a large cell lymphoma called the Richter Syndrome. Transformation occurs in less than 10% of patients.
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Small lymphocytic lymphoma/CLL
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M=F, adults and elderly, ~5% of all NHL; Generalized adenopathy, splenomegaly, almost always high stage at presentation; peripheral blood involvement; if WBC >15,000 and lymphs >50%: CLL;;; anemia, thrombocytopenia–> hypoproliferative or autoimmune
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Burkitt’s lymphoma pathology
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architecture: diffuse, “starry sky”; cytology: intermediate sized cells, distinct nucleoli, amphophilic cytoplasm; phenotype: B cell: + CD19, CD20, CD10; genetics: t(8;14)involving c-myc and IgH
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lymphomas with nodular architecture
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Follicular lymphoma (some)Mantle cell lymphoma;; (most) Marginal zone lymphoma
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lymphomas with diffuse architecture
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Lymphoblastic lymphoma; Small lymphocytic lymphoma; Mantle cell lymphoma (most) ; Burkitt’s lymphoma; (some) Marginal zone lymphoma; Large cell lymphoma (B, T); Peripheral T cell lymphoma;§ Anaplastic large cell NHL (some are sinusoidal)
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lymphomas with small cell size
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Small lymphocytic; Mantle cell; Follicular (I); Marginal zone
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Lymphomas with medium cell size
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Lymphoblastic; Burkitt’s
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Lymphomas with large cell size
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Large cell NHL; Immunoblastic; Follicular (III); Anaplastic T cell
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lymphomas with mixed small and large cells
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Follicular NHL (II); Peripheral T cell NHL
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B cell lymphomas
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Lymphoblastic; Small lymphocytic; Mantle cell; Follicle center cell; Burkitt’s; Marginal zone; Large cell
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T cell lymphomas
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Lymphoblastic; Anaplastic T cell; Peripheral T cell, NOS
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MCL: karyotype, genes, and consequence
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t(11;14) cyclin D1, IgH cell cycle
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FL: karyotype, genes, and consequence
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t(14;18) IgH, bcl-2 apoptosis
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BL: karyotype, genes, and consequence
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t(8;14) c-myc, IgH cell cycle and apoptosis
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ALCL: karyotype, genes, and consequence
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t(2;5) NPM, alk abnormal kinase
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DLCL: karyotype, genes, and consequence
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t(3q27;V) bcl-6, variable differentiation?
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NS-HL Clinical Features
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Most common, 60-70% cases; Younger age, ~25 years; Common sites: Lower cervical, supraclavicular & mediastinal lymph nodes ~1/3 of patients have B-symptoms, ~40% are stage III-IV;• Prognosis is better than MC-HL & LD-HL but not as good as nLP-HL.
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NS-HL Histopathology
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Lacunar cells-distinct variants of RS cells; (CD15+, CD30+, CD20-, CD45-). Broad bands of collagen fibrosis that divides the tissue into nodules. Cellular infiltrate of T cells and eosinophils.
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