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21 Cards in this Set
- Front
- Back
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tdt + cells indicate what type of condition?
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an acute LYMPHOID LEUKEMIA
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what are the translocations associated with B-cell acute lymphoid leukemia (B-ALL)?
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t (12;21) good prognosis, seen in kids
t (9;22) poor prognosis, seen in adults - note that this translocation is also characteristic (prolly moreso) for chronic myelogenous leukemia but indeed can be seen too in B-ALL. |
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B-cell acute lymphoid leukemia (B-ALL) generally has a good chemo response but two areas of the body need to be administered chemo directly. Which two parts?
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scrotum and CSF
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What are the CD markers for B-cell acute lymphoid leukemia (B-ALL) and T-cell acute lymphoid leukemia (T-ALL), respsectively?
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B-ALL: CD 10, 19, 20
T-ALL: CD 2-8, (no CD10) |
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T-cell acute lymphoid leukemia (T-ALL) are seen in what age group and where?
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T-cell acute lymphoid leukemia (T-ALL) is seen as a
thymic mass in teenagers (Ts!!!) since it is a mass, it is also sometimes called acute lymphoblastic lymphoma. T-cell acute lymphoid leukemia (T-ALL) is associated with pts with down syndrome who gets a lymphoma/leukemia AFTER 5 years old. |
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What two leukemias/lymphomas are associated with Down Syndrome patients? Which one is prior to 5 y/o and which is after 5 y/o?
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Prior to 5: Acute megakaryoblastic leukemia
After 5: T-cell acute lymphoid leukemia (T-ALL) |
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What histiologic structures can be seen in acute mylogenous leukemia?
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Auer rods, which are precipitated MPO+
note: a version of acute mylogenous leykemia, called acute promylocytic leukemia, Auer rods accumulate and there is increased risk of DIC this APML is a medical emergency! |
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Why is acute promyelocytic leukemia a medical emergency?
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Promyelocytes accumulate due to the disrupted retinoic acid receptor and thus Auer rodes accumulate. They are toxic in high concentrations b/c can cause DIC!! So, medical emergency!
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What leukemia/ lymphoma is associated with a disrupted retinoic acid receptor and what is the translocation responsible?
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Acute promyelocytic leukemia, t(15;17)
Treat with ATRA which binds to abnormal receptor and enables maturation of promyelocytes. |
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What leukemia/ lymphoma is associated with involvement of the GUMS?
A. acute megakaryoblastic leukemia B. acute monocytic leukemia C. acute myelogenous leukemia |
B. acute monocytic leukemia
monoblast proliferaiton also lacks MPO (thus can distinguish it stain-wise from an acute myelogenous leukemia , one step up) |
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What leukemia/ lymphoma lacks MPO and is associated with Down Syndrome patients if they develop a leukemia/lymphoma before 5 years of age?
A. acute megakaryoblastic leukemia B. acute monocytic leukemia C. acute myelogenous leukemia |
A. acute megakaryoblastic leukemia
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For the myeloproliferative disorders, there is increased risk of hyperuricemia (due to cell turnover) and thus gout in nearly all of them except for which one?
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Essential thrombocytopenia is not associated with increased risk of hyperuricemia and gout because it just buds from the megakaryocyte!
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Chronic myelogenous leukemia is associated with what translocation that leads to what activity being increased?
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chronic myelogenous leukemia is associated with t(9;22) bcr-abl translocation which leads to increased tyrosine kinase activity.
In CML there is a prolif of granulocytes! esp basophils! |
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How can you differentiate chronic myloogenous leukemia from a leukemoid reaction?
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CML: LAP - , increased basophils and t (9;22)
Leukemoid: LAP + , normal basophil levels |
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Polycythemia vera is due to a mutation in what receptor? What ar ethe symptoms and how do you treat this?
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Due to JAK2 mutation. Symptoms: blurry vision, HA, increase venous thrombosis risk, flushed face, itching after bathing (b/ cof mast cell degran). Treat with phlebotomy.
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Which leukemia/lypmphoma is associated with intense itching after bathing? Why?
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Polycythemia vera because of the increased number of mast cells and the fact that they are degranulated.
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How do you differentiate polycythemia vera from a reactive polycythemia due to lung dz or ectopic EPO production?
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PV: oxygen saturation would be normal, EPO would be low
Lung dz: oxygen sat low ectopic EPO: EPO would be high |
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Which leukemia/lypmphoma is associated with tear drop cells?
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Myelofibrosis
bone marrow is FIBROSED!! Splenomegaly occurs due to extramedullary hematopoesis! |
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A neoplastic proliferation of naive B cells is called what and what are the CD characteristics and histological cell type seen?
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Prolif of naive B cells is chronic lymphocytic leukemia
CD5 adn CD20 expressed Smudge cells seen Complications: hpoglobinulinemia, autoimmune hemolytic anemia, transformation to diffuse large B-cell lymphoma |
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A neoplastic proliferation of mature B cells is called what and stains positive for what?
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Hairy cell leukemia , stains positive for TARP (tartrate resistant acid phsophatase).
Clinical features: splenomegaly, dry tap on bone marrow aspiration, no lymph node enlargement. Excellent response to 2-CDA, an adenosine deaminase in the tumor cells. |
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What leukemia/ lymphoma is characterized by a rash and lytic bone lesions with hypercalcemia as well as generalized LAD and hepatosplenomegaly?
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Adult T-cell leukemia/lymphoma ,a CD4+ T cell proliferaiton
note: mycosis fnugoides is also a CD4_ T cell prolif but it is more infiltrating hte skin and leads to localized rash, plaques and nodules |
