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35 Cards in this Set
- Front
- Back
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Definition of leukemia
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General term for a group of malignancies of either lymphoid or hematapoietic cell origin. inc number of circulating leukocytes.
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Acute Leukemias
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predom blasts; most often in children (ALL most common)
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ALL
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most common malignancy in children. predom of lymphoblasts; most responsive to therapy; CD10 marker
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AML
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adults; predom of myeloblasts; responds to current therapy more poorly than ALL
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Chronic leukemias
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prolif of lymphoid or hemat cells that are more mature than those of the acute leukemias; longer, less devastating course
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CLL definition
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prolif of neoplastic lymphoid cells (B cells MC) Men > 60yo
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Smudge cells
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CLL
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CLL characteristics
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leukemic cells closely resemble normal mature peripheral blood lymphocytes - express B-cell markers CD19 and CD20; CD5+ and CD10(-); less capable of developing into anti-body producing cells
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CLL complications
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1. Warm Ab autoimmune hemolytic anemia
2. hypogammaglobulinemia |
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leukemic cells with hair-like projections and stain positive for tartrate-resistant acid phosphate (TRAP)
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Hairy cell leukemia - responds to a-interferon, 2-chlorodeoxyadenosine, and deoxycoformycin
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CML definition
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neaoplastic clonal proliferation of myeloid stem cells (precursor to erythrocytes, granulocytes, monocytes, platelets)
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CML characteristics
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Philadelphia chromosome (9:22)= brc-abl fusion --> codes for a protein w/ tyrosine kinase activity
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Myeloproliferative diseases
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CML, polycythemia vera, chronic idiopathic myelofibrosis, essential thrombocythemia
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erythrocytosis with decreased EPO
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polycythemia vera
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Causes of secondary polycythemia
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1. chronic hypoxia, 2. inappropriate production of EPO (androgen Tx, adult polycystic kidney disease, tumors); 3. Endocrine abn (pheo, Cushings)
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Tear-drop shaped erythrocytes
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chronic idiopathic myelofibrosis (myelofibrosis w/ myeloid metaplasia)
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Heterophil antibodies
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Infectous mononucleosis
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Infectious mono characteristics
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EBV
atypical lymphocytes anti-EBV heterophil antibodies spleen sus to traumatic rupture |
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Multiple Myeloma
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malignant plasma cell tumor usu affecting older persons that thypically involves bone
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Multiple myeloma - tumor cells
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produce lytic bone lesions, ("punched out") w severe bone pain; M protein
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M protein and bence jones protein
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= tumor cells in multiple myeloma produce lots of ident immunoglobulin molecule (seen electrophoretically as M spike); either IgG or IgA; kappa or lambda light chains in urine = BJ proteins
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Rouleaux formation
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in Multiple myeloma; RBCs stack together like poker chips
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Myeloma kidney
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prominent tubular casts of Bence-jones proteins, numberous multinuc macrophage derived giant cells, and metastatic calcification in multiple myeloma
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Waldenstrom macroglobulinemia
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lymphoplasmacytic lymphoma, tumor cells produce monoclonal IgM
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Hodgkin lymphoma
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malignant neoplasm with features resembling an inflammatory d/o
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Reed-Sternberg cells
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Dx of Hodgkin lymphoma depends on this histologic finding = binucleated or multinucleated giant cells with inclusion - like nucleoli
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Prognosis of Hogkin's lymphoma
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severity of the disease directly proportional to the number of Reed-Sternbergs; greater number of reactive lymphocytes = better prog
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Classification of Hodgkin lymphoma
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lymphocyte predom - no EBV assoc; good prog
Lymphocyte rich - EBV Mixed cellularity - EBV assoc Lymphocyte depletion - majority EBV; poorest prognosis Nodular Sclerosis - most frequent, young women, no EBV assoc; good prog |
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Non-hodgkin lymphomas
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malignant neoplasms; most frequently originate within lymph nodes; tumor invlvement of the periaortic lymph nodes
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Nodular sclerosis Hodgkin lymphoma
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most frequent hodgkin, in young women, affected lymph nodes - fibrous bands and presence of lacunar cells, reed-sternbery
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Non-Hodgkin lymphomas
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small lymphocytic lymphoma
Follicular lymphoma Mantle cell lymphoma Extranodal marginal zone B cell lymphoma of MALT type Diffuse large B-cell lymphoma Precursor T lymphoblastic lymphoma/leukemia Burkitt lymphoma Cutaneous T-cell lymphoma |
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Follicular lymphoma
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B-cell lymphoma, indolent course in older persons, MC form of non-Hodgkin lymphoma; t(14;18) w/ expression of bcl-2
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Burkitt Lymphoma
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aggressive B-cell lymphoma; close link to EBV; histo - "starry-sky"; cytogenic change t(8;14) --> inc expression of c-myc
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Cutaneous T-cell lymphomas
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1. Mycosis fungoides - cerebriform nuclei & Pautrier microabscesses
2. Sezary syndrome - circulating neoplastic cells and cerebriform nuclei |
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Fibrous bands and lacunar cells in woman with cervical and mediastinal lymphadenopathy
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Nodular Sclerosis subtype of hodgkin lymphoma. (Lacunar cell is a variant of reed-sternberg cell) this variant not assoc w EBV
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