Pathology Exa Mthree Vinettes

Front 1

52 yo patient presents with, fatigue, lymphadenopathy, hepatosplenomegaly, cytopenia, proliferative centers, ocular involvement,
positive CD5, CD19, CD20, CD22, CD23;
Negative: CD10 and Cyclin D1;

diagnosis?

Back 1

Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Front 2

51 yo male Patient presents with fatigue, lymphadenopathy, hepatosplenomegaly, greater than 5000 small round lymphocytes that are disrupted, autoimmunity towards erythrocytes or platelets, and hypogammuglobulinemia,

Diagnosis?

Back 2

Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Front 3

59 yo patient present with lymphadenopathy, hepatosplenomegaly, no proliferation centers, small irregular lymphocytes, a leukemia phase, GI polyposis,
Positive: CD5, Cyclin D1, CD19, CD20, CD22
negative: CD10, BCL-6, and CD23

Diagnosis?

Back 3

Mantle Cell Lymphoma

Front 4

62 yo Patient presents with lymphadenopathy, hepatosplenomegaly, GI tract polyposis, walkdeyer's ring, alph4beta7 receptor and t(11;14)

Diagnosis?

Back 4

Mantle Cell Lymphoma

Front 5

54yo Patient presents with lymphadenopathy, closed packed poorly formed neoplastic follicles without mantle zones, leukemic phase, waldeyer's ring involvement,
Positive: CD10, CD19, CD20, CD22, BCL-6
Negative: CD5, Cycl D1;

diagnosis?

Back 5

Follicular lymphoma

Front 6

55 yo Patient presents with centrocytes and 8/HPF of centroblasts, diagnosis? be specific:

Back 6

Grade 2 Follicular Lymphoma

Front 7

15 yo patient presents with head and neck lymphoma appearance, skin involvement, waldeyer's ring, GI tract,
Positive: CD10, CD19, CD20, CD22, BCL-6
Negative: Cyc D1, BCL-2, CD5,

diagnosis?

Back 7

Follicular Lymphoma

Front 8

63 yo patient presents with:
;arge transformed lymphocyte cells (2x small lymph), centroblastic, immunoblastic, anaplastic,
positive: CD19, CD20, CD22
negative: CD10, CD5

Diagnosis?

Back 8

Diffuse Large B-cell Lymphomas (primary or secondary)

Front 9

60 yo patient presents with t(14;18), 3q27, c-MYC rearrangements, diagnosis?

Back 9

Diffuse Large B-cell lymphomas

Front 10

Patient presents with CNS lymphomas, testicular involvement,
Positive CD19, CD20, CD22
negative: CD10, CD5, prior history of having MALT lymphoma,

diagnosis?

Back 10

diffuse large B cell lymphoma secondary!

Front 11

19 yo patient from a low income family, might have had earlier EBV infection, presents with abdominal mass, illeocecal, ovary, but no lymph node lymphoma involvement,

Diagnosis?

Back 11

Burkitt Lymphoma - Sporadic

Front 12

5 yo patient from equatorial africa presents with jaw, omentum, and kidney, but NO lymph node lymphoma involvement

diagnosis?

Back 12

Burkitt Lymphoma - Endemic

Front 13

35 yo presents with medium sized blasts with sharp lipid vacuoles and a starry sky appearance,

Diagnosis?

Back 13

Burkitt Lymphoma

Front 14

Patient presents with
Positive: CD10, BCL6, CD19, CD20, CD22
Negative: TdT, CD5, BCL-2, CD23, CD34

KI-67 proliferation Index: 100%

t(8;14)

diagnosis?

Back 14

Burkitt Lymphoma

Front 15

Patient presents with single tumor with regional lymph node involvement, two lympho node regoins same side of diaphragm, tumor in ovary and kidney same side,

diagnosis, be specific?

Back 15

Stage II: Burkitt's Lymphoma

Front 16

53 yo Patient presents with pancytopenia, splenomegaly, infections and vasculitis, marrow friend egg appearance cells,

diagnosis?

Back 16

Hairy Cell Leukemia

Front 17

Patient presents with splenomegaly, marrow has dry tap, lymph nodes and liver involvement,
Positive: CD103, CD22, CD25, CD11c, Cyc D1, CD19, CD20, annexin A positive, with strong TRAP stain
Negative: CD5, CD10, CD23

Diagnosis?

Back 17

Hairy Cell Leukemia

Front 18

63 yo Patient presents with, lymphadenopathy, waldenstrom macroglobulinemia, hyperviscosity, increase in mast cells, rouleauex formations,

diagnosis?

Back 18

Lymphoplasmacytic Lymphoma

Front 19

64 yo patient presents with cryoglobulinemia, neuropathy, coagulopathy,
positive: CD19, CD20, CD22
negative: CD5, CD10,

diagnosis?

Back 19

Lymphoplasmacytic Lymphoma

Front 20

72 yo patient presetns with monoclonal serum protein, hypercalcemia, renal insufficiency, anemia, and bone pain,

diagnosis?

Back 20

Plasma Cell myeloma

Front 21

African american former farmer presents with bence jones proteins, hypogammaglobulinemia, with active hematopoiesis in flat bones, vertebrae, ribs and clavicle

diagnosis?

Back 21

Plasma Cell Myeloma

Front 22

71 yo african american cosmetologists presents with m-component positive, detectable serum spke in IgA and IgG,
Positive: CD38, CD20, CD56 and negative surface Ig;

Diagnosis?

Back 22

Plasma Cell Myeloma

Front 23

Patient presents with skin plaques, medium sized T cell with cerebriform nuclei, pautrier microabscesses (collection of mycosis of T-cell in the epidermal)

diagnosis?

Back 23

Mycosis Fungiodes

Front 24

Adult male presents with skin with erythroderma,early lymph node involvement and minimal blood involvment, with cerebriform cells, diagnosis, be specific:

Back 24

Mycosis Fungiodes - stage III

Front 25

61 yo male presents with erythroderma, lymphadenopathy, circulating tumor cells in blood, and alopceia, diagnosis?

Back 25

Sezary Syndrome

Front 26

60 yo male patient presents with cerebriform nuclei, lutzner cells,
Positive: CD2, CD3, CD5, CD4, CLA, Skin homing receptor CCR4,
Negative: CD7, CD8, ALK-protein
increased CD4/CD8 ratio>10:1

diagnosis?

Back 26

Sezary Syndrome

Front 27

58 yo patient presents with previous history of human T-cell leukemia virus, from japan, pleomorphic cells, (high nuclear/cytoplasmic ratio), leukemic phase - eosinophils in particular, pautrier like microabscess, hypercalcemia

diagnosis, be specific:

Back 27

Adult T cell Leukemia/Lymphoma - Acute

Front 28

57 yo patient presents with adenopathy without leukemic phase, cutaneous lesions, flower cels

diagnosis, be specific:

Back 28

Adult T cell Leukemia: Lymphomatous

Front 29

56 yo patient from central africa presents with pleomorphic an dflower cells, exfoliative skin rash, increased wbcs with atypical lymphocytes in blood, diagnosis, be specific?

Back 29

Adult T cell Leukemia: chronic

Front 30

58 yo patient presents with normal wbcs with >5% circulating tumor cells, skin and lung disease, morphologic variants in lymphocytes,
positive: CD2, CD3, CD5, CD4, CD25
negative: CD7, CD8, ALK

diagnosis, be specific

Back 30

Adult T cell leukemia: Smoldering

Front 31

28 yo patient presents with B cymptoms, lymphadenopathy, lymph node, BM, and soft tissue involvement, cells are large, kidney bean nucleaus, eosinophilic hoffregions, abundant cytoplasm, and they are concentrated around vessels ,

diagnosis, be specefic:

Back 31

Anaplastic Large Cell Lymphoma - Primary Systemic type

Front 32

31 yo presents with B symptoms, lymphadenopathy, skin involvement, multinucleated wreath cells,
positive: CD2, CD4, CD5, CD30, Anaplastic large cel lymphoma kinase
negative CD3, CD7, CD8, EBV

diagnosis, be specific:

Back 32

Anaplastic Large Cell Lymphoma - Primary Cutaneous Type

Front 33

Patient presents with large cell pleomorphic and abundant cytoplasm, with cytotoxic granule associated proteins:
TIA-1
Granzyme B
Perforn

t(2;5),

diagnosis?

Back 33

Anaplastic Large Cell Lmphoma

Front 34

42 yo patient presents with cervical, axillary, inguinal lymph node association, L and H type cells (scattered polymorphous large cells with folded/multilobated nucleus and scant cytoplasm),
positive CD45, CD20, OCT-2 and BOB.1
Negative: CD3, CD15, CD30, EBER


diagnosis?

Back 34

Nodular Lymphocyte Predominant

Front 35

35 yo Patient presents with popcorn cells, and large spherical follicular dendritic meshworks, BCL-6 translocation, lympho nodes, splenic, celiac, and paraaortic nodes all involved, diagnosis, be specific?

Back 35

Stage III - 2 : Nodular Lymphocyte Predominant

Front 36

14 yo Patient presents with mediastinal, bulky disease, thickened capsule, collagen bands surrounding nodule, lacunar cells, necrosis, increased EL2, 5, 10, TGF-beta, Eotaxin

diagnosis?

Back 36

Nodular Sclerosis - Hodgkin Lymphoma

Front 37

38 yo patient presents with B symtoms, lymphadenopathy, mononuclear RS cells, with epithelioid histiocytes granulmas like clusters as background cells, increased cytokines,

diagnosis?

Back 37

Mixed Cellularity - Hodgkin Lymphoma

Front 38

32 yo patient presents with history of EBV, mediastinal disease, bulky disease, eccentric small regressed germinal centers, capsule not thickened, scattered RS cells, resemble LP cells, small lymphocytes predominantly in background, essentially absent eosinophils

Diagnosis?

Back 38

Lymphocyte Rich

Differential: Nodular Lymphocyte Predominant HL

Front 39

37 yo Patient presents with B symptoms, EBV, abdominal and retroperitoneal lymph nodes involved, small lymphocytes depleted, diffuse interstitial fibrosis pattern,

diagnosis?

Back 39

Lymphocyte Depleted

Front 40

Patient presents with marrow failure, >20% blasts, very primitive cells,
MOP, SBB, and NSE negative, CD13, CD33, and CD34 positive, primitive cells,

Diagnosis?

Back 40

Acute Myeloid Leukemia, M0 - Minimal Differentiation

Front 41

46 yo patient presents with marrow failure, >20% blasts, most non-erythroid, and few are PMN/s with auer rods,
Positive: MPO, SBB
Negative: NSE

Immunophenotype: CD13, CD33, CD34, cMPO

diagnosis?

Back 41

Acute Myeloid Leukemia, M1 - Myeloid without maturation

Front 42

Patient presents with >20% blasts, >10% of these are PMN's, and <20% are monocytic w/ auer rods, neutrophil dysplasia,
Positive: MPO, SBB, CD13, CD33, CD34, CD15, cMPO
Negative: NSE

Diagnosis?

Back 42

Acute Myeloid Leukemia, M2 - myeloid with maturation

Front 43

Patient presents with marrow failure, >20% blasts,
Positive: MPO, SBB, CD13, CD33, CD34, CD14, CD4, CD11b/c, CD36

Diagnosis?

Back 43

Acute Myeloid Leukemia, M4 - Myelomonocytic

CD13, 33, 34 - myeloblasts
CD14, 4, 11b/c, 36 - monoblasts

Front 44

55 yo Patient presents with bleeding in gingival, and CNS disease, blasts >20% including promonocytes

Diagnosis?

Back 44

Acute Myeloid Leukemia, M5b - Monocytic

Front 45

5yo patient presents with CNS disease, blast >20% including promonocytes,
positive: NSE
Negative: MPO, SBB
Immuno: CD13, 33, 14, 4, 11b/c, 36

Diagnosis?

Back 45

AML: M5a, Monoblastic

Front 46

Patient presents with anemia, and normoblastemia, myeloblasts >20%,
Positive: MPO, SBB
Negative: NSE

Immunophenotype CD13, 33, glycophorin A, Heme A

Diagnosis?

Back 46

AML: M6, Erythroleukemia

Front 47

Patient presents with PAS positive red cells, anemia,
Negative: MPO, SBB, NSE

Immunohenotype: glycophorin A, Heme A

Diagnosis?

Back 47

M6b, Pure Erythroid

Front 48

Patient presents with bleeding in skin and gingival, and CNS disease, dry trap

Positive: PAS
Negative MPO, SBB
Immunophenotype:
cCD41, cCD61, CD13, CD33

Diagnosis?

Back 48

AML: M7, Megakaryoblastic

Front 49

25 yo Patient presents with t(8;21)(q22;q22) genetic workup, diagnosis?

Back 49

AML with AML1/ETO translocation presenting like M2 - Myeloid with maturation, even if <20% blasts

Front 50

Patient presents with DIC, genetic workup is: t(15;17)(q22;q12)

Diagnosis?

Back 50

Acute Promyelocytic Leukemia:presents like M3 -

PML/RAR-alpha translocation, RARalpha - retinoic acid receptor (17) and PML - promyelocytic leukemia gene (15)

Front 51

Patient presents with marrow failure, auer rods present, atypical eosinophils, increased monocytes,
Positive MPO, SBB
Weak positive: NSE
inv(16)(p13q22)

Diagnosis?

Back 51

AML: CBFbeta/MYH11 translocation presents like a M4e

Front 52

Patient presents with
positive: CD13, 33, cMPO, CD14, 4, 11b/c, 64
and
t(16;16)(p13;q22)

Diagnosis?

Back 52

AML: CBF-Beta/MYH11 translocation presents as an M4,

Front 53

Patient presents with DIC, myeloid sarcoma, and t(9;11)(p22q23)

Diagnosis?

Back 53

AML: MLLT3/MLL translocation presents as a M5,

Front 54

16 yo patient presents with lymphadenopathy, fatigue, rash,

Immunophenotype:
TdT, HLA-CR, CD19, CD10, CD22

positive: NSE
negative: MPO, SBB

diagnosis?

Back 54

precursor B lymphoblastic leukemia/lymphoma

Front 55

11 yo presents with lymphadenopathy, fatigure, hepatosplenomegaly, t(9;22)
positive: NSE
negative: MPO, SBB

Diagnosis?

Back 55

precursor B lymphoblastic leukemia/lymphoma

t(9;22) - BRC:ABL, can also have t(v;11q23) - MLL, t(1;19)PBX/E2A

hypodiploid, hyperdiploid, pseudodiploid

Front 56

45 yo presents with CNS, Spleen, liver, and mediastinal mass..

Positive NSE, TdT,
CD1a/2/3/4/5/7/8
Negative MPO, SBB

Diagnosis?

Back 56

Precursor T Lymphoblastic leukemia/lymphoma