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31 Cards in this Set
- Front
- Back
What is wrong with the neutrophils seen here?
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Toxic granulations. The azurophilic granules are indicative of immaturity. Patient could have a massive infection or another reason to be putting out immature cells
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What autosomal dominant congenital abnormality has basophilic inclusions that may resemble Dohle bodies? What other findings are characteristic on blood smear?
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May-Hegglin anomaly, but also GIANT platelets. Usually benign, sometimes thrombocytopenia
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What is a neutrophil anomaly associated with mucopolysaccharidoses, and what are the findings on blood smear?
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Alder-Reilly anomaly. Blood smear will show many azurophilic granules in granulocytes, lymphocytes and monocytes.
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What are the two possible causes of the pince-nez appearance of these polys?
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Congenital (innocuous)
or acquired (pseudo Pelger-Huet - myelodysplasia) |
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If this cell was on a peripheral smear of a child with oculocutaneous albinism, what else would you expect on history?
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Frequent infections from Chediak-Higashi syndrome, a defect in fusion/trafficking of vesicles (including melanosomes)
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What type of anemia is seen here?
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Iron deficiency anemia - hypochromatic with increased central pallor and pencil cells
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What type of anemia is seen here?
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Thallassemia - increased central pallor, target cells
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What causes this type of anemia?
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B12 deficiency - multilobulated PMN, irregular shapes
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What can cause the appearance of these cells?
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Thalassemia, Liver disease, severe Iron deficiency, Heme C disease, asplenia
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What causes spherocytosis?
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Hereditary spherocytosis caused by mutations in cytoskeleton proteins
Autoimmune hemolysis |
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What conditions can produce schistocytes?
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Shearing stress caused by microangiopathies (DIC), aortic stenosis, or a mechanical heart valve
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What disorder causes Rouleux, and what is the pathophysiology of it?
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Multiple Myeloma produced paraprotein, which coats RBCs and carries a negative charge which causes them to stack
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What infections, and which immunoglobulin is associated with this slide's appearance?
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IgM, Mononucleosis, mycoplasm
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What is seen here?
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RBC infected with malaria
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What type of lymphoma is seen here?
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Burkitt's - note large vacuoles
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What process is shown in this bone marrow biopsy?
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Idiopathic myelofibrosis - collagen III fiber deposition
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What type of ALL is seen here, and in what population is it most common
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L1 - Small cell ALL, most common in pediatric cases. Note lymphocytes are similar in size to RBCs
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What type of ALL is seen in this peripheral smear, and in what population is it most common?
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Large cell ALL - most common in adults. Note size of lymphocytes compared to RBCs
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What are the multinucleate RBCs here indicative of?
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myelodysplasia
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What are the ringed sideroblasts here indicative of?
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myelodysplasia - iron not leaving with RBCs stuck in marrow
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What feature of myelodysplastic syndrome is seen here?
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Micromegakaryocyte, washed out appearance
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What are these cells' appearance typical of?
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Hairy cell leukemia - rare CLL, normal life expectancy
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What is the appearance of these cells suggestive of in a patient with cervical adenopathy?
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Lacunar cells, indicative of nodular sclerosis (here in lower power), most common type of HL
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What are these popcorn appearing cells indicative of?
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Lymphocyte-predominant (non-classic) HL. Very rare. CD 15/30 negative
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If you didn't have a good heme pathologist, what might you mistake this biopsy from a retroperitoneal node for?
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A sarcoma. It is lymphocyte depleted HL
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How does this 2nd most common HL subtype differ from nodular sclerosis, the most common HL?
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Mixed cellularity HL - has R-S cells (nod sclerosis does not) and lacks collagen bands.
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What would these small, cleaved cells in a patient with diffuse rubbery adenopathy and CD19, 20 positive cell infiltrate suggest?
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Follicular lymphoma (NHL)
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How might a patient with this cell on peripheral smear present?
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With raised cutaneous plaques of malignant T cells - Mycosis fungoides/Sezary syndrome
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A patient presents with lymphocytosis, hypercalcemia, elevated LDH, and splenomegaly. You see this clover-leaf cell on peripheral smear. He is from Japan. What do you suspect, and what is prognosis?
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Suspect Human T-cell leukemia/lymphoma, and prior infection by HTLV.
Poor prognosis: <1 year |
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What do these cells suggest in a child with a quickly growing sub-mandibular mass?
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Burkitt's Lymphoma
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A patient with M-protein in urine has this bone marrow appearance. What do you expect from their clinical presentation?
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Multiple myeloma: CRAB:
HyperCalcemia Renal impairment Anemia Bone lesions |
