Hematology & Oncology - Leukemia and lymphoma

eesohbel's version from 2015-07-17 00:44

Lymphomas and Multiple Myeloma

Question Answer
characterized by reed sternberg cellsHodgkin lymphoma
strongly associated with EBVHodgkin lymphoma
multiple peripheral nodesnon Hodgkin lymphoma
leukemoid reactionincreased LAP in contrast to CML
CD15 and CD30 positivereed sternberg cells
t(8;14)Burkitt lymphoma
starry sky appearanceBurkitt Lymphoma
mc type non-hodgkin lymphoma in adultsdiffuse large B cell lymphoma
t(14;18)diffuse large B-cell
t(11,14)mantle cell lymphoma
mycosis fungiodespresents with skin patches/plaques characterized by atypical CD4 cells with cerebriform nuclei
more RS cells in hodgkin's lymphomathe worst the prognosis
symptoms of multiple myelomaCRAB hyperCalcemia, Renal involvement, Anemia, Bone lytic lesions
monoclonal m spikemultiple myeloma
M spike equals IgG or IgAmultiple myeloma
M spike equals IgMWaldenstrom Macroglobulinemia
MGUSasymptomatic but patients may develop multiple myeloma
IgG light chains in urinemultiple myeloma
IL-1osteoclast activating factor and its released by myeloma cells in multiple myeloma


Question Answer
General pathophys of leukemiaunregulated growth of leukocytes in the BM → anemia (↓ RBCs), infxns (↓ mature WBCs), hemorrhage (↓ platelets)
associated with Down's syndromeALL and AML
smudge cellsSLL/CLL
TRAPhairy cell leukemia
diagnosis for acute leukemiamade when there is at least 20% blasts in bone marrow or peripheral blood
AML M3auer rods
vitamin AAML
birbeck granuleslangerhans cell histiocytosis
t(9,22)philadelphia CML BCR-ABL
t(11,14)mantle cell lymphoma
t (15; 17)M3 AML

Leukemia/Lymphoma picture quiz

Question Answer
Reed-Sternberg cells → Hodgkin's lymphoma
?Width=600&Height=450&Format=4Burkitt's lymphoma (non-hodkin's B cell lymphoma)
Multiple myeloma
Hairy cell leukemia
Langerhans cell histiocytosis

Chronic myeloproliferative disorders

Question Answer
Polycythemia vera labs↑ RBCs, ↑ WBCs, ↑ platelets, negative -Phili-chomosome, Positive JAK2 mutation
Essential thrombocytosis↑ platelets, negative Phili-chromosome, Positive (30-50%) JAK2 mutations
Myelofibrosis↓ RBCs, Variable WBCs, Variable platelets, negative Phili-chromosome, Positive (30-50%) JAK2 mutations
CML↓ RBCs, ↑ WBCs, ↑ platelets, Positive Phili-chromosome, Negative JAK2 mutation
Polycythemia vera pathABnormal clone of hematopoietic stem cells with contitutively active JAK2 receptors
Proliferate without EPO stimulation
Presents as intense itching after hot shower
Essential thrombocytosisMegakaryocytes with consitutively active JAK2 receptors that proliferate without EPO stimulation
MyelofibrosisFibrotic obliteration of bone marrow
Teardrop cell
CMLbcr-abl transformation leads to ↑ cell division and inhibition of apoptosis
Relative polycythemia↓ plasma volume
Appropriate absolute polycythemia↑ RBC mass, ↓ O2 saturation
Assoc w lung disease, congenital heart disease, high altitude
Inappropriate absolute polycythemia↑ RBC mass
Assoc w renal cell carcinoma, Wilms' tumor, cyst, heptocellular carcinoma, hydronephrosis
Due to ectopic erythropoietin
Polycythemia vera (Plasma volume and RBC mass)↑ plasma volume; ↑↑ RBC mass
intense itching after hot showerpolycythemia vera
tear drop RBCSmyelofibrosis
obliteration of bone marrowmyelofibrosis

Rapid-fire: Leukemia/Lymphoma associations

Question Answer
T-cell leukemiaALL
↑↑↑ peripheral/bone marrow lymphoblastsALL
Possible CNS/testes spreadALL
t(12;21) = good prognosisALL
>60 y/oCLL (maybe AML also)
smudge cells on smearCLL
autoimmune hemolytic anemiaCLL
B-cell leukemiaCLL & Hairy cell leukemia
TRAP+ (stain)Hairy cell leukemia
Tx w cladribineHairy cell leukemia
20-60 y/o (maybe older also)AML
auer rodsAML
↑↑↑ peripheral myeloblastsAML
tx w something that forces differentiationAML (all-trans retinoic acid)
40-60 y/oCML
↓↓ alkaline phosphatase levelsCML
bcr-ablCML (it's a tyrosine kinase)
↑ PMNs, basophils, and metamyelocytesCML
tx w imatinibCML

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