HemeOnc 1

gsafsaf's version from 2015-06-04 18:31


Question Answer
Dacrocyte (teardrop)Myeloid metaplasia/fibrosis
Acanthocyte (spur cell)Thalassemas/Anemia of chronic disease/Lead poisoning
Bite cellG6PD deficiency
ElliptocyteHereditary elliptocytosis
MacroovalocyteMegaloblastic anemia/marrow failure
Ringed sideroblastsIron overload anemia
Schistocyte (helmet cell)DIC/TTP-HUS/traumatic hemolysis
Sickle cellSickle cell anemia
SpherocyteHereditary spherocytosis/autoimmune hemolysis
Target cellHbC disease/Asplenia/Liver disease/Thalassemia
Heinz (-like) bodiesG6PD deficiency/alpha thalassemia
Howell Jolly bodies (basophilic nuclear remnants)Functional hyposplenia/asplenia/napthalene mothball ingestion
Reed-Sternberg cells (owl's eyes)Hodgkin's disease (required)
Starry sky appearance (lymphocytes w/interspersed macrophages)Burkitt's Lymphoma
Fried egg cellMultiple myeloma whole cell
Rouleax (stacked RBCs)Multiple myeloma RBC
Clock face chromatinMultiple myeloma Nuclei
White intracytoplasmic inclusionsMultiple myeloma Ig
Filamentous projectionsHairy cell leukemia (Mature B cell)
Birbeck granules (tennis rackets on EM)Langerhans cell histiocytosis
Auer rods (peroxidase positive cytoplasmic inclusions)AML (granulocytes and myeloblasts) particularly M3 (APML) subtype
Smudge cellsSLL/CLL
Fibrous bands/lacunar (RS variant) cellsNodular sclerosing Hodkin's Lymphoma


Question Answer
Folate deficiencyHigh homocysteine/MMA normal
B12 deficiencyHigh homocysteine/MMA
Reed Sternberg cells of Hodgkin'sCD30/CD15
Mantle cell lymphomaCD5 (CD19/CD20)
Waldenstrom's macroglobulinemiaHyper IgM
Multiple myelomaHyper IgA
Multiple myelomaHyper IgG
Hairy cell leukemiaStains TRAP (tartrate resistant acid phosphatase) positive
Langerhans cell histiocytosisS-100 (neural crest origin)
Langerhans cell histiocytosisCD1a
Normally on RBCs/missing in paroxymal nocturnal hemoglobinuriaCD55/CD59
Follicular B cell lymphomaCD10 (CALLA)/BCL2/BCL6 (CD19/CD20)
CLLCD5/CD23 (CD19/CD20)
B-ALLCD10 (CALLA)/CD22 (CD19/CD20)
Mycosis fungoides/Sezary syndromeCD4

Molecular Biology

Question Answer
Hereditary spherocytosisAnkyrin/band 3/protein 4.2/spectrin
HbCBeta globin residue 6 glutamic acid to lysine
HbSBeta globin residue 6 glutamic acid to valine
Hb Bartsgamma4 (4 alpha genes deleted-hydrops fetalis)
HbHbeta4 (3 alpha genes deleted)
Sideroblastic anemiaX linked/dALA synthase (glycine/succCoA to dALA)
Paroxysmal nocturnal hemoglobinuriaGPI anchor (X chromosome) for CD55-CD59/decay accelerating factor (degrades complement)
Lead poisoningdALA deH2ase (dALA to porphobilinogen)/ferrochelatase (protoporphyrin to heme)
Hemophila AXLR/factor VIII
Hemophila B/Christmas DiseaseXLR/factor IX
Vitamin K deficiencyII/VII/IX/X/C/S
Acute intermittent porphyriaPorphobilinogen deaminase (porphobilinogen to HO/Me/bilane)
Porphyria cutanea tardaUroporphyrinogen deCO2ase (uroporphyrinogen III to coproporphyrinogen III)
Bernard Soulie syndromelow GpIb
Glanzmann's thrombasthenialow GpIIb/IIIa
ITPanti GpIIb/IIIa antibodies
TTPADAMTS 13 (vWF metalloprotease-degrades vWF multimers)
vWF diseaselow vWF (indirectly VIII)
LeidenFactor V resistant to degradation by protein C
ProthrombinIncreased production causes clots
AntithrombinDecifiency causes clots
Protein C/SUnable to inactivate V/VIII
Adult T cell lymphomaHTLV-1
Polycythemia veraJAK2 on chromosome 9
Myelofibrosis/myeloid metaplasiaJAK2 on chromosome 9
Essential thrombocythemiaJAK2 on chromosome 9
EBVBurkitt's lymphoma/DLBCL/CNS lymphoma
HCVB cell lymphoma
Burkitt's lymphomat(8;14) (conjoins c-myc on 8 and heavy chain Ig on 14)
Mantle cell lymphomat(11;14) (conjoins cyclin D1 11 and heavy chain Ig on 14)
Follicular lymphomat(14;18) (conjoins heavy chain Ig on 14 and bcl-2 on 18)
ALLt(12;21) in some gives better prognosis
AML M3 (responds to ATRA)t(15;17)
CMLt(9;22) (bcr-abl)
CLLChromosomal translocations are rare

Transpositions in Cancers

Question Answer
Burkitt's lymphoma8/c-myc
Burkitt's lymphoma14/heavy chain Ig
Burkitt's lymphomat(8;14) (conjoins c-myc on 8 and heavy chain Ig on 14)
Mantle cell lymphoma11/cyclin D1
Mantle cell lymphoma14/heavy chain Ig
Mantle cell lymphomat(11;14) (conjoins cyclin D1 11 and heavy chain Ig on 14)
Follicular lymphoma14/heavy chain Ig
Follicular lymphoma18/bcl-2
Follicular lymphomat(14;18) (conjoins heavy chain Ig on 14 and bcl-2 on 18)
ALLt(12;21) in some gives better prognosis
AML M3t(15;17) responds to ALTRAt(x;x)
CML22/bcr (breakpoint cluster region)
CMLt(9;22) (bcr-abl tyrosine kinase)
Philadelphia chromosomet(9;22) (bcr-abl tyrosine kinase)
CLLChromosomal translocations are rare


Question Answer
Hodgkin'sYoung adults/>55/M>F except nodular sclerosing
Hodgkin'sLow grade fever/night sweats/weight loss/pruritus/nontender lymphadenopathy
Hodgkin'sEBV in 50%
Hodgkin'sNodular sclerosing better than lymphocyte mixed/depleted
NonHodgkin'sLow grade fever/night sweats/weight loss (fewer than Hodgkin's)
Burkitt's (NH) lymphomaAdolescent-young adult
Burkitt's (NH) lymphomaJaw lesion in endemic African/pelvis or abdomen in sporadic
Burkitt's (NH) lymphomaEBVAssociation
Diffuse large B cell (NH) lymphomaUsually adults/20% in childrenEpidemiology
Diffuse large B cell (NH) lymphomaRapidly enlarging mass anywhere in the body
Mantle cell (NH) lymphomaOlder males
Mantle cell (NH) lymphomaPoor (avg survival 3 years)
Follicular (NH) lymphomaAdults
Follicular (NH) lymphomaDifficult to cure/indolent
Adult T cell (NH) lymphomaAdults (esp Japan/West Africa/Carribean)
Adult T cell (NH) lymphomaCutaneous lesions
Adult T cell (NH) lymphomaAggressive
Mycosis fungoidesIndolentPrognosis
Sezary syndromeIndolentPrognosis
Mycosis fungoidesCutaneous rash/patches/nodules
Sezary syndromeCutaneous rash/patches/nodules
Mycosis fungoidesAdultsEpidemiology
Sezary syndromeAdultsEpidemiology
Multiple myelomaCRABBI/hyperCalcemia/Renal insufficiency/Anemia/Bone lytic lesions/Back Pain/Infections
Multiple myelomaPunched out lytic lesions on X ray/M spike on protein electrophoresis/Ig light chain Bence Jones proteins in urine
MGUS/Monoclonal Gammopathy of Undetermined SignificanceAsymptomatic (precursor to multiple myeloma)
MGUS/Monoclonal Gammopathy of Undetermined Significance1-2% progress to multiple myeloma
LeukemiasAnemia (RBC)/infections (WBC)/hemorrhage (platelets)
ALLT cell ALL may present as mediastinal mass (thymus infiltration)
ALLMost responsive leukemia to therapy/t(12;21) better
CLL/SLLOften asymptomatic/autoimmune hemolytic anemia
Hairy cell leukemiaAdults
Hairy cell leukemiaCladribine/adenosine analog
AMLMedian 65Epidemiology
AMLall trans retinoic acid in M3 subtype indcues myeloblast differentiation
CMLHighest incidence 30-60
CMLVery low leukocyte alkaline phosphatase (immature granulocytes)
CMLMay accelerate into AML/ALL (blast crisis)
CMLimatinib (small molecule bcr-able tyrosine kinase inhibitor)
Langerhans cell histiocytosisLytic bone lesions/skin rash
Langerhans cell histiocytosisChildren
Myelodysplastic syndromesRefractory anemia/w or wo ringed sideroblasts/chronic myelomonocytic leukemia/refractory anemia with excess blasts in transformation
Myelodysplastic syndromesM>50

GF and Granules

Question Answer
BasophilsGM-CSF/IL-3/TGF-Beta (also suppresses eosinophils)
NKIL-15 (commitment)/IL-18/IL-2 (maturation)
Neutrophils primary/azurophilicMyeloperoxidase/bactericidal-permeability increase protein/defensins/SERPs
Neutrophils secondary/specificAlkaline phosphatase/lysozyme/NADPH oxidase/collagenase/lactoferrin/cathelicidin
EosinophilsMajor basic protein/eosinophil cationic protein/peroxidase/neurotoxin