Ch. 13 Morphology

Question 1

When would you see Dohle bodies and Toxic granules

Answer 1

Leukocytosis (sepsis)

Question 2

Engorged, swollen, painful LNs

Answer 2

Acute Nonspecific Lymphadenitis

Question 3

Non-tender LNs with follicular and paracortical, hyperplasia as well as sinus histiocytosis

Answer 3

Chronic Nonspecific Lymphadenitis

Question 4

Hypercellular BM with a “starry sky” appearance that is PAS+ and MPO-

Answer 4

Acute Lymphoblastic Leukemia/Lymphoma (ALL)

Question 5

Presence of “smudge cells” (small, round lymphocytes that get disrupted when making a smear) and scattered spherocytes

Answer 5

Chronic Lymphoblastic Leukemia (CLL)

Question 6

Presence of centrocytes and centroblasts and parafollicular lymphoid aggregates in BM

Answer 6

Follicular Lymphoma (NHL)

Question 7

Sheets of large B-cells

Answer 7

Diffuse Large B-Cell Lymphoma

Question 8

Starry sky appearance in BM and aspirats show tumor cells with royal blue cytoplasm

Answer 8

Burkitt Lymphoma

Question 9

Homogenous populations of small lymphoctyes with irregular/occassionally deeply clefted/cleaved nuclear contours and a nodular follicular pattern with no proliferation centers

Answer 9

Mantle Cell Lymphoma

Question 10

Cells with two nuclei surrounded by a clear zone - Owls eyes

Answer 10

Reed-Sternberg cells of HL

Question 11

In which disease do cells sometimes undergo ‘mummification’ where they shrink and become pyknotic

Answer 11

Classic HL

Question 12

Lacunar RS cells and deposition of collagen bands that divide LNs into nodules

Answer 12

Nodular sclerosis HL

Question 13

Frequent RS cells and nodules w/out fibrous septae

Answer 13

Mixed cellularity HL

Question 14

Reactive lymphocytes with frequent mononuclear variants and RS cells

Answer 14

Lymphocyte rich HL

Question 15

Abundance of RS cells and small amounts of lymphocytes

Answer 15

Lymphocyte depletion HL

Question 16

L and H variants of cells with multilobed nucleus resembling popcorn kernel and few RS cells

Answer 16

Lymphocyte predominance

Question 17

Presence of flame cells, mott cells, russell bodies, and dutcher bodies

Answer 17

Multiple Myeloma

Question 18

Presence of Bence-Jones proteins

Answer 18

Multiple Myeloma (kidney)

Question 19

Russell bodies and Dutcher bodies with PAS+ inclusions and infiltration of nerve roots, meninges, and brain

Answer 19

Lymphoplasmacytic Lymphoma

Question 20

Pale blue cytoplasm with thread/bleb-like extensions, dry tap on BM aspirate and massive splenomegaly

Answer 20

Hairy Cell Leukemia

Question 21

Hallmark cells containing horse-shoe shaped nuclei and voluminous cytoplasm

Answer 21

Anaplastic Large Cell Lymphoma (ALK+)

Question 22

Cloverleaf/flower cells with multilobulated nuclei

Answer 22

Adult T-Cell Leukemia/Lymphoma

Question 23

Neoplastic T cells with a cerebriform appearance infiltrate the epidermis and upper dermis

Answer 23

Mycosis Fungoides

Question 24

Large lymphocytes with abundant blue cytoplasm and a few coarse granules in peripheral blood smears

Answer 24

Large Granular Lymphocytic Leukemia

Question 25

Needle-like azurophilic granules present in the cytoplasm (Auer Rods)

Answer 25

Acute Myeloid Leukemia

Question 26

Cells that lack Auer rods and are NSE+

Answer 26

Monoblasts

Question 27

Hypercellular BM with dysplastic/disordered differentiation w/in the BM and presence of ring sideroblasts, Pseudo-Pelger-Huet cells and Pawn Ball Megakaryocytes

Answer 27

Myelodysplastic syndrome

Question 28

What are Pseudo-Pelger-Huet cells

Answer 28

Neutrophils with only 2 nuclear lobes

Question 29

What are Pawn Ball Megakaryocytes

Answer 29

Neutrophils with only 1 nuclear lobe

Question 30

Hypercellular BM with a high eosinophil, basophil, and neutrophil count and "sea-blue Histiocytes"

Answer 30

Myeloproliferative disorder

Question 31

Hypercellular marrow that becomes fibrotic causing EMH and an increase in RBCs

Answer 31

Polycythemia Vera

Question 32

Presence of leukoerythroblastosis, poikilocytosis, and dacryocytes with potential for Osteosclerosis to form

Answer 32

Primary Myelofibrosis

Question 33

Pentalaminar tubules with dilated terminal ends producing tennis racket-like appearance (Birbeck granules)

Answer 33

Langerhans Cell Histiocytosis

Question 34

Pale, wedge-shaped, subcapsular with overlying fibrin covered capsule in the spleen

Answer 34

Bland infarct

Question 35

Appearance modified by suppurative necrosis with large scars forming during the healing process

Answer 35

Septic infarcts

Question 36

Medullary-type epithelial cells that are elongated/spindle shaped

Answer 36

Noninvasive Thymoma

Question 37

Cortical epithelial cells with abundant cytoplasm and rounded vesicular nuclei

Answer 37

Invasive Thymoma

Question 38

Fleshy, invasive masses with cytologic atypia

Answer 38

Thymic Carcinoma