Hematology: Malignant Lymphoproliferative

Question 1

Slow uncontrollable growth of abnormal lymphoid cells in the BM, spleen and lymph nodes

Anemia, granulocytopenia, thrombocytopenia

Answer 1

Acute Lymphoblastic leukemia

Question 2

• Normocytic, normochromic anemia
• CNS involvement with scrotal infiltration
• Petechiae, purpura and/or hemorrhage (secondary to thrombocytopenia)
• neg SBB, MPO
  + pos TdT, ACP, NSE

Answer 2

ALL

Question 3

Most common type (74%) of childhood leukemia

best prognosis

Answer 3

L1

Question 4

Burkitt type (Leukemic phase of Burkitt lymphoma)

Answer 4

L3

Question 5

Lymphoblasts are very small & homogenous

Scanty cytoplasm (↑N/C ratio)

Nucleus is round and regular in shape with inconspicuous nucleoli

Answer 5

L1

Question 6

Lymphoblasts are larger and variable (heterogenous) in size

Abundant, basophilic cytoplasm
Clefted nucleus with nucleoli present

Answer 6

L2: Large cell,
Heterogenous

Question 7

Lymphoblast is large but varies little with size

Moderate and deeply basophilic cytoplasm often with vacuoles
Nucleus is round with 1-3 nucleoli

Answer 7

L3

Question 8

Chronic disorder characterized by lymphadenopathy and infiltration of BM and peripheral blood by mature lymphocytes

More common among men, 40 to 60 y.o.

Answer 8

Chronic Lymphocytic Leukemia (CLL)

Question 9

Most common early signs: enlarged lymph nodes, splenomegaly (and hepatomegaly later)

Bacterial infection is the major cause of death

AIHA in 10% of cases

Answer 9

CLL

Question 10

-SMUDGE CELLS
-Hypogammaglobulinemia

Answer 10

CLL

Question 11

RAI CLASS

+ thrombocytopenia

Answer 11

STAGE 4

Question 12

Absolute lymphocytosis (>15 × 109/L) in the peripheral blood and BM

Answer 12

STAGE 0

Question 13

80% are of the B cell type

typically shows large lymphocytes with moderately abundant cytoplasm, and prominent nucleoli

Answer 13

Prolymphocytic Leukemia

Question 14

Leukemic Reticuloendotheliosi

lymphoproliferative disorder characterized by pancytopenia

Pancytopenia – most consistent laboratory observation

Normocytic, normochromic anemia

Answer 14

HCL

Question 15

Monoclonal neoplastic proliferation of one of the cellular components of the lymphoid system

Answer 15

LYMPHOMA

Question 16

LYMPHOMA DIAGNOSIS

Answer 16

LN BIOPSY

Question 17

LYMPHOMA VS LEUKEMIA

Answer 17

LYMPHOMA = LOCALIZED, LYMPHOID
LEUKEMIA = SYSTEMIC, BM

Question 18

enlarged, painless, cervical lymph nodes

Reed-sternberg cells (OWL’S EYE)

INC ESR, LAP

Answer 18

HODGKIN’S

Question 19

78%, lacunar cells IN HODGKIN’S IS WHAT

Answer 19

nodular sclerosis

Question 20

ann arbor stage where >2 lymph nodes on one side of the diaphragm

Answer 20

stage II

Question 21

ann arbor stage where lymph nodes on both sides of the diaphragm and spleen

Answer 21

stage III

Question 22

ann arbor stage where involves single lymph node region

Answer 22

stage I

Question 23

Proliferation of malignant lymphocytes that are arrested at certain stages of maturation (neoplasms of B cells and T/NK cells)

Answer 23

Non-Hodgkin’s Lymphoma

Question 24

causes skin itching, leading to ulcerative skin tumors

Lymphoid cells show a predilection for the epidermis (epidermotropism) and dermis and may spread to regional lymph nodes.

Answer 24

Mycosis Fungoides

Question 25

Leukemic phase of mycosis fungoides T/NK , resembles monocyte Disseminated disease with widespread skin involvement (erythroderma), lymphadenopathy, and circulating lymphoma cells

Answer 25

Sēzary Syndrome

Question 26

A B-cell neoplasm. t(8,21) Found most often in children in Africa & new guinea & commonly affects the jaw & facial bones;

Answer 26

Burkitt’s Lymphoma

Question 27

Rapid growth and tumor cell death results in “starry sky” appearance of biopsy caused by macrophage cleaning the dead cells Tumor growth rate is the highest of any tumor (doubling each day)

Answer 27

Burkitt’s Lymphoma

Question 28

Incidence of Hodgkin

Answer 28

Bimodal

Question 29

Incidence of non Hodgkin

Answer 29

No pattern

Question 30

Spread of Hodgkin

Answer 30

Predictable / Stepwise

Question 31

Malignant proliferation of a monoclonal population of plasma cells that may or may not secrete detectable levels of a monoclonal immunoglobulin

Answer 31

PLASMA CELL DYSCRASIA

Question 32

↑of one specific type of Ig produced by one neoplastic clone of plasma cells

Answer 32

Monoclonal gammopathy

Question 33

Main clinical finding is bone pain (bone lesions/fractures) Renal failure (BJP toxic to tubular epithelial cells) and bacterial infection are the major cause of death

Answer 33

MM

Question 34

Marked rouleaux; ↑ ESR Blue background to blood smear increase gamma band containing an M-spot which is composed of monoclonal CHONs

Answer 34

MM

Question 35

MM + for BJP in urine. True or False.

Answer 35

True

Question 36

Increased macroglobulins produce “hyperviscosity syndrome” which causes neurologic symptoms, CHF, visual impairment, nose/gum bleeding ALSO MARKED ROULEAUX AND ESR

Answer 36

Waldenström Macroglobulinemia

Question 37

IMMUNOGLOBULIN IN MM

Answer 37

IgG

Question 38

Malignant proliferation of lymphoid cells which produce incomplete Ig

Answer 38

Heavy Chain Disease

Question 39

Mediterranean lymphoma

Answer 39

ALPHA HCD

Question 40

resembles lymphoma, common in the elderly

Answer 40

Gamma HCD

Question 41

resembles myeloma

Answer 41

Delta HCD

Question 42

Generally found as an acute terminal stage in multiple myeloma 9 mos survival

Answer 42

Plasma Cell Leukemia