Heme Malignancies Flashcards
(26 cards)
Acute Lymphocytic Leukemia (ALL)
Main types and who they effect
T-ALL: Teenager
B-ALL: kids + adults
Translocation of B-ALL
kids: 12;21
adults: 9;22 (“Ph+”)
General features of ALL
pancytopenia
>25% blasts in marrow
increased WBC count, but it’s immature cells
Tx (beside chemo/whatever) for B-ALL
scrotum + CSF prophylaxis
for your BALLs
AML (general features and who it affects)
Myelogenous blast proliferation; can be several lineages
Older adults, esp with exposure to radiation/chemo
Acute Promyelocytic Leukemia (Translocation, Path, Tx)
Translocation: 15;17
Path: RAR receptor disrupted; Auer rods
Tx: ATRA (causes the blasts to differentiate)
Acute Megaloblastic Leukemia (Assoc)
Down Syndrom < 5 years old
Chronic Leukemia (Basics; Who?)
Mature lymphocytes in circulation
Older adults
Chronic Lymphocytic Leukemia (Path, S/S, Progression)
Path: naive B-cells w/ CD5 and CD20 coexpression; smudge (fade-out) cells
S/S: GenLAD possible; hypogammaglobulinemia; AIHA (shitty IgG produced)
Progression: DLBCL possible
Hairy Cell Leukemia (Acute/Chronic? Path, S/S, Tx)
Chronic Leukemia with mature B-cells
Path: hairy, cytoplasmic processes; TRAP+
S/S: red pulp SM; dry tap
Tx: 2-CDA (causes adenosine to accumulate toxically in neoplastic cells); IFN-α
Adult T-Cell Leukemia Lymphoma (Acute/Chronic? Assoc, S/S, Tx)
Chronic Leukemia of mature CD4’s
Assoc: HTLV-1 (Japan + Caribbean)
S/S: RASH, LAD/HSM, lytic bone lesions/hypercalcemia
Mycosis Fungoides (Acute/Chronic? Path, S/S, Complications)
Chronic Leukemia of mature CD4’s
Path: Pautrier microabscesses in epidermis
S/S: rash (nodules w/plaque)
Complication is Sezary Syndrome when you get the cells in the blood; “cerebriform nuclei”
Myeloproliferative Disorder: What is it? Findings? Who does it affect? Complications?
Mature myeloid-origin cell proliferation
ALL elevated, though
Late adulthood
Complications: gout; marrow fibrosis (“burnt out”); Acute leukemias
Chronic Myeloid Leukemia (S/S, Path, Tx, Complications)
Granulocyte predominance (esp basophils) S/S: SM Path: 9;22; LAP(-) Tx: imatinib (TK inhibitor) Complication: transformation to acute leukemia (could be ALL, too, though!)
Polycythemia Vera (S/S, Path, Tx)
RBC predominance
Path: JAK2 mutation (NRTK)
S/S: blurry vision, headache, venous thrombosis, flushing, prurits (s/p bath!)
Tx: Phlebotomy
Follicular Lymphoma (Cells, S/S, Path incl translocation, Tx, Complications)
Small CD20's S/S: painless LAD Path: architecture disruption and 14;18 Tx: CTX + rituximab Complications: DLBCL
Marginal Cell Lymphoma (Cells, Associations, Path)
Small CD20’s
Assoc: chronic inlamation (hashimoto, sjorgren, h.pylori)
Path: post-germinal cells in marginal zone; MALT is example
Mantle Cell Lymphoma (Cells,Path)
Small CD20’s
Path: 11;14; cyclin D1 overexpression (G1->S)
Burkitt Lymphoma (Cells, S/S, Who?, Association, Path incl translocation)
Intermediate CD20's S/S: extranodal mass (African = jaw, sporadic = abdomen) Who: kiddo/young adult Association: EBV Path: Starry Sky, 8;14 (b/c c-myc on 8)
DLBCL (Cells, S/S, Who?)
Large CD20’s
S/S: common and aggressive
Older adults (sporadic OR follicular advancement)
Hodgkin Lymphoma (Path, Cause, S/S)
Path: Reed-Sternberg cells = rare, neoplastic cells with multi-lobed nuclei AND nucleoli = CD15+CD30
Cause: Cytokines attract cells which form the mass
S/S: B-symptoms
Multiple Myeloma (Cells, Path, S/S)
Cells: malignant plasma cells in marrow
path: RANK activation -> punched-out bone lesions (vertebrae + skull)
S/S: Infection risk, fracture risk
Rouleaux formations of RBC’s (lack charge)
If no symptoms, just M-spike = MGUS (very common in elderly)
Langerhan Cell Histiocytosis (Cells, Rules)
Neoplastic Langerans Cells (monocyte origin, present to naive T-cells) = Birbeck TENNIS racket cells
Name = malignant = skin involvement
two names means 3 y.o.
Letterer-Siwe Disease
= Langerhan cell histiocytosis malignant baby < 2 y.o. S/S: skin rash an cystic skeletal defects VERY fatal quickly
