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Flashcards in Heme/Onc Deck (38):
1

Aflatoxins

aspergillus
HCC

2

vinyl chloride

liver
angiosarcoma

3

carbon tetrachlordie

liver
centrilobular necrosis, fatty change

4

nitrosamines

smoked foods
gastric cancer

5

arsenic

cutaneous squamous cell
liver angiosarcoma

6

naphthalene dyes

bladder transitional cell carcinoma

7

Alkylating agents

leukemia

8

Psammoma bodies

laminated, concentric calcific spherules
Papillary adenocarcinoma of thyroid
Serous papillary cystadenocarcinoma of ovary
Meningioma
Mesothelioma

9

CEA

CRC, pancreatic

10

CA 19-9

pancreatic

11

CA 125

Ovarian

12

Mycosis fungoides

Chronic T cell leukemia
CD4+
Pautrier microabscesses (skin)
--> sezary syndrome (blood) -- cerebroform nuclei

13

CLL

chronic lymphoid leukemia Small lymphocytic lymphoma (when in LNs)
Naive B Cells
60+
CD5, CD20
Smudge cells
hypo-IgG AIHA (bad IgG)
Can --> DLBCL (p/w enlarging spleen)

14

Hairy cell

chronic lymphoid leukemia
Mature B Cells
TRAP +
Red pulp of spleen, no LAD, dry BM tap
Tx: 2-CDA (cladribine) -- adenosine deaminase inhibitor

15

ATLL

Adult T cell Leukemia/Lymphoma
HTLV-1
Japan, Caribbean
Rash, HSM, LAD
Lytic Bone Lesions **

16

CML

30-60yrs
Granulocytes, basophils* (vs leukemoid)
t(9; 22) -- BCR-abl
Tx: imatinib
chronic phase: large spleen
Accelerating phase: enlarging spleen. can transform to AML or ALL (b/c mutx in HSCs, not myeloblasts)
LAP (-) (or v low) vs leukemoid rxn

17

PV

RBCs
JAK2
hyperurecemia/gout
thrombosis, itching, hyperviscosity
can --> acute leukemia
Tx: phlebotomy, hydroxyurea

18

ET

PLTs
JAK2
incr bleeding or incr thrombosis
no hyperuricemia/gout
no transformation

19

Myelofibrosis

megakaryocytes
JAK2
incr PDGF --> myelofibrosis
extra-medullary hematopoesis
infection, thrombosis, bleeding
leuko-erythroblastic smear, tear drop cells

20

Acute monocytc AML

AML: BM blasts >20%. Can arise from myelodysplasia. MPO+. 55yrs
subset of AML with gum involvement

21

Acute megakaryoblastic AML

AML: BM blasts >20%. Can arise from myelodysplasia. 55yrs
MPO -
Down's before 5

22

APML (M3)

AML: BM blasts >20%. Can arise from myelodysplasia. MPO+. 55yrs
t(15;17) --> RAR disruption
Auer rods
DIC!
Tx: ATRA

23

B ALL

ALL: tdt+, Down's after 5
CD 19, 20, 10
Tx: Chemo with ppx to brain, scrotum
t (12;21) = kids, good prognosis
t (9;22) (Phil) = adults, poor prognosis

24

T ALL

ALL: tdt+, Down's after 5
CD2 - CD8 +
no CD10
Thymic mass
Teenager

25

DLBCL

large cell lymphoma
CD20+
Older adults, sometimes kids
diffuse sheets of cells
sporadic vs transformed
clinically aggressive

26

Burkitt's

intermediate B Cell lymphoma
CD20
Adolescents/young adults
EBV
African --> jaw
sporadic --> abdomen
c-myc* (varied translocations eg t (8; 14))
Starry-sky (due to apoptosis from rapid cell growth

27

Marginal zone

small B cell lymphoma
CD20
2/2 chronic inflammation
Hashimoto's, Sjogren's --> parotid. H Pylori --> MALT

28

Small lymphocytic lymphoma

CLL involving LNs

29

Follicular lymphoma

small B cell
CD20
late adulthood
LAD --> lots of follicles
t(14; 18) = IgH- bcl2
Can --> DLBCL
vs reactive: bcl2+, loss of architecture, monoclonal, no tingible body MPhages
Tx: CTX or rituximab

30

Mantle cell

small B cell lymphoma
CD20
t(11;14) = IgH - Cyclin D (G1/S phase)

31

Hodgkin's lymphoma

Bimodal: young adults; > 55yo
rare neoplastic cells (R-S)
CD15, CD30
CD20 (-) (Although it is B cell lymphoma)
cytokine production --> B Sx, reactive infiltrate, fibrosis
localized, contiguous vs multiple peripheral
50% EBV

32

Nodular sclerosing

hodgkin's subtype
cervical, mediastinal with broad fibrosis
young female

33

Lymphocyte rich

hodgkin's subtype
best prognosis

34

lymphocyte depleted

hodgkin's subtype
worst prognosis
elderly/HIV

35

Mixed hodgkin's

Eosinophils! 2/2 IL-5
Can have peripheral eosinophilia

36

Waldenstrom's

B cell lymphoma producing IgM
Generalized LAD, incr serum protein with M spike 2/2 IgM (not IgG or A, as in MM)
Hyperviscosity --> bleeding, stroke, retinal hemorrhage, NO lytic bone lesions (vs MM)
Tx: pheresis

37

Langerhans cell histiocytosis

Proliferative d/o of dendritic cells from monocyte lineage
Kids
Lytic bone lesions and rash
S-100 and CD1a
"tennis rackets" on EM (looks like C Tetani spore)

38

multiple myeloma

IgG > IgA
Incr IL-6, osteoclast activating factor --> clast stimulation via RANK
infection (most common cause of death)
AL amyloidosis, reulauex formation
Bence Jones, myeloma kidney
M spike on SPEP
"punched out" lesions =/= ratty lesions of Paget's