INTRODUCTION TO HEMATOLOGIC MALIGNANCIES Flashcards
(190 cards)
1
Q
A disease, usually
of leukocytes, in the blood and
bone marrow
A
LEUKEMIA
2
Q
Leukemia is a disease usually of WHAT?
A
Leukocytes
3
Q
Leukemia is a disease, usually
of leukocytes, located where?
A
in the blood and
bone marrow
4
Q
What are the 2 Forms of Leukemia?
A
- Acute leukemia
- Chronic Leukemia
5
Q
short duration
acute leukemia or chronic leukemia
A
acute leukemia
6
Q
long duration
acute leukemia or chronic leukemia
A
Chronic leukemia
7
Q
Many immature cell forms in
the bone marrow and/or
peripheral blood
acute or chronic leukemia
A
Acute leukemia
8
Q
Mostly mature cell forms in the
bone marrow and/or peripheral
blood
Acute or chronic leukemia
A
Chronic leukemia
9
Q
Elevated total leukocyte count
Acute or chronic leukemia
A
acute leukemia
10
Q
Total leukocyte counts that
range from extremely elevated
to lower than normal
Acute or chronic leukemia
A
Chronic leukemia
11
Q
is a general term
for malignancy that starts in the
lymph system, mainly in the
lymph nodes.
A
Lymphomas
12
Q
Lymphomas is a general term
for malignancy that starts where?
A
lymph system, mainly in the
lymph nodes.
13
Q
What are the 2 Types of Lymphomas?
A
- Hodgkin Lymphoma
- Non-Hodgkin Lymphoma
14
Q
Proliferation of malignant
lymphocytes
Hodgkin or Non-Hodgkin Lymphoma
A
Hodgkin Lymphoma
15
Q
Proliferation of malignant
lymphocytes
Hodgkin or Non-Hodgkin Lymphoma
A
Hodgkin Lymphoma
16
Q
have a
basophilic vacuolated cytoplasm
with starry sky pattern
Hodgkin or Non Hodgkin
A
Hodgkin
17
Q
basophilic vacuolated cytoplasm
with starry sky pattern is due to what?
A
due to numerous tangible body
MACROPHAGE that are arrested at
certain stages of maturation
18
Q
What is the hallmark of Hodgkin Lymphoma?
A
presence of Reed-Sternberg cell
19
Q
Reed-Sternberg cell resembles what appearance?
A
owl’s eye appearance
20
Q
These are large binucleated or
multinucleated cell resembles owl’s
eye appearance with each nucleus
bearing a very large nucleolus.
A
Reed-Sternberg cell
21
Q
Presence of Reed-Sternerg cells
Hodgkin or Non Hodgkin
A
Hodgkin
22
Q
Diffuse large B-cell lymphoma
Hodgkin or Non Hodgkin
A
Non Hodgkin
23
Q
Reed-Sternberg is absent
Hodgkin or Non Hodgkin
A
Non Hodgkin
24
Q
mixed population of
lymphocytes, histiocytes,
eosinophils and some plasma
cells are present
Hodgkin or Non Hodgkin
A
Non Hodgkin
25
In Non Hodgkin Lymphoma, mixed population of what cells are present?
| HELP
- Histiocytes
- Eosinophils
- Lymphocytes
- Plasma cells
26
a form of cancer
of the plasma cells.
Myelomas
27
In myeloma, cells shrink
| True or False
In myeloma, cells overgrows
| FALSE
28
The mass or tumor in myelomas is located where?
Bone marrow
29
This is the form of cancer wherein the cells overgrows,
forming a mass or tumor that is
located in the bone marrow
Myelomas
30
Overproduction of
various types of immature
or mature leukocytes in
the bone marrow and/or
peripheral blood, in most
types of leukemias
Leukemia
31
Solid malignant tumors of
the lymph nodes
Lymphoma
32
Overproduction of plasma
cells in the bone marrow
with concurrent
production of abnormal
proteins
Myeloma
33
Cell Type: Plasma cells
Myeloma
34
Cell type: Lymphocyte is the
distinctive
cell type. Reed-Sternberg
cells are diagnostic for this.
Lymphoma
35
Cell type: Usually involves
leukocytes of the
myelogenous or
lymphocytic cell types
Leukemia
36
Site of malignant cells: Malignant cells are
initially confined to the
organs containing
mononuclear phagocyte
cells such as the
lymph nodes, spleen,
liver, and bone marrow.
Lymphomas
37
What are the organs containing
mononuclear phagocyte
cells?
- Lymph nodes
- Spleen
- Liver
- Bone marrow
38
Site of malignant cells: Malignant cells freely
trespass the blood brain
barrier
Leukemia
39
Site of malignant cells: Plasma cells form a mass
or tumor that is located in
the bone marrow.
Myeloma
40
Where is the site of malignant cells in Myelomas?
Bone marrow
41
Where is the site of malignant cells in Lymphomas?
confined to the organs containing mononuclear phagocyte cells such as the lymph nodes, spleen,
liver, and bone marrow.
42
Where is the site of malignant cells in Leukemia?
freely trespass the blood brain
barrier
43
Lymphomas can spill over into the circulating blood and present a leukemic appearing picture on a
peripheral blood smear
| True or False
TRUE
44
# French-American-British (FAB) Classification
What are the 3 broad Leukocyte groups?
| LMM
- Myelogenous
- Monocytic
- Lymphocytic
45
Major types of leukocytic leukemias can be classified as what?
- Acute
- Chronic
46
Major types of leukocytic leukemias can be classified as acute or
chronic according to the leukocyte groups. Give 4 examples of these.
1. Acute or chronic Myelogenous
2. Acute or chronic monocytic
3. Acute or chronic Myelomonocytic
4. Acute or chronic Lymphocytic Leukemia (CLL)
47
The World Health Organization (WHO)
Classification is based on these 3 aspects?
| BIG
1. Based on MORPHOLOGY
2. Immunophenotyping
3. Genetic studies
48
According to the World Health Organization (WHO)
Classification, morphology information is combined with what?
1. Immunophenotyping
2. Genetic studies
49
Immunophenotyping and Genetic studies are done on what samples?
- peripheral blood
- Bone marrow
- Lymph nodes
50
This leukemia must be distinguished from
acute lymphoblastic leukemia (ALL), myelodysplastic
syndrome (MDS), or AML arising in the presence of MDS
Acute Myeloid Leukemia (AML)
51
Acute myeloid leukemia (AML) must be distinguished from WHAT 3 LEUKEMIAS?
1. Acute LymphoBLASTIC leukemia (ALL)
2. Acute MYELODYSPLASTIC syndrome (AMS)
3. AML arising in the presence of MDS
52
Why must Acute myeloid leukemia (AML) must be distinguished from
acute lymphoblastic leukemia (ALL), myelodysplastic
syndrome (MDS), or AML arising in the presence of MDS?
because therapeutic strategies and the prognosis vary
53
This leukemia is characterized by the presence of blasts
and immature leukocytes in the peripheral blood and bone
marrow
Acute Leukemia
54
Acute leukemias are characterized by the presence of what?
presence of blasts
and immature leukocytes
55
Anemia is present in acute leukemia?
| True or False
TRUE
56
What are the 2 reasons why anemia is present in Acute Leukemia?
1. caused by bleeding
2. the replacement of normal marrow
elements by leukemic blasts.
57
What type of leukemia has a total leukocyte count that is usually elevated, some patients
may demonstrate normal or decreased leukocyte count.
| Acute or chronic
Acute leukemia
58
What are the 2 synonyms for AML?
1. Acute Myelogenous Leukemia
2. Acute Non Lymphocytic Leukemia (ANLL)
59
This type of leukemia remains a lethal disorder, which kills the majority of
afflicted adults
AML/ANLL
60
Acute Leukemia is divided into 2 Major Division. What are these?
1. Acute Myeloid Leukemia (AML)
2. Acute Lymphoid Leukemia (ALL)
61
Acute Lymphoid Leukemia is subdivided into 3 categories. What are those?
1. L1
2. L2
3. L3
| L for Lymphoid
62
Acute Lymphoid Leukemia is subdivided into 3 categories. What are those?
1. L1
2. L2
3. L3
| L for LympoBLASTIC
63
Acute Myeloid Leukemia is subdivided into 7 categories. What are those?
1. M1
2. M2
3. M3
4. M4
5. M5
6. M6
7. M7
| M for Myeloid
64
The WHO's classification of AML is based on what?
| McCyto GenIm
1. Morphology
2. Clinical features
3. Cytochemistry
4. Genetics
5. Immunophenotype
65
This is the most common leukemia subtype
Acute Myeloid Leukemia (AML)
66
This leukemia is recognized as a heterogenous clonal disorder
Acute Myeloid Leukemia (AML)
67
Acute Myeloid Leukemia is characterized by what? (2)
1. Maturation block
2. Accumulation of acquired somatic genetic alterations
68
In AML, what are the normal mechanisms altered by the accumulation of acquired somatic
genetic alterations in hematopoietic progenitor cells?
1. Self-renewal
2. Proliferation
3. Differentiation
69
AML according to the FAB classification, M0, M1, and M2 are classified as what?
myeloid
70
AML according to the FAB classification, M3 is classified as what?
Promyelocytic
71
AML according to the FAB classification, M4 is classified as what?
Myelomonocytic
72
AML according to the FAB classification, M5 is classified as what?
Monocytic
73
AML according to the FAB classification, M6 is classified as what?
Erythroleukemia
74
AML according to the FAB classification, M7 is classified as what?
Megakaryocytic
75
Classify the 7 classification of AML according to the FAB classification
- M0 (myeloid)
- M1 (myeloid)
- M2 (myeloid)
- M3 (Promyelocytic)
- M4 (Myelomonocytic)
- M5 (Monocytic)
- M6 (Erythroleukemia)
- M7 (Megakaryocytic)
76
Under what classification has undifferentiated blasts according to the FAB classification?
M0
77
What is the WHO classification of M0 in AML?
not otherwise categorized
78
What is the WHO SYNONYM for M1 in AML?
acute myeloBLASTIC leukemia
WITHOUT maturation
79
Under what classification has blasts and promyelocytes predominate without further maturation of myeloid cells?
M1
80
What is the WHO synonym for M2 in AML?
Acute MyeloBLASTIC leukemia WITH maturation
81
Under what classification has myeloid cells demonstrate maturation beyond the blast
and promyelocyte stage according to the FAB classification?
M2
82
Under what classification has promyelocytes predominate in
the bone marrow, according to the FAB classification?
M3
83
Under what classification has BOTH MYELOID and MONOCYTIC cells are present to the extent of
at least 20% of the total leukocytes, according to the FAB classification?
M4
84
In M4, both MYELOID and MONOCYTIC cells are PRESENT to the extent of at least how many percent of the total leukocytes?
at least 20% of the total
leukocytes
85
This classification according to the FAB classification is referred to as Naegeli type
monocytic leukemia.
M4
86
M4 is referred to as what type of monocytic leukemia?
Naegeli Type
87
What is the WHO synonym of M4 in AML?
Acute Myelomonocytic Leukemia
88
This has a WHO synonym termed as acute
myelomonocytic leukemia
M4
89
In M5, most cells are monocytic
| True or False
TRUE
90
This classification of AML according to the FAB classification is subdivided into subtypes A and B
M5
91
What are the 2 subtypes recognized in M5?
1. FAB M5a
2. FAB M5b
92
common in young adults
| FAB M5a or FAB MM5b
FAB M5a
93
common during middle age
| FAB M5a or FAB M5b
FAB M5b
94
characterized by large
blasts in bone marrow and
peripheral blood
| FAB M5a or FAB M5b
FAB M5a
95
differentiated type by
monoblasts, promonocytes, and
monocytes
| FAB M5a or FAB M5b
FAB M5b
96
FAB M5b is differentiated by what cells?
| Mono Mono Promono
1. MonoBLASTS
2. MonoCYTES
3. PromonoCYTES
97
M5 is referred to as what type of monocytic leukemia?
Schilling's Type
98
What are the WHO synonyms for M5?
- Acute MonoBLASTIC leukemia
- Acute MonoCYTIC leukemia
99
What is the WHO synonym of FAB M5a?
Acute MonoBLASTIC leukemia
100
What is the WHO synonym for FAB M5b?
Acute MonoCYTIC leukemia
101
This classification has WHO synonyms that are acute
monoblastic leukemia and acute monocytic
leukemia.
M5
102
This classification is referred to as Erythemic Myelosis
M6
103
M6 is also referred to as what?
Erythemic Myelosis or Di Guglielmo Syndrome
104
Erythemic Myelosis also termed as
| DGS
Di Guglielmo Syndrome
105
Under what classification has abnormal proliferation of both erythroid and granulocytic precursors, according to the FAB classification?
M6
106
M6 may include abnormal
megakaryocytic and monocytic
proliferations
| True or False
TRUE
107
What is the WHO synonym for FAB M6a and FAB M6b?
Acute Erythroid Leukemia
108
This classification has a WHO synonym of Acute Erythroid Leukemia?
FAB M6a and FAB M6b
109
M7 has large and small megakaryoblasts with a low nuclear cytoplasmic ratio
| True or False
High nuclear cytoplasmic ratio
| FALSE
109
M7 has large and small megakaryoblasts with a low nuclear cytoplasmic ratio
| True or False
High nuclear cytoplasmic ratio
| FALSE
110
Under what classification has pale and an agranular cytoplasm, according to the FAB classification?
M7
111
M7 has a granular cytoplasm
| True or False
Agranular cytoplasm
| FALSE
112
What is the WHO synonym for M7?
Acute MyeloBLASTIC leukemia
| Si M7 ay MyeloCYTIC pero BLASTIC kay WHO
113
What is the WHO synonym for M7?
Acute MyeloBLASTIC leukemia
| Si M7 ay MyeloCYTIC pero BLASTIC kay WHO
114
AML under what classifcation is with certain genetic abnormalities
| FAB or WHO
WHO classification
114
AML under what classifcation is with certain genetic abnormalities
| FAB or WHO
WHO classification
115
In the WHO classification, what are the 4 AML's with certain genetic abnormalitis?
| AML, AML, AML, APL
1. AML with t(8;21)
2. AML with inv (16) or t(16;16)
3. AML with t(9;11)
4. APL with t(15;17)
116
In the WHO classification, what are the 8 AML's that are "Not Otherwise Specified"?
| M0 - M2, M4-M7 + ABL
1. AML with MINIMAL DIFFERENTIATION (M0)
2. AML without maturation (M1)
3. AML with maturation (M2)
4. Acute Myelomonocytic Leukemia (M4)
5. Acute MonoBLASTIC/monoCYTIC leukemia (M5)
6. Acute Erythroid Leukemia (M6)
7. Acute Megakaryoblastic Leukemia (M7)
8. Acute Basophilic Leukemia
117
In the WHO classification, what are the ACUTE LEUKEMIAS of AMBIGUOUS LINEAGE?
| 1 Acute 4 Mixed
1. Acute undifferentiated leukemia
2. Mixed phenotype acute leukemia -> t(9;22)
3. Mixed phenotype acute leukemia -> t(v;11q23)
4. Mixed phenoytpe acute leukemia -> B lymphocytes-myeloid cells
5. Mixed phenotype acute leukemia -> T-myeloid
118
This leukemia is the most common cancer in children
Acute LymBLASTIC Leukemia (ALL)
119
ALL represents how many percent of cancer diagnoses among children?
23%
120
ALL represents 23% of cancer diagnoses among children of what age?
children younger than 15 years of age
121
ALL is divided into 3 subtypes. What are those?
1. L1
2. L2
3. L3
122
This ALL subtype is common in CHILDREN
L1
123
This ALL subtype is common in OLDER CHILDREN and ADULTS
L2
124
This ALL subtype is common in patient's with leukemia secondary to Burkitt lymphoma
L3
125
ALL subtype L3 is common in what?
in patients with leukemia secondary to Burkitt lymphoma
126
ALL subtype L1 is common in what?
children
127
ALL subtype L2 is common in what?
Older children and adults
128
- Size of Blasts: Small
- Nuclear shape: Indistinct
- Nucleoli: Scant
- Cytoplasm: Invisible
| Identify what FAB Type
L1
129
- Size of Blasts: Large, heterogenous
- Nuclear shape: Indented, prominent
- Nucleoli: Large, abundant
- Cytoplasm: Moderately clefted
| Identify what FAB Type
L2
130
- Size of Blasts: Large
- Nuclear shape: Regular oval to round
- Nucleoli: Prominent, basoophilic
- Cytoplasm: Prominent, vacuoles
| Identify what FAB Type
L3
131
# DETERMINE THE CHARACTERISTICS
- Size of Blasts:
- Nuclear shape:
- Nucleoli:
- Cytoplasm:
| L3 FAB Type
- Size of Blasts: Large
- Nuclear shape: Regular oval to round
- Nucleoli: Prominent, basophilic
- Cytoplasm: Prominent, vacuoles
132
# DETERMINE THE CHARACTERISTICS
- Size of Blasts:
- Nuclear shape:
- Nucleoli:
- Cytoplasm:
| L1 FAB Type
- Size of Blasts: Small
- Nuclear shape: Indistinct
- Nucleoli: Scant
- Cytoplasm: Invisible
133
# DETERMINE THE CHARACTERISTICS
- Size of Blasts:
- Nuclear shape:
- Nucleoli:
- Cytoplasm:
| L2 FAB Type
- Size of Blasts: Large, heterogenous
- Nuclear shape: Indented, Prominent
- Nucleoli: Large, abundant
- Cytoplasm: Moderately clefted
134
This FAB Type has SMALL blasts
L1
135
This FAB Type has an INVISIBLE cytoplasm
L1
136
This FAB Type has a SCANT nucleoli
L1
137
This FAB Type has an INDISTINCT nuclear shape
L1
138
This FAB Type has LARGE, HETEROGENOUS blasts
L2
139
This FAB Type has an INDENTED, PROMINENT nuclear shape
L2
140
This FAB Type has an INDENTED, PROMINENT nuclear shape
L2
141
This FAB Type has LAGE, ABUNDANT nucleoli
L2
142
This FAB Type has a MODERATELY CLEFTED cytoplasm
L2
143
This FAB Type has LARGE blasts
L3
144
This FAB Type has a REGULAR OVAL TO ROUND nuclear shape
L3
145
This FAB Type has PROMINENT, BASOPHILIC nucleoli
L3
146
This FAB Type has a PROMINENT, VACUOLES in the cytoplasm
L3
147
The WHO classification that is synonymous with the FAB L1 and L2 classification is:
- Precursor B lymphoblastic leukemia/lymphoblastic lymphoma
- Precursor T lymphoblastic leukemia/lymphoblastic lymphoma
148
What is the precursor cell of the precursor B lymphoblastic leukemia/lymphoblastic lymphoma?
Precursor B-cell ALL
149
What is the precursor cell of the precursor T lymphoblastic leukemia/lymphoblastic lymphoma?
Precursor T-cell ALL
150
What is the precursor cell of the precursor T lymphoblastic leukemia/lymphoblastic lymphoma?
Precursor T-cell ALL
151
The precursor B lymphoblastic leukemia/lymphoblastic lymphoma's neoplasm of lymphoBLASTS are committed to what lineage?
B-cell lineage
152
The precursor T lymphoblastic leukemia/lymphoblastic lymphoma's neoplasm of lymphoBLASTS are committed to what lineage?
T-cell lineage
153
L1 is heterogenous
| True or False
Homogenous
| FALSE
154
What FAB Type in Acute Leukemia has one population of cells within
the case?
L1
155
What are the predominant cells in L1?
small cells
156
L1 in acute leukemia according to the FAB classification has a regular nuclear shape
| True or false
TRUE
157
L1 in acute leukemia according to the FAB classification has an occasional cleft
| True or false
TRUE
158
L1 in acute leukemia according to the FAB classification has a homogenous chromatin pattern
| True or False
TRUE
159
L1 in acute leukemia according to the FAB classification has a RARELY VISIBLE nucleoli
| True or False
TRUE
160
L1 in acute leukemia according to the FAB classification has a MODERATELY BASOPHILIC cytoplasm
| True or False
TRUE
161
L2 is homogenous
| True or False
hetergenous
| FALSE
162
L1 in acute leukemia according to the FAB classification has LARGE and HOMOGENOUS cells in size
| True or False
L3
| FALSE
163
L2 in acute leukemia according to the FAB classification has LARGE CELLS
| True or False
TRUE
164
L2 in acute leukemia according to the FAB classification has an IRREGULAR nuclear shape
| True or False
TRUE
165
L2 in acute leukemia according to the FAB classification have CLEFTS in the NUCLEUS that are common
| True or False
TRUE
166
L2 in acute leukemia according to the FAB classification have one or more large nucleoli that are invisible
| True or False
VISIBLE
| FALSE
167
L2 in acute leukemia according to the FAB classification has a cytoplasm that varies in color
| True or False
TRUE
168
L2 is also referred to as the Burkitt Lymphoma Type
| True or False
L3
| FALSE
169
L3 in acute leukemia according to the FAB classification are LARGE and HOMOGENOUS in size
| True or False
TRUE
170
L2 in acute leukemia according to the FAB classification have a nuclear
shape that is ROUND or OVAL
| True or False
L3
| FALSE
171
L2 in acute leukemia according to the FAB classification have one to three PROMINENT NUCLEOLI
| True or False
L3
| FALSE
172
L3 in acute leukemia according to the FAB classification have a cytoplasm that is deeply basophilic with vacuoles often prominent
| True or False
TRUE
173
Symptoms of ALL can vary from a few weeks to a few months
| True or False
FROM FEW DAYS TO FEW WEEKS
| FALSE
174
Symptoms of ALL can vary from a few weeks to a few months
| True or False
FROM FEW DAYS TO FEW WEEKS
| FALSE
175
Symptoms of ALL include pain in the extremities, particularly in what part?
Legs
176
Symptoms of pain in extremities, particularly in the legs in ALL is produced byan infiltration of what?
infiltration of leukemic cells into the tissues.
177
In ALL, these are present in 75% of
patients
- Lymphadenopathy
- hepatomegaly
178
Lymphadenopathy and hepatomegaly are present in what percent of ALL patients?
75%
179
In ALL patients, these conditions are caused by
nerve infiltration by leukemic blasts, which are quite common in ALL patients
- Leukemic meningitis
- cranial nerve palsies
180
Leukemic meningitis and cranial nerve palsies caused by what?
caused by
nerve infiltration by leukemic blasts
181
In ALL, the total leukocyte count is ELEVATED in what percent of patients?
60% to 70% of patients
182
60% to 70% of ALL patints have an ELEVATED total leukocyte count of what?
ranging from 50 to 100 × 10^9/L
183
In ALL, what percent of patients exhibit EXTREME LEUKOCYTOSIS?
< 15% of patients
184
< 15% of ALL patients exhibit EXTREME LEUKOCYTOSIS with a total leukocyte count of what?
TL > 100 × 10^9/L
185
In ALL, approx. 25% of patients exhibits what?
leukocytopenia
186
In ALL, approx. what percent of patients exhibits leukocytopenia?
25%
187
In ALL, a PBS display what? (2)
1. predominance of blast cells
2. close to 100% lymphoblasts, lymphocytes & smudge cells
188
Leukemic cells can infiltrate many areas of the body
| True or False
TRUE
