Leukemias and Lymphomas

Question 1

Rapid clonal proliferation in the bone marrow of lymphoblasts or myeloblasts caused by a malignant neoplasm which in turn causes high numbers in the peripheral blood

Answer 1

Acute Leukemias

Question 2

• affects children, adolescents, people >50
• 2-5 is peak age
• Types: T and B cell
• Diagnosis is small and large lymphoblast

Answer 2

Acute Lymphoblastic Leukemia (ALL)

Question 3

• a type of ALL

- symptoms: fatigue due to anemia, fever, mucocutaneous bleeding, bone pain, hepatosplenomegaly

Answer 3

B-cell ALL

Question 4

• a type of ALL

- symptoms: large mass in mediastinum, anemia, thrombocytopenia, organomegaly, bone pain

Answer 4

T-cell ALL

Question 5

• affects adults and increases with age
• diagnosis: WBC counts average 5 to 30x10^3 and can range greatly
• symptoms: anemia, thrombocytopenia, neutropenia
• has other lab tests for confirmation

Answer 5

Acute Myeloid Leukemia (AML)

Question 6

hyperuricemia due to cell turnover

Answer 6

uric acid

Question 7

hyperphosphatemia due to cell lysis and bone destruction

Answer 7

phosphorous

Question 8

hypocalcemia due to bone destruction

Answer 8

calcium

Question 9

hypokalemia due to tumor and external loss

Answer 9

potassium

Question 10

• seen in granulocytic cells and small amounts in monocytes

- differs AML from ALL

Answer 10

Myeloperoxidase stain

Question 11

• neutrophils show a positive reaction and lymphocytes a negative reaction
• differs AML from ALL

Answer 11

Sudan Black B

Question 12

• affects 40’s

- diagnosis: small lymphoid cells and smudge cells

Answer 12

Chronic Lymphoid Leukemia

Question 13

Reason for smudge cells and how you fix them

Answer 13

• due to weak cellular membrane

- make an albumin slide

Question 14

• cause: neoplasms of lymph nodes

- types: T and B cell

Answer 14

Lymphomas

Question 15

• age: elderly
• characteristics: all produce monoclonal light chain immunoglobulins, and/or clonal immunoglobulin gene rearrangement
• common types: follicular lymphoma and diffuse large B-cell lymphoma

Answer 15

Mature B-cell lymphoma

Question 16

-based on location of origin

Answer 16

CLL and SLL

Question 17

originated in the bone marrow and peripheral blood

Answer 17

CLL

Question 18

originated in the lymph node and lymphoid organ

Answer 18

SLL

Question 19

• age affected: middle age (55)
• small B-cells with abundant cytoplasm and fine (hairy) cytoplasmic projections
• cells originated post-germinal center stage
• symptoms: splenomegaly and pancytopenia
• Trap stain

Answer 19

Hairy Cell Leukemia

Question 20

• lymphoproliferative disorder characterized by medium size lymphoid cells with irregular nuclear outlines derived from the follicular mantle zone
• indented nuclei reminiscent of the cleaved nuclei

Answer 20

Mantle Cell Lymphoma

Question 21

• originate from the germinal center B-cells and in most cases, recapitulates follicular architecture
• numerous closely spaced follicles
• medium size cells with anglular or indented nuclei and a mix of large lymphoid cells
• butt cells

Answer 21

Follicular Lymphoma

Question 22

• twice the size of normal lymphocytes

- have diffuse histologic growth pattern and can differ significantly in cytologic appearance

Answer 22

Diffuse Large B-cell Lymphoma

Question 23

• characterized by medium sized, highly proliferating lymphoid cells with basophilic vacuolated cytoplasm
• starry-sky appearance
• tumor cells and macrophages

Answer 23

Burkitt Lymphoma

Question 24

Two types of Hodgkin Lymphoma

Answer 24

• Nodular Lymphocyte-Predominant Hodgkin Lymphoma

- Classical Hodgkin Lymphoma

Question 25

- age: males in their 30's - B-cell neoplasm composed of relatively rare neoplastic cells scattered within nodules of reactive lymphocytes - popcorn cells

Answer 25

Nodular Lymphocyte-Predominant Hodgkin Lymphoma

Question 26

- age: 15-34 and >54 - heterogenous group of lymphoid neoplasms derived from the germinal center with few diagnostic neoplastic cells - Reed-Sternberg cells with a rich reactive background

Answer 26

Classical Hodgkin Lymphoma

Question 27

large lymphoid cells with abundant cytoplasm and vesicular multilobed nuclei

Answer 27

Popcorn cells

Question 28

large cells with bilobed nucleus with eosinophilic nucleoli and abundant cytoplasm, "owl eyes"

Answer 28

Reed-Sternberg cells