Lymphocytosis and Lymphoid Leukemias Flashcards Preview

Heme/Lymph > Lymphocytosis and Lymphoid Leukemias > Flashcards

Flashcards in Lymphocytosis and Lymphoid Leukemias Deck (15):
1

What is the lymphocyte count in a benign/non-clonal disorder verses a neoplastic/clonal disorder?

benign: ~10,000 or less
neoplastic: 20-40,000

Remember Normal range: 1,000-3,500

2

What are the lymphocytes doing in mononucleosis?

Cytotoxic T cells responding to EBV-infected B cells

3

What are the 3 PB smear criteria that must be met for a diagnosis of mononucleosis?

1. >50% mononuclear cells in diff
2. marked lymphocytic heterogeneity
3. >10% reactive lymphocytes

Confirmation with heterophile antibody monospot test.

4

Typical reactive lymphocytoses

Polyclonal and demonstrate an admixture of kappa- and lambda-expressing B cells and CD4+ and CD8+ T cells

5

Lymphoid leukemia vs lymphoid lymphoma

Neoplastic lymphoid cell in the blood
Neoplastic lymphoid cells in tissue (LN, spleen, liver)

6

CD34+
CD10+
TDT+
CD19+
CD20-

B-ALL

7

CD3+
CD4-8 dual+
TDT+

T-ALL

8

Lymphocytosis of small lymphs with round nuclei and "soccer ball" or "gingersnap" chromatin

CLL/SLL

9

CD5+
CD19+
CD23+

CLL/SLL

10

Lymphocytes with "hairy" cytplasmic projections and reniform nuclei

Hairy cell leukemia

11

CD19+
CD20+
CD11c+
CD22 bright +

Hairy cell leukemia

12

TRAP + cells

Found in hairy cell leukemia
Positive for tartrate-resistant acid phosphatase

Also, cells "trapped" in red pulp and bm --> cannot get to lymph node --> splenomegaly d/t accumulation
Dry tap on bm aspiration

13

HTLV-1 provirus in tumor cells

Adults with skin lesions, HSM, LAD and hypercalcemia
Common in Japan and Caribbean
Rapidly progressive

"flower" cells, helper T cells, CD25+ CD4+

Adult T-cell leukemia/lymphoma (ATLL)

14

Adult patients with cutaneous patches, plaques
Or generalized erythema and LAD

Lymphocytes with cerebriform nuclei and powdery chromatin in skin or blood

Mycosis fungoides/Sezary syndrome

15

Adult patients with neutropenia, anemia, splenomegaly

May be assoc with autoimmune disorder (RA); indolent

Lymphocytes with eosinophilic granules; cytotoxic T cells CD8+

T-cell large granular lymphocytic leukemia (LGLL)