Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

_MS2 HemeOnc > 8/11- Pathology of Leukemia and Lymphoma > Flashcards

8/11- Pathology of Leukemia and Lymphoma Flashcards

1
Q

Name 2 things that distinguish acute from chronic leukemias

A

?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name 3 morphological characteristics seen in Hodgkin lymphomas distinguish them from non-Hodgkin lymphoma

A

?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is a lymphoma different from a leukemia

A

?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can you distinguish myeloid blasts form lymphoid blasts?

A

?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the difference between a leukemoid reaction and leukemia?

A

?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What cells/organs/tissue comprise the lymphoid system?

A
  • B cells, T cells, NK cells
  • Lymphoid organs: lymph nodes, thymus, spleen, tonsils, adenoids
  • Less well organized tissue: MALT (GI Peyer’s patches), bone marrow, skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is this?

A

Lymph node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the architecture of a lymph node

A

Cortex: B cell zone, follicles

Paracortex: T cell zone, T cells, histiocytes, high endothelial venules (HEVs)

Medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

B cell Development Process (flowchart/picture)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T cell Development Process (flowchart/picture)

A
  • Originate in bone marrow and move to thymus to mature
  • Initially 4- and 8-
  • Become either 4+ (Th) or 8+ (CTL)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some cell surface markers involved in lymphocyte development?

A

B cells:

  • Very young: CD34 (SC marker)
  • CD19 -> CD10 -> CD20 -> sIg

T cells:

  • Very young: CD34
  • CD2, CD7
  • CD5
  • CD4, CD8
  • At then end, either: (CD3 + CD8) or (CD3 + CD4)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Overall, list the CDs of B cells and T cells

A

B-cells: think in the 20s

  • CD19, 20, 22, 23 (and Ig)

T-cells: think single digits

  • CD2, 3, 5, 7, 4, 8
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are characteristics of neoplastic conditions of the hematopoietic-lymphoid system?

A
  • Clonal diseases of hematopoietic cells
  • Usually resemble their benign counterparts in morphology and immunophenotype
  • Many have recurrent cytogenetic abnormalities (often translocations)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are a few names for hematopoietic tumors?

A
  • Lymphomas
  • Leukemias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are a few names for solid tumors?

A
  • Carcinomas
  • Sarcomas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Key features of Hematopoietic tumors vs. Solid tumors

A

Hematopoeitic tumors:

  • Systemic disease
  • Replacement of normal marrow or LN elements
  • Circulating tumor cells in the peripheral blood

Solid tumors:

  • Localized growth
  • Invasion
  • Metastasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are main differences between leukemias and lymphomas?

A

Leukemia: marrow based; any Hp lineage

Lymphoma: LN based (or anything non-marrow); lymphoid lineage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Key characteristics of leukemias?

A
  • Malignant marrow-based neoplasms
  • Can be of any hematopoietic lineage (e.g. lymphoid, granulocytic, megakaryocytic, and erythroid)
  • Acute or chronic
  • Often involve the peripheral blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Key characteristics of lymphomas?

A
  • Malignancies of the immune system, arising in extramedullary sites (outside the BM)
  • Arise from lymphocytes (B, T, or rarely NK cells)
  • Arise from cells at different stages of maturation/development
  • Cell of origin determines morphology and clinical course
  • Diverse group clinically and morphologically
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How to distinguish between a lymphoid leukemia vs. a lymphoma

A
  • Lymphocytes normally reside in the bone marrow, peripheral blood, and lymphoid tissues
  • Malignancies of these cells may have the same distribution
  • The distinction is generally based on the predominant clinical manifestation (blood and bone marrow = leukemia, lymph node = lymphoma)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Example of differentiating lymphoid leukemia and lymphoma: Acute lymphoblastic leukemia vs. Lymphoblastic lymphoma

A

Acute lymphoblastic leukemia

  • Blasts in teh blood and bone marrow
  • Express immature markers

Lymphoblastic lymphoma

  • Cells infiltrate thymus or lymph nodes
  • Express immature markers
  • “Blastic morphology”

Both have blasts, they’re just in different places!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How are lymphomas and leukemias classified (by WHO)?

A

Entities distinguished by:

  • Clinical features
  • Morphology
  • Immunophenotype (markers or CDs the cells express)
  • Genotype (cytogenetics, molecular diagnostics)

Based on specific clinicopathologic entities when possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What features are used to classify leukemias as either acute or chronic?

A
  • Cell maturity
  • Clinical course
  • Age of pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is seen in acute vs. chronic leukemia in regard to:

  • Cell maturity
  • Clinical course
  • Age of patient
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What cells are involved in acute leukemia?

A

BLASTS!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is shown here?

A

BLASTS (Acute Leukemia)

  • Medium to large
  • High N/C ratio
  • Fine chromatin
  • +/- nucleoli
27
Q

What cells are involved in chronic leukemia?

A
28
Q

What is shown here?

A

More mature cells in chronic leukemia (CML)

29
Q

Cells involved in Myeloid vs. Lymphoid cell lines?

A

Non-lymphoid:

  • Granulocytic
  • Monocytic
  • Eosinophilic
  • Basophilic
  • Erythroid
  • Megakaryocytic

Lymphoid

  • B cell
  • T cell
  • NK cell
30
Q

How to tell if blasts are lymphoid vs. myeloid?

A

Myeloid

  • Larger
  • More cytoplasm
  • More prominent nucleoli
  • +/- Auer rods

Lymphoid

  • Smaller
  • Scant cytoplasm
  • Small to no nucleoli
31
Q

What is this?

A

Lymphoid blasts

  • Smaller
  • Scant cytoplasm
  • Small to no nucleoli
32
Q

What is this?

A

Myeloid blasts

  • Larger
  • More cytoplasm
  • More prominent nucleoli
  • +/- Auer rods
33
Q

What is the only 100% myeloid morphologic marker?

A

Auer rods!!!

34
Q

Provide leukemia names based on their status as either myeloid/lymphoid and acute/chronic

A
35
Q

What cells are seen in:

  • Acute myeloid leukemia (AML)
  • Acute lymphoblastic leukemia (ALL)
  • Chronic myelogenous leukemia (CML)
  • Chronic lymphocytic leukemia (CLL)
A
  • AML: myeloblasts
  • ALL: lymphoblsats
  • CML: neutrophils and myeloid precursors
  • CLL: mature B lymphocytes
36
Q

AML Immunophenotype: myeloid markers

A

(think of the 3s)

  • CD13
  • CD33
  • May express other markers depending on the lineage and differentiation of the blasts
37
Q

AML Immunophenotype: immature markers (blasts)

A
  • CD34 (stem cell marker)
  • TdT (terminal deoxynucleotidal transferase)

Can be myeloid or lymphoid; just tells you that cells are immature!

38
Q

What is this? Don’t need to know genotype

A

AML with t(8;21)

39
Q

What is this? Key features?

A

Acute promyelocytic leukemia (APL) with t(15;17)

  • Granules!!
  • Auer rods (“faggot cell”; lots of Auer rods)
  • Bi-lobed nucleus Tend to present with DIC (coagulopathic)
40
Q

What is this? Key features?

A

AML with inv(16)

  • Eos with funny granules!)
41
Q

What is this? Key features?

A

AML with monocytic differentiation

  • Lobular, folded nucleus
42
Q

What is this? Key features?

A

AMkL (megakaryoblastic leukemia)

43
Q

AMkL (megakaryoblastic leukemia) is often associated with what?

A

Reticulin fibrosis

  • When megs are up to no good, fibrosis often follows
44
Q

Chronic myeloid leukemias = myeloproliferative neoplasms (disorders)

A

THEY’RE THE SAME THING

45
Q

What conditions are included among chronic myeloid leukemias (myeloproliferative neoplasms (disorders))?

A
  • Chronic myelogenous leukemia
  • Essential thrombocytopenia
  • Polycythemia vera
  • Primary myelofibrosis (Chronic idiopathic myelofibrosis)
46
Q

Describe hematopoiesis in myeloproliferative neoplasms?

A

Effective but abnormal

  • Hypocellular marrow
  • High PB counts
47
Q

Describe hematopoiesis in myelodysplastic syndromes?

A

Ineffective

  • Hypercellular marrow
  • Cytopenias in PB
48
Q

What is seen here?

A

Multilineage dysplasis

  • Funny looking cells of all types
49
Q

Describe myeloproliferative and myelodysplastic disorders in terms of:

  • Clonal
  • PB counts
  • Marrow cellularity
  • Dysplastic features
  • Potential for AML
A
50
Q

What is a main division in the classification of lymphomas?

A

Non-Hodgkin lymphomas

Hodgkin lymphoma

51
Q

What are characteristics of Non-Hodgkin vs. Hodgkin lymphomas?

A

Non-Hodgkin:

  • More common
  • Usually have a monomorphic growth pattern
  • Neoplastic cell = predominant cell

Hodgkin Lymphoma:

  • Less common
  • Pleomorphic growth pattern
  • Neoplastic cell is rare
  • Predominant cells are reactive
52
Q

What cells are involved in Non Hodgkin lymphomas? Classified how? Characteristics?

A

B, T, and NK-cell lymphomas

  • Classified in part based on maturity of the cells: lymphoblasts versus mature B and T cells
  • Some have characteristic patterns of cell marker expression (those CD’s again)
  • Some have characteristic genetic abnormalities: translocations – similar to the way some leukemias have recurrent genetic abnormalities Many types, corresponding to different classes of lymphocytes
53
Q

Where in the lymphoid tissue are B cell lymphomas likely to arise?

A

The germinal center is a hazardous place where B cells engage in risky behavior; muck about with their genes (somatic mutations and class switching)

54
Q

Is Follicular lymphoma Hodgkins or NHL?

A

NHL (It’s a peripheral B cell lymphoma)

55
Q

Characteristics of Follicular Lymphoma

A
  • Non-Hodgkins Lymphoma (NHL)
  • Peripheral B cell lymphoma
  • Morphology and immunophenotype reminsicent of germinal center B cells

— Nodule follicular architecture

— Small cleaved lymphocytes

— Looks like there are too many follicles!

56
Q

What is shown here?

A
57
Q

Describe Hodgkin Lymphoma

A
  • Malignant cell = Reed Sternberg cell (RS cell)

— Recent studies have shown RS cells are actually post germinal center B-cells

— They have forgotten a lot of their “B-ness”

  • Morphology: few RS cells in a background of lymphocytes, histiocytes, eosinophils, plasma cells, fibrosis
  • Prognosis and therapy determined by stage (extent of involvement)

- Unlike NHL, has pattern of spread is orderly and contiguous

58
Q

What is the hallmark of Hodgkin Lymphoma?

A

Reed-Sternberg Cell

  • Very large compared to other surrounding lymphocytes
  • Huge nucleoli (like owl eyes)
59
Q

What is this?

A

Nodular Sclerosing Hodgkin Lymphoma

60
Q

What are the arrows pointing to?

A

Reed-Sternberg cells

61
Q

What are features of plasma cell neoplasms?

A

Have features of leukemia:

  • Involve the bone marrow

Have some features of lymphoma:

  • Usually doesn’t involve the peripheral blood
  • Cells like to stick together and can cause more localized lesions (plasmacytomas)

Cause a lot of systemic symptoms and laboratory abnormalities

  • Produce a monoclonal immunoglobulin
  • Anemia, kidney problems, bone lesions, high calcium Morphology: sheets of plasma cells in the bone marrow
62
Q

What is seen here?

A

WAY too many plasma cells (usually less than 5%)

63
Q

What is this?

A

Plasma cells (again, way too many)

_MS2 HemeOnc (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions