Flashcards in Plasma Cell Disorders and Hodgkin Lymphoma Deck (29)
Most Plasma Cell Neoplasms originate as bone marrow tumors and are detectable by measuring ______ in the serum or urine
monoclonal protein (M protein)
What does CRAB stand for?
hypercalcemia, renal insufficiency, anemia, bone lesions
When CRAB accompanies 20% nucleated cells in bone marrow, what is the diagnosis?
Plasma Cell Myeloma.
CRAB is the most important diagnostic test for PCM
Bone marrow is normally 3%, in PCM it can be ____
elevated creatinine is related to ____
in PCM which immunoglobulins are you looking to be elevated?
IgM and IgA. Other types of PCM include light chain only, and nonsecretory also IgD, IgE but these are rare.
In testing for PCM what does it mean if in a serum protein immunofixation test there are very high levels of one type of heavy chain and one type of light chain?
This is positive for PCM. The abnormal plasma cells all arise from one progenitor, have same ABs.
Which chain appears on urine test?
only the light chain.
What is rouleaux formation?
occurs in PCM. Its when RBCs stack on top of each other because of all the antibodies. ABs are + charged and RBCs are - charged. Occurs with high m protein serum levels
What do you use SPEP and SPI for?
SPEP to see which AB is high, SPI to see which AB (will show a band as opposed to a smear).
True or False: If you see the nucleolus in a plasma cell it is neoplastic.
Hematologic tumor is systemic or local?
systemic, can metastasize everwhere
What is MGUS?
presence of monoclonal antibody in the serum or urine with no evidence of a plasma cell myeloma.
T or F- MGUS is a precursor to PCM?
What is Solitary plasmacytoma?
just the singular version of PCM (which is also called multiple myeloma). a single plasmacytoma of bone which is a localized tumor of bone.
T or F? Solitary plasmacytoma of bone involves the bone marrow?
F. If it does then it is PCM.
Diagnostic criteria for Solitary plasmacytoma of bone
No CRAB. absent or low serum M protein, single bone lesion
Diagnostic criteria for MGUS?
low M protein levels
What is extraosseous plasmacytoma and where do they typically occur?
localized plasma cell tumors that arise in tissues outside of the bone marrow.
75% occur in the upper respiratory tract.
CHL and NLPHL are both lymphomas involving what?
CHL and NLPHL both originate where?
B cells in the germinal center
What are the four types of CHL?
What are RS cells?
Reed sternberg cells. Found in CHL. They are:
-large (100 um compared to RBC 8 um)
-multiple lobulated nuclei
-nucleolus is large and pink
What markers do RS cells have? What do they lack that is significant?
Have CD30 and CD 15
lack common leukocyte antigen CD45
morphology of Nodular sclerosis?
nodular areas surrounded by broad bands of collagen (nodular sclerosis)
lacunar cells- large tumor cells surrounded by prominent clear space. They are scattered, not clustered, at high power
Background of mixed lymphocytes
What is mixed cellularity CHL?
Like NSHL there is a background of mixed lymphocytes but there is no nodular fibrosis or sclerosis- won't see the broad bands of collagen.
If there is even a single nodule associated with fibrosis it should be labeled as NSHL
What is lymphocyte rich CHL?
not alot on this
classic HRS cells are present though rare
lacks the broad bands of collagen seen in NSHL
patients present with stage III or IV B cell symptoms
when do you typically see lymphocyte depleted CHL?
in older patients and those with HIV