Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
CML
PV
PMF
ET
Non-Hodgkin
& Hodgkin
Lymphoma
B cell NonHodgkin
Lymphomas
(B-cell NHL)
All CD20+; treat
w/ rituximab
Follicular
lymphoma
Chronic
lympholytic
leukemia/small
lymphocytic
lymphoma
(CLL/SLL)
Marginal Zone
Lymphoma
(MZL)
Hairy cell
leukemia (HCL)
Aggressive Bcell non-
Presentation
splenomega
ly
Diagnosis
t(9,22)
Philadelphi
a
chromosom
e
Labs/Cytogenetics
High WBC,
high/preserved
platelets, low
emoglobin
Images
Treatment
Tyrosine kinase inhibitor
hodgkin
lymphomas
Diffuse large B
cel lymphoma
(DLBCL)
Mantle cell
lymphoma (MCL)
Burkitts
lymphoma/leuke
mia
Starry sky
Lymphaden
opathy
Starry sky
t(8,14) =>
incr c-myc
expression
EBV in
almost all
African
cases, but
only 50%
US
Primary CNS
lymphoma
(PCNSL)
Post-transplant
lymphoproliferati
ve disorder
(PTLD)
T-cell NonHodgkin
Lymphomas (Tcell NHL)
Hodgkin
CD15 &
Lyphoma (HL)
Myelodysplasti
c Syndromes
(MDS)
BM
Cellularity
(+/-10%) =
100-age
Median age
dx: 65 yo
Incidental
finding on
CBC
Lineagespecific
symptoms:
Leukopenia:
recurrent
infxn, poor
wound
healing
Anemia:
fatigue,
chest pain,
shortness
of breath w/
rest/exertio
n, dizziness
Thrombocyt
openia:
easy
bleeding,
bruising
Constitutio
nal
symptoms:
CD30
(CD20 neg)
Use history
& labs to
rule out
other
causes; if
CBC
abnormaliti
es persist,
order flow
cytometry
&
cytogenetic
s/FISH
nucleat cell)
Dysmyelopoiesis/dysgranulo
poiesis: abnormalities in
nuclear segmentation
hyposegmented (1-2 lobeS)
or hypersegmented (>5-6
lobes)
Hypercellul
ar BM
Blasts
<20%
(otherwise,
AML)
Peripheral
blood
cytopenia(s
)
Dysplastic,
dysfunction
al cells
abnormal granulocytes
(eosinophil, basophil); may
show vacuolated cytoplasm
fevers,
night
sweats,
weight loss
Dyserythropoiesis
Abnormality in nuclear
contour; multi-nuclearity
Dyssynchrony: discrepancy
btwn nuclear & cytoplasmic
maturation
Megablastic changes:
abnormally large precursors
Cytoplasmic/basophilic
stippling (also seen with
lead poisoning)
Dysmegakaryopoiesis
Hypolobation, separation of
nuclear lobes, abnormally
small megakaryocytes
Acute Myeloid
Leukemia
(AML)
Blast
fraction
greater
than or
equal to
20%
BMB: >20%
marrow
cells
comprising
myeloblasts
;
hypercellul
ar (often
100%)
Cytogenetic
abnormaliti
es:
myeloblast
Acute
promyelocytic
leukemia with
t(15;17)
(q22;q12)
Acute
Lymphoblastic
Translocatio
n btwn PML
& RARA
gene =>
Cells
cannot
mature
beyond the
promyelocy
te stage
given the
abnormal
fusion
protein and
subsequent
block of
transcriptio
n
Promyelocytes
instead of blasts,
with slightly
clefted/bilobed
nucleus &
prominent
cytoplasmic
granules, multiple
Auer rods
Flow
cytometry
Leukemia
(ALL)
Subtypes:
precursor B
(~80%),
precursor T
for TdT to
test for
lymphoblas
ts, and
categorize
subtypes
Philadelphia
chromosome