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Chronic Myeloproliferative Disorders MPD, Leukemia, Lymphomas

Proliferative Phases youngest to oldest Myeloblast,Promyelocyte,Myelocyte,Metamyelocyte
Only way to identify myeloblast Auer Rod
Myeloctye no nucleoli, clumped cromatin, 12-18 micrometers
Monocytic-Macrophage Series Monoblasts,promocytes, Monocytes
absolute Cell Counts Total # of leukocytes x % of specific WBC= Absolute Count
LAP Leukocyte Alkaline Phosphatase cytochemical stain. Differentiation of malignant disorders from leukomoid reactions.
Toxic granulation azo granules. Precipitated RNA proteins. Infectious disease, burn, malignant disorders
Dohle Bodies Light staining inclusions in neuts. viral infections burns or drugs. Seen in May-Hegglins anomaly
Hypersegmentation associated with B12 , folate or megloblastic anemia
Pelger-Huet Anomaly Acquired disorder. dumbell shaped, pence nez. Cell function is normal
May-Hegglin Anomaly Genetic condition. Large granulated platelets in low volumes.
Chediak-Higashi Syndrome Mutation of lysosomal trafficking and not working. Large granules in neuts.
Morphological Abnormalities of Mature Granulocytes morulae in WBC gram neg bact.
Gauchers Disease Lipid storage disease. 1-3 eccentric nuclei and wrinkled cytoplasm.
Lymphoblast in bone marrow. N:C 4:1
Prolymphocyte seen in bone marrow and thymus. Oval to round with 0-1 nucleoli
Atypical lymphs Downey cells, reactive, transformed or virocytes
Vacuolated lymphs associated with Niemann-Pick Disease, Tay Sachs, Hulers and Burketts lymphoma
CMV herpes DNA Virus. leukocytosis, abnormal liver function tests, IgM or IgG positive titer
Bordetella Pertussis Infection aka Whooping Cough Bacterial Infection. Leukocytosis high as 100x10. Absolute lymphs 15-40
DiGeorge Syndrome increased helper to suppressor. low lymphs
Lupus butterfly rash. Autoimmune disease. Positive ANA antibodies. Old test LE PREP. Titers greater then 1:32.
MPD Chronic Myeloproliferative Disorders closely related diseases characterized by normal cells with high production.
Examples of Myeloproliferative Disorders Chronic Myelogenous Leukemia CML, Polycythemia Rubra Vera, Primary Myelofibrosis
Chronic Myelogenous Leukemia AKA Chronic Granulocytic Leukemia Myeloproliferation of primitive hematopoetitic progenitor cells. Excessive increase in mature myeloid cells in peripheral blood
Philadelphia Chromosome found in 90% in CML cases. translocation of chromosome 22 to 9
LAP Leukocyte Alkaline Phosphatase Differentiate CML and leukemoid reaction. Decreased in CML. Increased in Leukemoid reaction adn PCV.
Polycythemia Rubra Vera Elevated RBC, leukocytosis and thrombocythemia. Increased RBC, HCT,HGB, decrease epo
Essential Throboythemia elevated platelets 600x10
Myelodysplastic Syndromes MDS clonal disorders of the bone marrow resulting in increased proliferation and inadequate maturation or imbalance of one or more cell lines.
Major difference is the blast threshold for diagnosis of AML. WHO vs FAB 20% blasts to 30% blasts
Examples of myelodysplastic syndromes MDS Refractory anemia RA, chronic myelomoncytic leukemia,
Neoplastic new growth
Proliferation high volume
Lymphomas malignant tumor of lymph nodes and associated leukocytes in the bone tissue
Special cytochemical stains applied to blood and bone marrow and reflect the chemical composition of the cells using color reactions.
Sudan Black B stain Stains the lipid membrane black in mature neutrophilic ganulocyte. Used to differentiate AML from ALL
Myeloperoxidase stain MPX positive reactions intensifies with maturity of the cell. Myeloblasts strong positive, Lymphocytes negative. Differentiate acute monocytic and acute myelogenous leukemias from ALL
Periodic Acid Schiff Stain PAS Aldehydes>> bright red-pink lymphoblasts. Myloblasts negative
Leukocyte Alkaline Phosphate Stain LAP Differentiates between Chronic Myelogenous leukemia and leukomoid reaction seen in severe infection or inflammation.
Hary Cell Leukemia Variant of CLL. Predominance of B lymphocytes. Hairlike projections cytoplasmic projections, slate blue cytoplasm.
Multiple myeloma Bone pain. Anemia, increased volume, rouleaux, Bence Jones Proteins in urine precipitates at 56 degree. M spike--- IgG
Waldenstrom IgM
Hodgkins Lymphoma abnormalaties of B lymphocytes. Reed-Sternberg cells in lymph nodes- giant binuclear cells with red nucleus ( acidophilic nuclei). Peripheral blood not involved.
Burkitts lymphoma associated with EBV. High proliferation rate of cells. Translocation of chromosome 8 and 2 , 22 and 14
Defining characteristic of Acute Lymphoblastic leukemia Many blast cells with an absolute lymphocytosis
Factors related to leukemia include genetic,radiation, chemicals,infectious agents
Finding 50-90% myeloblasts on a peripheral blood sample myelobibrosis with myeloid metaplasia
This finding in ALL can help differentiate if from AML Positivity for CD 19 and CD 22
Harry Cell leukemia is a chronic lymphocytic leukemia
Most childhood leukemias are acute lymphocytic
Commonly has B cell origin Waldenstroms macroglobinemia
CLL is classically B cell disorder
A common characteristic of ALL is bone and joint pain
Created by: Kateskate