Lymphoma and Leukemia: Key Chromosomal Translocations and Types

t(8;14) (drives proliferation)

Burkitt lymphoma (c-myc activation)

t(11;14) (cyclin D1 amplification)

Mantle Cell lymphoma (Cyclin D1 activation)

t(11;18) (dysregulates cell cycle)

marginal zone lymphoma

t(14;18) (blocks apoptosis)

follicular lymphoma (BCL2-activation)

t(15;17) (high DIC risk)

APL (formerly M3 type of AML) (PML-RARA fusion)

t(9;22) (overactive kinase)

CML (BCR-ABL hybrid), ALL (less common)

NLPHL

Nodular lymphocyte predominant Hodgkin lymphoma

ALL

Acute Lymphoblastic Leukemia

AML

Acute myeloid leukemia

APL

Acute Promyelocytic Leukemia

CML

Chronic Myeloid leukemia

CLL

Chronic Lymphocytic Leukemia

HCL

Hair Cell Leukemia

PV

Polycythemia Vera

ET

Essential Thrombocythemia

PMF

Primary Myelofibrosis

MDS

Myelodysplastic syndromes

HL

Hodgkin Lymphoma

FL

Follicular Lymphoma

DLBCL

Diffuse Large B-Cell Lymphoma

MCL

Mantle Cell Lymphoma

MZL

Marginal Zone Lymphoma

LPL/WM

Lymphoplasmacytic Lymphoma/Waldenstrom Macroglobinemia

BL

Burkitt Lymphoma

PTCL-NOS

Peripheral T cell Lymphoma Not otherwise specified

ALCL

Anaplastic Large Cell Lymphoma

BI-ALCL

Breast Implant-Associated ALCL

MF/SS

Mycosis Fungoides / Sezary Syndrome

ATLL

Adult T-Cell Leukemia/Lymphoma

LGLL

Large Granular Lymphocytic Leukemia

MM

Multiple Myeloma

MGUS

Monoclonal Gammopathy of Undetermined Significance

SMM

Smoldering Multiple Myeloma

t(12;21)

Most common for B-ALL (B-cell Acute lymphoblastic leukemia/lymphoma)

tdt+

CD7-

B ALL/LBL

tdt+

CD7+

T ALL/LBL

MPO+

>20% blasts or <20% with myeloid sarcoma, common genetic abnormality (t15;17 is the big one)

Auer rods

AML

multiple auer rods

t(15;17), PML-RARA

APL (at risk for DIC, treat with ATRA)

sustained, unexplained cytopenias

increased blasts

dysplastic morphology in erythroid cells, granuolyctes, or megakaryocytes

-can have ringed sideroblasts, nuclear budding

MDS

Basophilia (>200)

High white count

BCR/ABL fusion protein tyrosine kinase

possible short philadelphia chromosome

treat with imatinib (gleevec)

CML

High Hbg/Hct

Headaches, visual disturbances, pruritis after shower

PV

high platelets

ET

Warm Coombs +

Richter formation (transformation to large cell lymphoma)

lymphocytosis

sparse cytoplasm, round to oval nuclei

CD5+ (dim), CD23+

Positive B cell markers CD19,CD20

CD38+, Zap70+ (less common)

CLL/SLL

CD103+

CD11c+

CD25+

Annexin A1+

TRAP+

BRAF V600E mutation common

Dry BM tap, fried egg appearance

HCL

CRAB

bone pitting

monoclonal spike

Russel bodies -->mott cells

Dutcher bodies (Waldenstrom)(dark outline, clear inside)

Rouleaux formation

MM

>10% plasma cells

larger M-spike

SMM

<10% plasma cells

Smaller M-spike

MGUS

MYD88 mutation

IgM MGUS

apple green after congo red stain

t(11;14) is common

systemic light chain amyloidosis

CD15+

CD30+

CD20-

PAX5+ (dim)

Hodgkin Lymphoma

Lacunar Cells

Nodular Sclerosis Hodgkin Lymphoma (NSHL)

CD20+

CD15-

CD30-

Popcorn cells (L&H cells)

Non-classic Hodgkin Lymphoma

B-cell pos: CD19, CD20

CD5-

CD10+

BCL6+, BCL2+

Follicular lymphoma

B-cell pos: CD19, CD20

CD5+

CD10-

CD23-

Cyclin D1+

Mantle Cell lymphoma

B cel pos: CD19, CD20

CD5-

CD10-

Marginal zone lymphoma

B cell pos: CD19, CD20

CD5-

CD10-

MYD88 L265P gene mutations common

lymphoplasmacytic lymphoma (LPL)

CD5+

CD23+

CD10-

CLL/SLL

B cell pos: CD19, CD20

CD10+, BCL6+ (germinal center origin)

Burkitt Lymphoma

EBV+ and typical NK cell phenotype:

CD56+, CD2+, CD3-

Extranodal NK/T-cell lymphoma

CD4+

CD25+

HTLV1 cause

Adult T-cell leukemia/lymphoma

T cell (CD3+, CD8+) or NK Cell (CD3-, CD56+)

STAT3 mutation (common)

Large granular lymphocytic leukmia