Hema 2 Lec Module 20: Malignant Lymphoproliferative Disorders

TRUE

In B-Cell ALL, lymph node enlargement is often found.

TRUE or FALSE

FALSE

World Health Organization (WHO) Classification

DOH classification, emphasizes the immunophenotype and cytogenetic findings, which have more clinical and prognostic relevance than morphology.

TRUE or FALSE

FALSE

T-Cell ALL

B-Cell ALL is not further subdivided, because none of the genetic abnormalities is clearly associated with specific biologic features.

TRUE or FALSE

TRUE

French-American-British (FAB) classification is the more popular classification

TRUE or FALSE

FALSE

Anemia is most common

In ALL, anemia is rare.

TRUE or FALSE

FALSE

Lymphoblasts

In ALL, lymphocytes are present in blood smears for the majority of patients, including most who present with leukopenia.

TRUE or FALSE

TRUE

In hairy cell leukemia, the enzyme resists the tartrate digestion and the acid phosphatase remain and are stained, and appears as granular deposits.

TRUE or FALSE

morphology

For lymphoblasts and myeloblasts, _____________ is the first tool used to distinguish ALL from AML.

Small Lymphoblast

Large Lymphoblast

What are the two morphologic types of lymphoblasts?

TRUE

In AML, auer rods are present in 60-70% of cases.

TRUE or FALSE

FALSE

AML

In ALL, nuclear chromatin is usually finely dispersed.

TRUE or FALSE

Hairy cells

______________ are small to medium-sized lymphoid cells with an oval or indented (bean-shaped) nucleus with homogenous, spongy, groundglass chromatin that is slightly less clumped than that of a normal lymphocyte

Fatigue

Which of the following symptoms is most commonly associated with patients diagnosed with Acute Lymphoblastic Leukemia (ALL)?

A. Hypertension

B. Jaundice

C. Fatigue

D. Joint pain

Reduced production of neutrophils

What is the primary reason for patients with ALL experiencing frequent infections?

A. Excess production of white blood cells

B. Reduced production of neutrophils

C. Increased production of antibodies

D. Overactive immune response

Immunophenotyping

Which laboratory test is considered the most reliable indicator for distinguishing between Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid Leukemia (AML)?

A. Blood pressure monitoring

B. Immunophenotyping

C. Urinalysis

D. Electrocardiogram (ECG)

CD34

What surface marker is commonly expressed by both B and T cells in patients with ALL during immunophenotyping?

A. CD34

B. CD4

C. CD8

D. CD20

Annexin A1

In hairy cell leukemia, ____________ is the most specific marker, since it is not expressed in any B-cell lymphoma other than HCL.

hairy

The cytoplasm is abundant and pale blue, with circumferential "________" projections on smears

TRUE

In hairy cell leukemia, the only cytochemical stain utilized in the diagnosis is tartrate-resistant acid phosphatase (TRAP).

TRUE or FALSE

TRUE

Cytochemical stains are used primarily to help distinguish ALL from AML.

A. TRUE

B. FALSE

FALSE

Myeloblasts are myeloperoxidase negative

Lymphoblasts are myeloperoxidase positive

A. TRUE

B. FALSE

TRUE

Most cases in hairy cell leukemia lack both CD10 and CD5.

TRUE or FALSE

Periodic acid-Schiff (PAS) stain

In Acute Lymphoblastic Leukemia (ALL), which stain is typically positive and corresponds to glycogen deposits in the cytoplasm?

A. Wright stain

B. Periodic acid-Schiff (PAS) stain

C. Gram stain

D. Giemsa stain

Oil Red O Stain

Which of the following stains is used to identify vacuoles in blasts of ALL-L3?

A. Wright stain

B. Oil Red O stain

C. Hematoxylin and eosin stain

D. Sudan Black B stain

Presence of lipids

What does a positive Oil Red O stain indicate in blasts of ALL-L3?

A. Presence of lipids

B. Presence of glycogen

C. Increased neutrophil count

D. Reduced platelet count

Bone marrow lymphoid cells

Terminal Deoxynucleotidyl Transferase (TdT) is a unique DNA polymerase found in:

A. Bone marrow erythroid cells

B. Bone marrow myeloid cells

C. Bone marrow lymphoid cells

D. Bone marrow megakaryocytes

Its presence is indicative of ALL

Which of the following statements about TdT is true?

A. It is commonly found in all bone marrow cells

B. It is associated with the myeloid lineage

C. Its presence is indicative of ALL

D. It is primarily found in mature lymphocytes

TRUE

TRUE or FALSE:

Occasionally, a lymphoma can develop into a leukemia when the cells of the diseased organ spreads to the bone marrow and then to the blood.

Acute Lymphoblastic Leukemia

Is a systemic, neoplastic proliferation of lymphoblasts originating in lymphocyte progenitor cells of the bone marrow or thymus.

TRUE

TRUE or FALSE:

ALL is the most common type of leukemia in pediatric patients.

blood cytopenias

The presenting signs and symptoms are similar to those of acute myeloid leukemia (AML) and are usually related to _______________.

FALSE

TRUE or FALSE:

T-cell ALL and B-cell ALL are differentiated primarily by flow cytometry.

L1

Cell size: Small cells predominate

L2

Nuclear shape: Irregular; clefting and indentation common

L3

Nuclear chromatin: Finely stippled and homogeneous

L1

Nucleoli: Not visible, or small and inconspicuous

L3

Cell size: Medium to large and homogeneous

L2

Amount of cytoplasm: Variable; often moderately abundant

Presence of extramedullary tissue involvement

What factor is NOT associated with a poor prognosis in ALL?

A. Patient's age at diagnosis

B. Immunophenotype

C. Tumor burden

D. Presence of extramedullary tissue involvement

≥5 x 109 /L

In CLL/SLL, what is the minimum requirement for the presence of monoclonal lymphocytes in the peripheral blood?

A. ≥10 x 109 /L

B. ≥5 x 109 /L

C. ≥20 x 109 /L

D. ≥30 x 109 /L

Large, irregularly shaped cells with abundant cytoplasm

Which of the following characteristics is typically NOT seen in the peripheral blood smears of CLL patients?

A. Small lymphocytes with clumped chromatin

B. Scanty cytoplasm

C. Presence of smudge cells

D. Large, irregularly shaped cells with abundant cytoplasm

Chronic lymphocytic leukemia

What is the most common leukemia of adults in Western countries?

A. Hairy cell leukemia

B. Acute lymphoblastic leukemia

C. Chronic lymphocytic leukemia

D. Chronic myeloid leukemia

Hairy cell leukemia

A neoplasm of small mature B lymphoid cells with oval

nuclei and abundant cytoplasm with "hairy" projections

A. Hairy cell leukemia

B. Acute lymphoblastic leukemia

C. Chronic lymphocytic leukemia

D. Chronic myeloid leukemia

TRUE

Smudge cells or basket cells are typically seen in PB

smears of CLL patients.

A. TRUE

B. FALSE