Neoplastic proliferation arising from white blood cells. Introductory remarks. Classification

Size: px
Start display at page:

Download "Neoplastic proliferation arising from white blood cells. Introductory remarks. Classification"

Transcription

1 Neoplastic proliferation arising from white blood cells Lymphoproliferative and myeloproliferative diseases and syndromes Oliver Rácz, Introductory remarks Leukemia and lymphoma are old descriptive terms On the other side the new classification is also descriptive and not fully rational. High number of subtypes in most group. Typisation is based on new knowledge histology, surface antigens (imunochemistry, flow cytometry) and genetics Not without purpose different treatment regimes 2 Classification LYMPHOID NEOPLASMS Hodgkin, non-hodgkin ALL, CLL CHAOS TILL 1994 REAL, 1997 WHO Immunochemical and genetic characteristics MYELOID NEOPLASMS Acute AML Chronic CML Myelodysplastic syndromes 3 1

2 LYMPHOID NEOPLASMS, B;T; HODGKIN 1. Precursor B cell neoplasms (1) 2. Peripheral B cell neoplasms (12) why? Hairy cell leukemia, plasmocytoma, Burkitt lymphoma 3. Precursor T cell neoplasms (1) 4. Peripheral T and NK cell neoplasms (12) why? 5. Hodgkin lymphoma (5 subtypes) 4 LYMPHOID NEOPLASMS, B;T; HODGKIN 1. Precursor B cell neoplasms (1) 2. Peripheral B cell neoplasms (12) why? Hairy cell leukemia, plasmocytoma, Burkitt lymphoma 3. Precursor T cell neoplasms (1) 4. Peripheral T and NK cell neoplasms (12) why? WHY 1:12? There is only one precursor but many development stages 5 6 2

3 LYMPHOID NEOPLASMS, B;T; HODGKIN 1. Precursor B cell neoplasms (1) NHL 2. Peripheral B cell neoplasms (12) NHL 3. Precursor T cell neoplasms (1) NHL 4. Peripheral T and NK cell neoplasms (12) NHL 5. Hodgkin lymphoma (5 subtypes) HL CLINICAL PICTURE NODAL ENLARGEMENT IN 80% NHL, ALL HL SUPRESSION OF NORMAL HEMATOPOIESIS SPLEEN AND LIVER INFILTRATION IMMUNE SYSTEM DYSFUNCTION SPECIFIC OR also NOTHING 7 LYMPHOID NEOPLASMS, B;T; HODGKIN 1. Precursor B cell neoplasms (1) NHL 2. Peripheral B cell neoplasms (12) NHL 3. Precursor T cell neoplasms (1) NHL 4. Peripheral T and NK cell neoplasms (12) NHL 5. Hodgkin lymphoma (5 subtypes) HL LABORATORY PICTURE PERIPHERAL BLOOD NEOPLASM BIOPSY ANTIGEN RECEPTORS AND OTHER SURFACE PROTEINS (CD1 79) PRESENT ALSO ON NORMAL CELLS FLOW CYTOMETRY CHROMOSOME AND GENE ANALYSIS 8 Hodgkin: Reed-Sternberg cells 9 3

4 Hodgkin: Reed-Sternberg cells Size between microns; Amphofilic, finely granular/homogenous cytoplasm; Two mirror-image nuclei ("owl eyes") each with an eosinophilic nucleolus and a thick nuclear membrane (chromatin is distributed on the inner surface of the nuclear membrane, generating a halo image around the nucleolus). 10 Hodgkin: Clinical picture 5 subtypes according Ly morphology and tumor histology, 1 4 is the same, 5 (nodular lymphocyte predominant Hodgkin disease; NLPHD) is a separate disease Enlargement of one ore more lymphatic nodes, without pain, mostly in the cervical or mediastinal region Fever, sweat, quiver, weight loss (or no) Later dissemination to other organs 11 The Reed-Sternberg cells affect the immune system! 12 4

5 Non-Hodgkins: More frequent B >> T (80-85 vs %) Associated with (cause???) Epstein Barr virus (Africa, Burkitt) HTLV human T-cell Lymphotropic (Japan) HIV Posttransplantation (immunosupression?) Helicobacter MALT lymphoma? 13 Non-Hodgkins B >> T (80-85 vs %) V(D)J recombinations and regulated somatic hypermutations higher possibility of mistakes 14 Non-Hodgkins: Symptoms, prognosis More generalized as HL Enlarged L.N., no pain Many types, for general medicine is enough Low grade Aggressive Very aggressive (but radio-chemosenzitive) During disease the aggresivity can increase Therapy with monoclonal antibodies rituximab against CD20 (B) with 90 Y Transplantation of stem cells or bone marrow 15 5

6 Lymphoid and myeloid leukemias ABNORMAL PROLIFERATION OF CELLS, CIRCULATING IN BLOOD, INFILTRATING ORGANS IN AGE 1 14 YEARS LEADING CAUSE OFMORTALITY, DESPITE THE FACT THAT LEUKÉMIA IS 10-TIMES MORE REQUENT IN ADULTS ALL children, 2 4 y. CLL older, m > w AML adults CML 30 50, and also children 16 Etiology in general Radiation Hiroshima, Tchernobyl and? Aromatic substances Antitumor drugs!!! Down (RR 10), Recklinghausen, Fanconi, Bloom > 500 different translocations and other chromosomal aberrations (Philadelphia) 17 Philadelphia chromosome, chronic myeloid leukemia (CML) 9 22 bcr abl-bcr hybrid gene p210 tyrosinkinase with increased activity abl 18 6

7 Neurofibromatosis 1 Recklinghausen (and Genersich) Tumor supressor gene on 17th ch. (NF1) Risk of other malignities, too AD, 1/ Acute lymphatic leukemia Children, boys > girls Whites > nonwhites (2x) preb > > pret, B earlier, T later Blood cell morphology makes possible differential dg ofall and AML, further immunophenotypisation Chromosomes: hyperploidia (> 50), polyploidia, Philadelphia and other translocations Microchip technology specific patterns of abnormal gene expression 20 Symptoms (common for ALL, AML) Rapid onset of symptoms (weeks) Anaemia, fatigue, fever, bleeding Bone pain Generalised lymphadenopatia, splenomegaly, hepatomegaly ALL > AML, sometimes testes (ALL) Headache, cramps (ALL) THE PROGNOSIS IS IMPROVING 21 7

8 Chronic lymphatic leukemia, CLL Most frequent from all Manifestation in age over 50, M > W Ly > 4000/µl, sometimes /µl Prolymphocytes in LN, high number of mitoses In blood small Ly, small amount of cytoplazma, fragile smudge cells. Ly in bone marrow and other tissues Special immunophenotype Low number of chromosomal abnormalities Often asymptomatic Danger of increase in degree of malignancy 22 Myeloid neoplasma types in general From developmemtal stages of these cells Less infiltrate spleen, liver and L.N. AML cells are nondifferentiated, haematopoesis blocked CML differentiated cells Myelodysplastic syndromes Danger of transformation towards more agressive forms 23 AML Mostly in young adults The maturation is blocked!!! Blasts /µl Frequent chromosomal aberrations (up to 90 % with modern technology) The prognosis is not very good 24 8

9 AML Classification M0 M7, mostly 1 and 2, AML without and with maturation, but also erytro... (M6) a megakaryo... (M7) M3 often associated with DIC (acute promyelocyte L) WHO classification according to chromosomal aberrations 25 Symptoms (common for ALL, AML) Rapid onset of symptoms (weeks) Anaemia, fatigue, fever, bleeding Bone pain Generalised lymphadenopatia, splenomegaly, hepatomegaly ALL > AML, sometimes testes (ALL) Headache, cramps (ALL) THE PROGNOSIS IS IMPROVING 26 Chronic myeloid leukemia, CML Philadelphia chromosome in 90 %, with special methods the hybrid gene can be identified also in the remaining 10 % Uncontrolled proliferation of cells, inhibition of apoptosis Bone marrow is 100 % cellular (n: 50%) Peripheral blood up to granulocytes, myelocytes, metamyelocytes Often high number of eosinophiles and bazophiles Thrombocytosis Extramedullan haematopoesis 27 9

10 Chronic myeloid leukemia, CML Slow nonspecific onset Fatigue, anorexia, weight loss Splenomegaly Cca after 3 years often acceleration New chromosomal abnormalities Blast crises Therapy: Inhibition of BCR-ABL kinase Bone marrow transplantation 28 Myelodysplastic syndromes Pimary or in association with the therapy of other leukemias After 60 Ineffective and abnormal haematopoesis, apoptosis Pancytopenia Transformation into AML 29 Other Polycytaemia vera Also platelets increased, ht up to 60 Flebotomy as therapy Essencial thrombocytosis (up to ) Primary myelofibrosis cytopenia and compensatory extramedullar haematopoesis 30 10

11 31 References Robbins Cotran: Pathologic basis of disease, 7th Ed. (Kumar-Abbas-Fausto) Elsevier 2005 Aster: Diseases of white blood cells Porth: Essentials of Pathophysiology, 2nd Ed., Lippincott 2007 Gaspard: Disorders of white blood cells and lymphoid tissues 32 11

CHAPTER:4 LEUKEMIA. BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY 8/12/2009

CHAPTER:4 LEUKEMIA. BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY 8/12/2009 LEUKEMIA CHAPTER:4 1 BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY Leukemia A group of malignant disorders affecting the blood and blood-forming tissues of

More information

WBCs Disorders 1. Dr. Nabila Hamdi MD, PhD

WBCs Disorders 1. Dr. Nabila Hamdi MD, PhD WBCs Disorders 1 Dr. Nabila Hamdi MD, PhD ILOs Compare and contrast ALL, AML, CLL, CML in terms of age distribution, cytogenetics, morphology, immunophenotyping, laboratory diagnosis clinical features

More information

Non-Hodgkin lymphomas (NHLs) Hodgkin lymphoma )HL)

Non-Hodgkin lymphomas (NHLs) Hodgkin lymphoma )HL) Non-Hodgkin lymphomas (NHLs) Hodgkin lymphoma )HL) Lymphoid Neoplasms: 1- non-hodgkin lymphomas (NHLs) 2- Hodgkin lymphoma 3- plasma cell neoplasms Non-Hodgkin lymphomas (NHLs) Acute Lymphoblastic Leukemia/Lymphoma

More information

7 Omar Abu Reesh. Dr. Ahmad Mansour Dr. Ahmad Mansour

7 Omar Abu Reesh. Dr. Ahmad Mansour Dr. Ahmad Mansour 7 Omar Abu Reesh Dr. Ahmad Mansour Dr. Ahmad Mansour -Leukemia: neoplastic leukocytes circulating in the peripheral bloodstream. -Lymphoma: a neoplastic process in the lymph nodes, spleen or other lymphatic

More information

Lymphoma: What You Need to Know. Richard van der Jagt MD, FRCPC

Lymphoma: What You Need to Know. Richard van der Jagt MD, FRCPC Lymphoma: What You Need to Know Richard van der Jagt MD, FRCPC Overview Concepts, classification, biology Epidemiology Clinical presentation Diagnosis Staging Three important types of lymphoma Conceptualizing

More information

Pathology of Hematopoietic and Lymphoid tissue

Pathology of Hematopoietic and Lymphoid tissue CONTENTS Pathology of Hematopoietic and Lymphoid tissue White blood cells and lymph nodes Quantitative disorder of white blood cells Reactive lymphadenopathies Infectious lymphadenitis Tumor metastasis

More information

HAEMATOLOGICAL MALIGNANCY

HAEMATOLOGICAL MALIGNANCY HAEMATOLOGICAL MALIGNANCY Reference Compulsory reading Haematology at Glance 2 nd ed. Atul Mehta & Victor Hoffbrand Chapters: 20 to 31 Pages: 46 to 69 Pathogenesis of Haematological Malignancy Figure (a)

More information

Pathology of Hematopoietic and Lymphoid tissue

Pathology of Hematopoietic and Lymphoid tissue Pathology of Hematopoietic and Lymphoid tissue Peerayut Sitthichaiyakul, M.D. Department of Pathology and Forensic Medicine Faculty of Medicine, Naresuan University CONTENTS White blood cells and lymph

More information

Myeloid neoplasms. Early arrest in the blast cell or immature cell "we call it acute leukemia" Myoid neoplasm divided in to 3 major categories:

Myeloid neoplasms. Early arrest in the blast cell or immature cell we call it acute leukemia Myoid neoplasm divided in to 3 major categories: Myeloid neoplasms Note: Early arrest in the blast cell or immature cell "we call it acute leukemia" Myoid neoplasm divided in to 3 major categories: 1. AML : Acute myeloid leukemia(stem cell with myeloid

More information

Heme 9 Myeloid neoplasms

Heme 9 Myeloid neoplasms Heme 9 Myeloid neoplasms The minimum number of blasts to diagnose acute myeloid leukemia is 5% 10% 20% 50% 80% AML with the best prognosis is AML with recurrent cytogenetic abnormality AML with myelodysplasia

More information

Pathology. #11 Acute Leukemias. Farah Banyhany. Dr. Sohaib Al- Khatib 23/2/16

Pathology. #11 Acute Leukemias. Farah Banyhany. Dr. Sohaib Al- Khatib 23/2/16 35 Pathology #11 Acute Leukemias Farah Banyhany Dr. Sohaib Al- Khatib 23/2/16 1 Salam First of all, this tafreegh is NOT as long as you may think. If you just focus while studying this, everything will

More information

What is a hematological malignancy? Hematology and Hematologic Malignancies. Etiology of hematological malignancies. Leukemias

What is a hematological malignancy? Hematology and Hematologic Malignancies. Etiology of hematological malignancies. Leukemias Hematology and Hematologic Malignancies Cancer of the formed elements of the blood What is a hematological malignancy? A hematologic malignancy is a malignancy (or cancer) of any of the formed elements

More information

Done By : WESSEN ADNAN BUTHAINAH AL-MASAEED

Done By : WESSEN ADNAN BUTHAINAH AL-MASAEED Done By : WESSEN ADNAN BUTHAINAH AL-MASAEED Acute Myeloid Leukemia Firstly we ll start with this introduction then enter the title of the lecture, so be ready and let s begin by the name of Allah : We

More information

Myelodysplastic syndrome (MDS) & Myeloproliferative neoplasms

Myelodysplastic syndrome (MDS) & Myeloproliferative neoplasms Myelodysplastic syndrome (MDS) & Myeloproliferative neoplasms Myelodysplastic syndrome (MDS) A multipotent stem cell that can differentiate into any of the myeloid lineage cells (RBCs, granulocytes, megakaryocytes)

More information

LEUKAEMIA and LYMPHOMA. Dr Mubarak Abdelrahman Assistant Professor Jazan University

LEUKAEMIA and LYMPHOMA. Dr Mubarak Abdelrahman Assistant Professor Jazan University LEUKAEMIA and LYMPHOMA Dr Mubarak Abdelrahman Assistant Professor Jazan University OBJECTIVES Identify etiology and epidemiology for leukemia and lymphoma. Discuss common types of leukemia. Distinguish

More information

WBCs Disorders. Dr. Nabila Hamdi MD, PhD

WBCs Disorders. Dr. Nabila Hamdi MD, PhD WBCs Disorders Dr. Nabila Hamdi MD, PhD ILOs Compare and contrast ALL, AML, CLL, CML in terms of age distribution, cytogenetics, morphology, immunophenotyping, laboratory diagnosis clinical features and

More information

Bone marrow aspiration as the initial diagnostic tool in the diagnosis of leukemia - A case study

Bone marrow aspiration as the initial diagnostic tool in the diagnosis of leukemia - A case study Original Research Article Bone marrow aspiration as the initial diagnostic tool in the diagnosis of leukemia - A case study Priyanka Poonam 1*, N.K. Bariar 2 1 Tutor, Department of Pathology, Patna Medical

More information

HENATOLYMPHOID SYSTEM THIRD YEAR MEDICAL STUDENTS- UNIVERSITY OF JORDAN AHMAD T. MANSOUR, MD. Part 4 MYELOID NEOPLASMS

HENATOLYMPHOID SYSTEM THIRD YEAR MEDICAL STUDENTS- UNIVERSITY OF JORDAN AHMAD T. MANSOUR, MD. Part 4 MYELOID NEOPLASMS HENATOLYMPHOID SYSTEM THIRD YEAR MEDICAL STUDENTS- UNIVERSITY OF JORDAN AHMAD T. MANSOUR, MD Part 4 MYELOID NEOPLASMS Introduction: o Myeloid neoplasms are divided into three major categories: o Acute

More information

Myelodysplastic Syndromes Myeloproliferative Disorders

Myelodysplastic Syndromes Myeloproliferative Disorders Myelodysplastic Syndromes Myeloproliferative Disorders Myelodysplastic Syndromes characterized by maturation defects that are associated with ineffective hematopoiesis and a high risk of transformation

More information

MECHANISMS OF HUMAN DISEASE: LABORATORY SESSIONS LYMPHOMA. April 16, 2008

MECHANISMS OF HUMAN DISEASE: LABORATORY SESSIONS LYMPHOMA. April 16, 2008 MECHANISMS OF HUMAN DISEASE: LABORATORY SESSIONS LYMPHOMA April 16, 2008 FACULTY COPY GOAL: Learn the appearance of normal peripheral blood elements and lymph nodes. Recognize abnormal peripheral blood

More information

Disclosures. Myeloproliferative Neoplasms: A Case-Based Approach. Objectives. Myeloproliferative Neoplasms. Myeloproliferative Neoplasms

Disclosures. Myeloproliferative Neoplasms: A Case-Based Approach. Objectives. Myeloproliferative Neoplasms. Myeloproliferative Neoplasms Myeloproliferative Neoplasms: A Case-Based Approach Disclosures No conflicts of interests regarding the topic being presented Adam M. Miller, MD PGY-4 Resident Physician Department of Pathology and Laboratory

More information

Lymphatic System Disorders

Lymphatic System Disorders Lymphatic System Disorders Lymphomas Malignant neoplasms involving lymphocyte proliferation in lymph nodes Specific causes not identified // Higher risk in adults who received radiation during childhood

More information

Group of malignant disorders of the hematopoietic tissues characteristically associated with increased numbers of white cells in the bone marrow and

Group of malignant disorders of the hematopoietic tissues characteristically associated with increased numbers of white cells in the bone marrow and Group of malignant disorders of the hematopoietic tissues characteristically associated with increased numbers of white cells in the bone marrow and / or peripheral blood Classified based on cell type

More information

Classification of Hematologic Malignancies. Patricia Aoun MD MPH

Classification of Hematologic Malignancies. Patricia Aoun MD MPH Classification of Hematologic Malignancies Patricia Aoun MD MPH Objectives Know the basic principles of the current classification system for hematopoietic and lymphoid malignancies Understand the differences

More information

Pathology #07. Hussein Al-Sa di. Dr. Sohaib Al-Khatib. Mature B-Cell Neoplasm. 0 P a g e

Pathology #07. Hussein Al-Sa di. Dr. Sohaib Al-Khatib. Mature B-Cell Neoplasm. 0 P a g e Pathology #07 Mature B-Cell Neoplasm Hussein Al-Sa di Dr. Sohaib Al-Khatib 0 P a g e Thursday 18/2/2016 Our lecture today (with the next 2 lectures) will be about lymphoid tumors This is a little bit long

More information

Leukemia and Myelodysplastic Syndromes

Leukemia and Myelodysplastic Syndromes Leukemia and Myelodysplastic Syndromes Lenise Taylor, RN, MN, AOCNS Heme Malignancies/BMT CNS Seattle Cancer Care Alliance/UWMC Lymphoid 1 Myeloid 2 Presenting Signs and Symptoms Diagnostic Evaluation

More information

Myeloproliferative Disorders - D Savage - 9 Jan 2002

Myeloproliferative Disorders - D Savage - 9 Jan 2002 Disease Usual phenotype acute leukemia precursor chronic leukemia low grade lymphoma myeloma differentiated Total WBC > 60 leukemoid reaction acute leukemia Blast Pro Myel Meta Band Seg Lymph 0 0 0 2

More information

Low grade High grade , immune suppression chronic persistent inflammation viruses B-symptoms

Low grade High grade , immune suppression chronic persistent inflammation viruses B-symptoms We've one category for lymphoid neoplasm which is the lymphoma in contrast to that of myeloid which has three categories; acute myeloid leukemias, myeloproliferative & myelodysplastic disorders. Lymphoma

More information

Differential diagnosis of hematolymphoid tumors composed of medium-sized cells. Brian Skinnider B.C. Cancer Agency, Vancouver General Hospital

Differential diagnosis of hematolymphoid tumors composed of medium-sized cells. Brian Skinnider B.C. Cancer Agency, Vancouver General Hospital Differential diagnosis of hematolymphoid tumors composed of medium-sized cells Brian Skinnider B.C. Cancer Agency, Vancouver General Hospital Lymphoma classification Lymphoma diagnosis starts with morphologic

More information

Molecular Pathology of Lymphoma (Part 1) Rex K.H. Au-Yeung Department of Pathology, HKU

Molecular Pathology of Lymphoma (Part 1) Rex K.H. Au-Yeung Department of Pathology, HKU Molecular Pathology of Lymphoma (Part 1) Rex K.H. Au-Yeung Department of Pathology, HKU Lecture outline Time 10:00 11:00 11:15 12:10 12:20 13:15 Content Introduction to lymphoma Review of lymphocyte biology

More information

Hematology Unit Lab 2 Review Material

Hematology Unit Lab 2 Review Material Objectives Hematology Unit Lab 2 Review Material - 2018 Laboratory Instructors: 1. Assist students during lab session Students: 1. Review the introductory material 2. Study the case histories provided

More information

MYELOPROLIFARATIVE NEOPLASMS. Dr. Hasan Fahmawi, MRCP(UK), FRCP(Edin).

MYELOPROLIFARATIVE NEOPLASMS. Dr. Hasan Fahmawi, MRCP(UK), FRCP(Edin). MYELOPROLIFARATIVE NEOPLASMS Dr. Hasan Fahmawi, MRCP(UK), FRCP(Edin). These are a group of chronic conditions characterised by clonal proliferation of marrow precursor cells. PRV, essential thrombocyathaemia,

More information

Hematopathology Lab. Third year medical students

Hematopathology Lab. Third year medical students Hematopathology Lab Third year medical students Objectives Identify the lesion Know the specific name of the lesion Know associated disease Know relevant pathologic background Spherocytes: appear small,

More information

BIOS222 Pathology and Clinical Science 2

BIOS222 Pathology and Clinical Science 2 BIOS222 Pathology and Clinical Science 2 Session 5 Lymphatic and Haematological Disorders 3 Bioscience Department www.endeavour.edu.au Session Learning Outcomes At the end of the session, you should be

More information

The Lymphomas. An overview..

The Lymphomas. An overview.. The Lymphomas An overview.. Peter Anglin MD, FRCPC, MBA Stronach Regional Cancer Centre Newmarket, ON The lymphomas are an important part of the history of medicine 1666 Magpighi publishes first recorded

More information

2013 Pathology Student

2013 Pathology Student About this guide If you re reading this introduction, it means you are probably either a) covering hematopathology in your pathology class right now, or b) studying for boards. Either way, you ve come

More information

Chronic Idiopathic Myelofibrosis (CIMF)

Chronic Idiopathic Myelofibrosis (CIMF) Chronic Idiopathic Myelofibrosis (CIMF) CIMF Synonyms Agnogenic myeloid metaplasia Myelosclerosis with myeloid metaplasia Chronic granulocytic-megakaryocytic myelosis CIMF Megakaryocytic proliferation

More information

Instructions for Chronic Lymphocytic Leukemia Post-HSCT Data (Form 2113)

Instructions for Chronic Lymphocytic Leukemia Post-HSCT Data (Form 2113) Instructions for Chronic Lymphocytic Leukemia Post-HSCT Data (Form 2113) This section of the CIBMTR Forms Instruction Manual is intended to be a resource for completing the CLL Post-HSCT Data Form. E-mail

More information

Leukemias. Prof. Mutti Ullah Khan Head of Department Medical Unit-II Holy Family Hospital Rawalpindi Medical College

Leukemias. Prof. Mutti Ullah Khan Head of Department Medical Unit-II Holy Family Hospital Rawalpindi Medical College Leukemias Prof. Mutti Ullah Khan Head of Department Medical Unit-II Holy Family Hospital Rawalpindi Medical College Introduction Leukaemias are malignant disorders of the haematopoietic stem cell compartment,

More information

Large cell immunoblastic Diffuse histiocytic (DHL) Lymphoblastic lymphoma Diffuse lymphoblastic Small non cleaved cell Burkitt s Non- Burkitt s

Large cell immunoblastic Diffuse histiocytic (DHL) Lymphoblastic lymphoma Diffuse lymphoblastic Small non cleaved cell Burkitt s Non- Burkitt s Non Hodgkin s Lymphoma Introduction 6th most common cause of cancer death in United States. Increasing in incidence and mortality. Since 1970, the incidence of has almost doubled. Overview The types of

More information

Bone Marrow. Procedures Blood Film Aspirate, Cell Block Trephine Biopsy, Touch Imprint

Bone Marrow. Procedures Blood Film Aspirate, Cell Block Trephine Biopsy, Touch Imprint Bone Marrow Protocol applies to acute leukemias, myelodysplastic syndromes, myeloproliferative disorders, chronic lymphoproliferative disorders, malignant lymphomas, plasma cell dyscrasias, histiocytic

More information

Disclosures/COI. Cases in Hematopathology. Outline. Heme Path Findings Not to Miss. Normal Peripheral Smear 6/30/2016

Disclosures/COI. Cases in Hematopathology. Outline. Heme Path Findings Not to Miss. Normal Peripheral Smear 6/30/2016 Disclosures/COI Cases in Hematopathology Vamsi Kota Assistant Professor Department of Hematology & Medical Oncology Leukemia/BMT I have no disclosures or conflicts of interest regarding this presentation.

More information

1 Introduction. 1.1 Cancer. Introduction

1 Introduction. 1.1 Cancer. Introduction Introduction 1 1.1 Cancer 1 Introduction Cancer is the most precarious disease characterized by uncontrolled proliferation of cells without any physiological demands of the organism. Cancer may be defined

More information

HEMATOLOGIC MALIGNANCIES BIOLOGY

HEMATOLOGIC MALIGNANCIES BIOLOGY HEMATOLOGIC MALIGNANCIES BIOLOGY Failure of terminal differentiation Failure of differentiated cells to undergo apoptosis Failure to control growth Neoplastic stem cell FAILURE OF TERMINAL DIFFERENTIATION

More information

Leukemias and Lymphomas Come From Normal Blood Cells

Leukemias and Lymphomas Come From Normal Blood Cells Leukemias and Lymphomas Come From Normal Blood Cells by Steve Anderson, Ph.D. Steve Anderson has a Ph.D. in Immunology with 25 years experience in biomedical research. His scientific expertise includes

More information

2010 Hematopoietic and Lymphoid ICD-O Codes - Alphabetical List THIS TABLE REPLACES ALL ICD-O-3 Codes

2010 Hematopoietic and Lymphoid ICD-O Codes - Alphabetical List THIS TABLE REPLACES ALL ICD-O-3 Codes Acute basophilic leukemia 9870/3 Acute biphenotypic leukemia [OBS] 9805/3 Acute erythroid leukemia 9840/3 Acute megakaryoblastic leukemia 9910/3 Acute monoblastic and monocytic leukemia 9891/3 Acute myeloid

More information

2012 Hematopoietic and Lymphoid ICD-O Codes - Numerical List THIS TABLE REPLACES ALL ICD-O-3 Codes

2012 Hematopoietic and Lymphoid ICD-O Codes - Numerical List THIS TABLE REPLACES ALL ICD-O-3 Codes Malignant lymphoma, NOS 9590/3 Non-Hodgkin lymphoma, NOS 9591/3 B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma 9596/3 Primary

More information

Lymphoma/CLL 101: Know your Subtype. Dr. David Macdonald Hematologist, The Ottawa Hospital

Lymphoma/CLL 101: Know your Subtype. Dr. David Macdonald Hematologist, The Ottawa Hospital Lymphoma/CLL 101: Know your Subtype Dr. David Macdonald Hematologist, The Ottawa Hospital Function of the Lymph System Lymph Node Lymphocytes B-cells develop in the bone marrow and influence the immune

More information

Easy Trick to Spot Leukemia for Pediatricians

Easy Trick to Spot Leukemia for Pediatricians Easy Trick to Spot Leukemia for Pediatricians Piya Rujkijyanont, MD Division of Hematology-Oncology Department of Pediatrics Phramongkutklao Hospital Most Common Pediatric Cancers Age 0-14 Leukemia 32%

More information

HENATOLYMPHOID SYSTEM THIRD YEAR MEDICAL STUDENTS- UNIVERSITY OF JORDAN AHMAD T. MANSOUR, MD. Parts 2 and 3

HENATOLYMPHOID SYSTEM THIRD YEAR MEDICAL STUDENTS- UNIVERSITY OF JORDAN AHMAD T. MANSOUR, MD. Parts 2 and 3 HENATOLYMPHOID SYSTEM THIRD YEAR MEDICAL STUDENTS- UNIVERSITY OF JORDAN AHMAD T. MANSOUR, MD Parts 2 and 3 NEOPLASTIC LYMPHOID DISEASES Introduction o The bone marrow is the source of all cells in the

More information

Flow Cytometry. Leukemia and Myelodysplastic Syndromes. Bone Marrow Aspirate and Biopsy

Flow Cytometry. Leukemia and Myelodysplastic Syndromes. Bone Marrow Aspirate and Biopsy Diagnostic Evaluation of Blood Disorders Leukemia and Myelodysplastic Syndromes Lenise Taylor, MN, RN, AOCNS, BMTCN BMT/Immunotherapy CNS Seattle Cancer Care Alliance/UWMC ltaylor@seattlecca.org History

More information

Recommended Timing for Transplant Consultation

Recommended Timing for Transplant Consultation REFERRAL GUIDELINES Recommended Timing for Transplant Consultation Published jointly by the National Marrow Donor Program /Be The Match and the American Society for Blood and Marrow Transplantation BeTheMatchClinical.org

More information

Lymphatic system component

Lymphatic system component Introduction Lymphatic system component Statistics Overview Lymphoma Non Hodgkin s Lymphoma Non- Hodgkin's is a type of cancer that originates in the lymphatic system. It is estimated to be the sixth most

More information

Prepared by: Dr.Mansour Al-Yazji

Prepared by: Dr.Mansour Al-Yazji C L L CLL Prepared by: Abd El-Hakeem Abd El-Rahman Abu Naser Ahmed Khamis Abu Warda Ahmed Mohammed Abu Ghaben Bassel Ziad Abu Warda Nedal Mostafa El-Nahhal Dr.Mansour Al-Yazji LEUKEMIA Leukemia is a form

More information

Corrigenda. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (revised 4th edition): corrections made in second print run

Corrigenda. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (revised 4th edition): corrections made in second print run Corrigenda WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (revised 4th edition): corrections made in second print run In addition to corrections of minor typographical errors, corrections

More information

ADx Bone Marrow Report. Patient Information Referring Physician Specimen Information

ADx Bone Marrow Report. Patient Information Referring Physician Specimen Information ADx Bone Marrow Report Patient Information Referring Physician Specimen Information Patient Name: Specimen: Bone Marrow Site: Left iliac Physician: Accession #: ID#: Reported: 08/19/2014 - CHRONIC MYELOGENOUS

More information

The spectrum of flow cytometry of the bone marrow

The spectrum of flow cytometry of the bone marrow The spectrum of flow cytometry of the bone marrow Anna Porwit Lund University Faculty of Medicine Dept. of Clinical Sciences Div. Oncology and Pathology anna.porwit@med.lu.se Disclosure of speaker s interests

More information

Leukocytosis - Some Learning Points

Leukocytosis - Some Learning Points Leukocytosis - Some Learning Points Koh Liang Piu Department of Hematology-Oncology National University Cancer Institute National University Health System Objectives of this talk: 1. To provide some useful

More information

The primary medical content categories of the blueprint are shown below, with the percentage assigned to each for a typical exam:

The primary medical content categories of the blueprint are shown below, with the percentage assigned to each for a typical exam: Hematology Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the certified hematologist

More information

Flow Cytometry. Bone Marrow Aspirate and Biopsy. Leukemia and Myelodysplastic Syndromes

Flow Cytometry. Bone Marrow Aspirate and Biopsy. Leukemia and Myelodysplastic Syndromes Diagnostic Evaluation of Blood Disorders Leukemia and Myelodysplastic Syndromes Elise Frans, MN, RN, CWON Oncology CNS University of Washington Medical Center delterzo@uw.edu 1 History & Physical Labs:

More information

BLASTIC CRISIS AND MYELOFIBROSIS SIMULTANEOUS COMPLICATIONS IN A CASE OF CHRONIC MYELOCYTIC LEUKEMIA

BLASTIC CRISIS AND MYELOFIBROSIS SIMULTANEOUS COMPLICATIONS IN A CASE OF CHRONIC MYELOCYTIC LEUKEMIA BLASTIC CRISIS AND MYELOFIBROSIS SIMULTANEOUS COMPLICATIONS IN A CASE OF CHRONIC MYELOCYTIC LEUKEMIA Abstract Pages with reference to book, From 151 To 153 Khalid Hassan ( Department of Pathology (Haematology)

More information

Blood Cancers. Blood Cells. Blood Cancers: Progress and Promise. Bone Marrow and Blood. Lymph Nodes and Spleen

Blood Cancers. Blood Cells. Blood Cancers: Progress and Promise. Bone Marrow and Blood. Lymph Nodes and Spleen Blood Cancers: Progress and Promise Mike Barnett & Khaled Ramadan Division of Hematology Department of Medicine Providence Health Care & UBC Blood Cancers Significant health problem Arise from normal cells

More information

Lymphoma: The Basics. Dr. Douglas Stewart

Lymphoma: The Basics. Dr. Douglas Stewart Lymphoma: The Basics Dr. Douglas Stewart Objectives What is lymphoma? How common is it? Why does it occur? How do you diagnose it? How do you manage it? How do you follow patients after treatment? What

More information

The patient had a mild splenomegaly but no obvious lymph node enlargement. The consensus phenotype obtained from part one of the exercise was:

The patient had a mild splenomegaly but no obvious lymph node enlargement. The consensus phenotype obtained from part one of the exercise was: Case History An 86 year old male was admitted to hospital with chest infection. Haematological examination subsequently revealed the following: Hb- 11.0 g/dl; WBC- 67.1 x 10^9/l; PLT- 99 x10^9/l; RBC-

More information

Hematopathology Case Study

Hematopathology Case Study Hematopathology Case Study AMP Outreach Course 2009 AMP Annual Meeting John Greg Howe Ph.D. Department of Laboratory Medicine Yale University School of Medicine November 19, 2009 HISTORY Case History An

More information

a resource for physicians Recommended Referral Timing for Stem Cell Transplant Evaluation

a resource for physicians Recommended Referral Timing for Stem Cell Transplant Evaluation a resource for physicians Recommended Referral Timing for Stem Cell Transplant Evaluation This resource has been developed to help guide you regarding the appropriate timing and conditions for a referral

More information

Blood Cancer: Chronic Myelogenous Leukaemia

Blood Cancer: Chronic Myelogenous Leukaemia Published on: 30 May 2017 Blood Cancer: Chronic Myelogenous Leukaemia What Is Cancer? The body is made up of cells that grow and die in a controlled way. Sometimes, cells keep dividing and growing without

More information

SWOG ONCOLOGY RESEARCH PROFESSIONAL (ORP) MANUAL LEUKEMIA FORMS CHAPTER 16A REVISED: DECEMBER 2017

SWOG ONCOLOGY RESEARCH PROFESSIONAL (ORP) MANUAL LEUKEMIA FORMS CHAPTER 16A REVISED: DECEMBER 2017 LEUKEMIA FORMS The guidelines and figures below are specific to Leukemia studies. The information in this manual does NOT represent a complete set of required forms for any leukemia study. Please refer

More information

Juvenile Myelomonocytic Leukemia (JMML)

Juvenile Myelomonocytic Leukemia (JMML) Juvenile Myelomonocytic Leukemia (JMML) JMML: Definition Monoclonal hematopoietic disorder of childhood characterized by proliferation of the granulocytic and monocytic lineages Erythroid and megakaryocytic

More information

Beyond the CBC Report: Extended Laboratory Testing in the Evaluation for Hematologic Neoplasia Disclosure

Beyond the CBC Report: Extended Laboratory Testing in the Evaluation for Hematologic Neoplasia Disclosure Beyond the CBC Report: Extended Laboratory Testing in the Evaluation for Hematologic Neoplasia Disclosure I am receiving an honorarium from Sysmex for today s presentation. 1 Determining the Etiology for

More information

2007 Workshop of Society for Hematopathology & European Association for Hematopathology Indianapolis, IN, USA Case # 228

2007 Workshop of Society for Hematopathology & European Association for Hematopathology Indianapolis, IN, USA Case # 228 2007 Workshop of Society for Hematopathology & European Association for Hematopathology Indianapolis, IN, USA Case # 228 Vishnu V. B Reddy, MD University of Alabama at Birmingham Birmingham, AL USA 11/03/07

More information

LYMPHOMA Joginder Singh, MD Medical Oncologist, Mercy Cancer Center

LYMPHOMA Joginder Singh, MD Medical Oncologist, Mercy Cancer Center LYMPHOMA Joginder Singh, MD Medical Oncologist, Mercy Cancer Center Lymphoma is cancer of the lymphatic system. The lymphatic system is made up of organs all over the body that make up and store cells

More information

, , 2011 HODGKIN LYMPHOMA

, , 2011 HODGKIN LYMPHOMA European Federation of Cytology Societies 4tu Annual Tutorial in Cytopathology Trieste, June 6-10, 2011 HODGKIN LYMPHOMA Classification The World Health Organization Classification of Lymphomas (2001)

More information

Combinations of morphology codes of haematological malignancies (HM) referring to the same tumour or to a potential transformation

Combinations of morphology codes of haematological malignancies (HM) referring to the same tumour or to a potential transformation Major subgroups according to the World Health Organisation (WHO) Classification Myeloproliferative neoplasms (MPN) Myeloid and lymphoid neoplasms with eosinophilia and abnormalities of PDGFRA, PDGFRB or

More information

Understanding your diagnosis. Dr Graham Collins Consultant Haemtologist Oxford University Hospitals

Understanding your diagnosis. Dr Graham Collins Consultant Haemtologist Oxford University Hospitals Understanding your diagnosis Dr Graham Collins Consultant Haemtologist Oxford University Hospitals Common questions I get asked What is lymphoma? What subtype do I have and what does that mean? What are

More information

Lymphoma and Myeloma Kris3ne Kra4s, M.D.

Lymphoma and Myeloma Kris3ne Kra4s, M.D. Lymphoma and Myeloma Kris3ne Kra4s, M.D. Hematologic Malignancies Leukemia Malignancy of hematopoie3c cells Starts in bone marrow, can spread to blood, nodes Myeloid or lymphoid Acute or chronic Lymphoma

More information

Acute Lymphoblastic Leukaemia

Acute Lymphoblastic Leukaemia Acute Lymphoblastic Leukaemia Terri Boyer 17 th October 2006 Overview Disease information: Aetiology of ALL proposed theory, contributing factors Symptoms Complications Diagnostic approaches - morphology

More information

Polycthemia Vera (Rubra)

Polycthemia Vera (Rubra) Polycthemia Vera (Rubra) Polycthemia Vera (Rubra) Increased red cells Clonal Myeloid lineages also increased 2-13 cases per million Mean age: 60 years Sites of Involvement Bone marrow Peripheral blood

More information

Integrated Hematopathology. Morphology and FCI with IHC

Integrated Hematopathology. Morphology and FCI with IHC Integrated Hematopathology Morphology and FCI with IHC FrontMatter.indd i 9/6/2009 9:30:12 PM FrontMatter.indd ii 9/6/2009 9:30:18 PM Integrated Hematopathology Morphology and FCI with IHC Cherie H Dunphy,

More information

5/21/2018. Disclosures. Objectives. Normal blood cells production. Bone marrow failure syndromes. Story of DNA

5/21/2018. Disclosures. Objectives. Normal blood cells production. Bone marrow failure syndromes. Story of DNA AML: Understanding your diagnosis and current and emerging treatments Nothing to disclose. Disclosures Mohammad Abu Zaid, MD Assistant Professor of Medicine Indiana University School of Medicine Indiana

More information

Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Post-HCT Data

Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Post-HCT Data Instructions for Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Post-HCT Data (Form 2114) This section of the CIBMTR Forms Instruction Manual is intended to be a resource for completing the Myelodysplasia/Myeloproliferative

More information

Immunopathology of Lymphoma

Immunopathology of Lymphoma Immunopathology of Lymphoma Noraidah Masir MBBCh, M.Med (Pathology), D.Phil. Department of Pathology Faculty of Medicine Universiti Kebangsaan Malaysia Lymphoma classification has been challenging to pathologists.

More information

DETERMINATION OF A LYMPHOID PROCESS

DETERMINATION OF A LYMPHOID PROCESS Chapter 2 Applications of Touch Preparation Cytology to Intraoperative Consultations: Lymph Nodes and Extranodal Tissues for Evaluation of Hematolymphoid Disorders INTRODUCTION As discussed in Chap. 1,

More information

YEREVAN STATE MEDICAL UNIVERSITY DEPARTMENT OF HEMATOLOGY COURSE DESCRIPTION HEMATOLOGY

YEREVAN STATE MEDICAL UNIVERSITY DEPARTMENT OF HEMATOLOGY COURSE DESCRIPTION HEMATOLOGY 1. Module/unit Code II. 1.2. 2. Module/unit Title Hematology 3. Subject Field Internal Diseases Group 4. Faculty/Department General Medicine, Department of Hematology 5. Programme(s) to which the Doctor

More information

Reactive and Neoplastic Lymphocytosis

Reactive and Neoplastic Lymphocytosis Reactive and Neoplastic Lymphocytosis Koranda A. Walsh, VMD, BS Assistant Professor, Clinical Pathobiology University of Pennsylvania School of Veterinary Medicine PLEASE NOTE: These notes are meant as

More information

PROBLEMS OF THE HEMATOLOGICAL SYSTEM

PROBLEMS OF THE HEMATOLOGICAL SYSTEM PROBLEMS OF THE HEMATOLOGICAL SYSTEM UNIT 5 Review A & P of Hematological system Outline focused exam Differentiate and start to evaluate diagnostic exams used to assess problems of the hematological system

More information

Lymphoid Neoplasms. Sylvie Freeman Department of Clinical Immunology, University of Birmingham

Lymphoid Neoplasms. Sylvie Freeman Department of Clinical Immunology, University of Birmingham Lymphoid Neoplasms Sylvie Freeman Department of Clinical Immunology, University of Birmingham Incidence of Haematological Malignancies UK2001 (CRUK) Malignancy New Cases All Cancers 271,000 Leukaemia 6,760

More information

LYMPHOPROLIFERATIVE DISORDERS. Dr Mere Kende MBBS, MMED (Path), MACTM, MACRRM, MAACB Lecturer: SMHS, UPNG

LYMPHOPROLIFERATIVE DISORDERS. Dr Mere Kende MBBS, MMED (Path), MACTM, MACRRM, MAACB Lecturer: SMHS, UPNG LYMPHOPROLIFERATIVE DISORDERS Dr Mere Kende MBBS, MMED (Path), MACTM, MACRRM, MAACB Lecturer: SMHS, UPNG Outline What are lymphoproliferative Disorders? Examples of LPD Classification Causes Clinical Features

More information

Blood Cell Identification: 2011-B Mailing: Acute Myeloid Leukemia (AML)

Blood Cell Identification: 2011-B Mailing: Acute Myeloid Leukemia (AML) Please Note: To view the Figures and Images contained within this education activity in color, access the electronic version of the reading. CASE HISTORY This peripheral blood smear is from a 51-year-old

More information

JAK2 V617F analysis. Indication: monitoring of therapy

JAK2 V617F analysis. Indication: monitoring of therapy JAK2 V617F analysis BCR-ABL genotyping The exact chromosomal defect in Philadelphia chromosome is a translocation. Parts of two chromosomes, 9 and 22, switch places. The result is a fusion gene, created

More information

Case Presentation No. 075

Case Presentation No. 075 Case Presentation No. 075 Session 4. Myelodysplastic Syndrome Cristina Montalvo, MD Baylor College of Medicine Houston, Texas 2007 Workshop of Society for Hematopathology and European Association for Haematopathology

More information

Acute myeloid leukemia. M. Kaźmierczak 2016

Acute myeloid leukemia. M. Kaźmierczak 2016 Acute myeloid leukemia M. Kaźmierczak 2016 Acute myeloid leukemia Malignant clonal disorder of immature hematopoietic cells characterized by clonal proliferation of abnormal blast cells and impaired production

More information

Adult Acute leukemia. Matthew Seftel. August

Adult Acute leukemia. Matthew Seftel. August Adult Acute leukemia Matthew Seftel August 21 2007 mseftel@cancercare.mb.ca Principles 3 cases Diagnosis and classification of acute leukemia (AL) Therapy Emergencies Remission induction BMT Complications

More information

Leukemia and Myelodysplastic Syndromes

Leukemia and Myelodysplastic Syndromes Leukemia and Myelodysplastic Syndromes Lenise Taylor, RN, MN, AOCNS, BMTCN Oncology CNS Seattle Cancer Care Alliance/UWMC ltaylor@seattlecca.org Lymphoid 1 Myeloid 2 Diagnostic Evaluation of Blood Disorders

More information

74y old Female with chronic elevation of Platelet count. August 18, 2005 Faizi Ali, MD Hematopathology Fellow

74y old Female with chronic elevation of Platelet count. August 18, 2005 Faizi Ali, MD Hematopathology Fellow 74y old Female with chronic elevation of Platelet count August 18, 2005 Faizi Ali, MD Hematopathology Fellow Clinical History Patient is a 74y old otherwise healthy Caucasian female with no major complaint

More information

MYELOPROLIFERATIVE DISEASE. Dr Mere Kende MBBS (UPNG), MMED (Path),MAACB, MACTM, MACRRM (Aus) Lecturer-SMHS UPNG

MYELOPROLIFERATIVE DISEASE. Dr Mere Kende MBBS (UPNG), MMED (Path),MAACB, MACTM, MACRRM (Aus) Lecturer-SMHS UPNG MYELOPROLIFERATIVE DISEASE Dr Mere Kende MBBS (UPNG), MMED (Path),MAACB, MACTM, MACRRM (Aus) Lecturer-SMHS UPNG Myeloproliferative Diseases Essential to diagnosis Acquired clonal abnormalities of the hematopoietic

More information

CHALLENGING CASES PRESENTATION

CHALLENGING CASES PRESENTATION CHALLENGING CASES PRESENTATION Michael C. Wiemann, MD, FACP Program Co-Chair and Vice President Indy Hematology Education President, Clinical St. John Providence Physician Network Detroit, Michigan 36

More information