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8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 1/15
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Bone marrow : acute leukemia
22 Winter 13 AJalan
ManyAuer rods
AML M3 (Acute promyelocytic leukemia)
Promyelocyteswith granules
40 Winter 13 AJalan
PPSC
Myeloid Stem cell
CFU –GEMM
MonoblastAcute monocytic
AML M5
Meyloblast AML M1,M2 & M3
Eosinophil
Erythroblast
Megakaryoblast
Acute ErythroleukemiaAML M6
Acute Megakaryocyticleukemia AML M7
Acute myelomonocyticAML M4
AML M0
CFU-GM
36 Winter 13 AJalan
MeyloblastMonoblast
8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 2/15
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Small lymphocytes
Disrupted tumor cells(smudge cells).
Spherocytes
Nucleated erythroid cell
Chronic lymphocytic leukemia.
26 Win 13 AJalan
29 Win 13 AJalan
Peripheral smear findings
WBC count
11 Win 13 AJalan
8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 3/15
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Tumor cells with finehair like cytoplasmic
projections
TRAPposi tivity
Hairy cell leukemia
39 Win 13 AJalan 35
Whatdoyousee???
TRAPpositivity
Whatdoes thispatienthave?
Win 13 AJalan
37 Win 13 AJalan
5
Multinucleated RBC precursors Ringed sideroblasts
Pseudo-Pelger Huet cells
Megakaryocytewith multiple nucleiSpring 12 AJalan
8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 4/15
8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 5/15
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25
African BurkittLymphoma - jaw tumor Small bowel
Burkitt lymphoma
B
A AJalanSpring 12 26
Tingible bodymacrophages
producing a "starry sky"appearance
Starry sky appearance
AJalanSpring 12
31
Nodular aggregatesof lymphoma cells
Follicular lymphoma (spleen).
AJalanSpring 12
8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 6/15
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3.
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4.
Thyroid gland lymphoma! Hashimotos thyroiditis
5.
Stomach lymphoma! H.pylori gastritis***
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35
Diffuse large B-cell lymphoma(spleen)
Presence ofisolated largemass is typical
Large tumor cellswith largenuclei &
prominent nucleoli.
AJalanSpring 12
8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 7/15
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47
Mycosis fungoides
AJalanSpring 12
50
•
Sezary syndrome:
– MF with a leukemicphase.
–
Characterized bypresence ofneoplastic cells inperipheral blood***.
• These cells are k/aSezary cells*** Sezary cells : have
characteristic
cerebriform appearance.
AJalanSpring 12
8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 8/15
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6
Serum proteinelectrophoresis
Normal
Spring 12 AJalan 10
•
Etiology and pathogenesis
–
Bone destruction : due to factors from plasma
cells:•
IL-1: osteoclast activating factor***
Plasma cell myeloma - lytic lesions in the skullSpring 12 AJalan
16
Multiple myeloma: microscopy
Medium Power Mott cell
High power High power
BA
C D
AB
Spring 12 AJalan 2
Rounded
"punched out
lesion
Plasma cells:Ink blue cytoplasm
Eccentrically situated nucleus
Spring 12 AJalan
8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 9/15
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8
What do you see?
Spring 12 AJalan
23
Increased platelets
Peripheral smearPeripheral smear What do you see?
Spring 12 AJalan
32Tear drop cells
Nucleated RBC s Immature WBC
Spring 12 AJalan33
Normal BM
Myelofibrosis
Spring 12 AJalan
8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 12/15
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8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 13/15
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8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 14/15
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5
Inappropriate Activation of coagulation system
Thrombosis
Consumption of
Platelets and
Coagulation factors
Activation of
fibrinolytic systemTissue hypoxia
And infarction
Bleeding
Sum 11 AJalan
8
SepsisMassive tissueDestruction
Endothelialinjury
Release oftissue factor
Widespreadthrombosis
Activation ofPlasmin
FibrinolysisProteolysis of
Clotting factors
Fibrin splitproducts
Inhibition ofplatelet aggregation
Vascularocclusion
Ischemictissue damage
Consumptionof CF & platelets
Plateletaggregation
BleedingSum 11 A Jalan
8/11/2019 Acute Lymphocytic Leukemia TABLE
http://slidepdf.com/reader/full/acute-lymphocytic-leukemia-table 15/15
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