Documente Academic
Documente Profesional
Documente Cultură
March 2010
Learning issues
Leucopoiesis:
1.
2.
3.
4.
5.
6.
Myeloblast
Promyelocyte
Myelocyte
Metamyelocyte
Band Neutrophil
Segmented Neutrophil.
Myeloid cells
WBC disorders:
Myeloma
Premalignant conditions:
Classification
Leukemia Classification
Acute Leukemias:
Chronic Leukemias:
Acute Leukemias:
Etiology
Platelet
Coagulation
Petechiae, Purpura
Organomegaly
Diagnosis of AML
PS EXAMINATION IN AML
BM examination in AML
Hypercellular Marrow
Blasts are > 20%
Blasts with intracytoplasmic rods- Auer
Rods
Increased M: E ratio
Less of Megakaryocytes
AML-M3 Promyelocytic
Special investigations
Immunophenotyping
Cytogenetics in AML
Common in Children.
FAB classification L1, L2 & L3
Neoplastic cells are CD10 +ve & most are
Pre B cell type.
2% of child ALL & 20-30% of adult onset
ALL has t(9;22)
Growth failure, Fever, Anemia
Lymphadenopathy, bleeding.
Mild to Moderate Hepatosplenomegaly
ALL:Cervical Lymphadenopathy
ALL-L2
Diagnosis of ALL
Morphological diagnosis
Chronic leukemias
Chronic Myeloproliferative
syndrome
1. Chronic myeloid leukemia (CML)
2. Polycythaemia vera
3. Essential thrombocytosis
4. Myelofibrosis.
Marrow fibrosis Cytopenias
Acute leukemia
PATHOPHYSIOLOGY
PHILADELPHIA CHROMOSOME
PHILADELPHIA CHROMOSOME
BLOOD PICTURE
COURSE OF CML
BLAST CRISIS
Chronic course
Spontaneous remission
Accelerated phase
Blast crisis
LEUKEMOID REACTION
Leukemoid Reaction:
CML
Malignancy
Hepatosplenomegaly
Large spleen
Slow course
Total count Increased
Thrombocytosis
LAP decreased
Ph chromosome
Basophilia
Leukemoid reaction
Inflammatory lesion
Hepatomegaly
Mild spleen if present
Short duration
Increased but not much
Platelets- Normal
LAP increased
No Ph chromosome
Antibiotics
CLL:
Morphology in CLL
Prolymphocytic leukemia
Diffuse large B cell lymphoma (Richter syndrome)
CLL:
Myeloproliferative Syndromes:
Classification:
MPS: Classification
POLYCYTHEMIA VERA
CLASSIFICATION OF POLYCYTHEMIA
PATHOPHYSIOLOGY OF PV
CLINICAL FEATURES
BLOOD & BM
No known cure.
Phlebotomy, Myelosuppression
Progression to Myelofibrosis or rarely
acute leukemia.
Summary:
Premalignant conditions
Learning issues