Extra haematology

Question 1

What can you do with tissue biopsy to establish diagnosis?

Answer 1

Morphology
Immunophenotype
Cytogenetics
Molecular genetics

Question 2

What surface markers can show us which lymphocyte malignancy is present?

Answer 2

T cell- CD3/4

B cells- TDT (immature) / Ig (if mature)

Question 3

What do you look for in Morphology?

Answer 3

1. malignant cells; large or small, mature or immature?

2. Lymph node diffuse invasion or forming follicles?

Question 4

What do you look for in Immunophenotype?

Answer 4

1. myeloid or lymphoid? T or B lineage?

2. stage of maturation precursor or mature?

Question 5

What do you look for in cytogenetics?

Answer 5

1. Philadelphia Chromosome > CML.
2. Prognostic information eg Chromosome 17p del in CLL
3. t(8;14) activates c-myc oncogene in Burkitt Lymphoma

Question 6

What do you look for in Molecular genetics?

Answer 6

1. JAK2 mutation in suspected polycythemia vera

2. BCR-ABL1 cDNA detection and quantification

Question 7

How do you differentiated B cell ALL and multiple myeloma?

Answer 7

B cell Acute lymphoblastic lymphoma
TdT +ve
CD19 +ve
Surface Immunoglobulin -ve

Multiple myeloma
TdT negative
Surface Immunoglobulin +ve
CD138 positive

Question 8

What are some appropriate treatments for haematology cancers?

Answer 8

An abl tyrosine kinase inhibitor for CML

Combination chemotherapy for acute leukaemias

Chemo+immunotherapy for lymphomas

Watch and wait for indolent lymphomas

Question 9

If bloods come back with a high skew to kappa or lambda what does that mean?

Answer 9

Monoclonal mature B cells

Question 10

What is Budd Chiari?

Answer 10

Budd-Chiari syndrome is a condition in which the hepatic veins (veins that drain the liver) are blocked or narrowed by a clot (mass of blood cells). This blockage causes blood to back up into the liver, and as a result, the liver grows larger.