Acute Lymphocytic Leukemia TABLE

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



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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



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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





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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



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4.

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35

Diffuse large B-cell lymphoma(spleen)

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Large tumor cellswith largenuclei &

prominent nucleoli.

AJalanSpring 12



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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



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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

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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



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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



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Acute Lymphocytic Leukemia TABLE