Difference between revisions of "Leukemia"
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==Clinical factors== | |||
Clinical are important in the classification of leukemia. | |||
*Hx of [[myelodysplastic syndrome]]? | |||
*Chemotherapy? | |||
*[[Down syndrome]]? | |||
==Algorithms== | |||
There is a nice set of algorithms from D. Arber - that were presented at the 2009 USCAP. | |||
==Leukemia classification== | |||
AML: | |||
#AML. | |||
#AML with recurrent cytogenetic abnormalities. | |||
#AML from MDS. | |||
#AML in the setting of Down syndrome. | |||
ALL: | |||
#B cell. | |||
#B cell with recurrent cytogenetic abnormalities. | |||
#T cell. | |||
===AML with recurrent cytogenetic abnormalities=== | |||
====t(8;21)==== | |||
*t(8;21)(q22;q22).<ref>{{Cite journal | last1 = Berger | first1 = R. | title = Translocation t(8;21)(q22;q22): cytogenetics and molecular biology. | journal = Nouv Rev Fr Hematol | volume = 36 Suppl 1 | issue = | pages = S67-9 | month = | year = 1994 | doi = | PMID = 8177719 }}</ref> | |||
IHC: | |||
*CD34+, CD13+, MPO+ (cytoplasm), CD33+ (weak). | |||
*CD56+, CD117+. | |||
**Usu. assoc. with a bad prognosis. | |||
Flow cytometry: | |||
*CD19+, PAX5+, CD79a +/-. | |||
====inv(16)==== | |||
*inv(16)(p13.1q22).<ref name=pmid16917916>{{Cite journal | last1 = Lu | first1 = CM. | last2 = Murata-Collins | first2 = JL. | last3 = Wang | first3 = E. | last4 = Siddiqi | first4 = I. | last5 = Lawrence | first5 = HJ. | title = Concurrent acute myeloid leukemia with inv(16)(p13.1q22) and chronic lymphocytic leukemia: molecular evidence of two separate diseases. | journal = Am J Hematol | volume = 81 | issue = 12 | pages = 963-8 | month = Dec | year = 2006 | doi = 10.1002/ajh.20716 | PMID = 16917916 }} | |||
</ref> | |||
*Assoc. with myeloid sarcoma. | |||
Microscopic: | |||
*Blast count usu. ~20% (low). | |||
*Eosinophilic granules. | |||
**Used to be classified as "M4" with eosinophilia. | |||
IHC: | |||
*CD2+ -- common. | |||
==See also== | ==See also== | ||
| Line 34: | Line 81: | ||
==References== | ==References== | ||
{{Reflist| | {{Reflist|2}} | ||
[[Category:Haematopathology]] | [[Category:Haematopathology]] | ||
Revision as of 18:16, 29 May 2011
The article addresses leukemia, which is uncommonly seen by anatomical pathologists. It is a subset of hematopathology. Lymphoma is discussed in the lymphoma article, and overlaps somewhat with this article as the clear distinction between the two is historical.
Definition
All of the following:[1]
- Morphologic abnormalities.
- >20% blasts or recurrent cytogenetic abnormality.
Some recurrent cytogenetic abnormalities:
- t(8;21).
- inv(16).
- t(15;17).
Histomorphologic overview
| Disease/Feature | Blast size | Auer rods | Granulation of cytoplasm |
| AML | larger | present | present |
| ALL | smaller | none | absent or present |
Clinical factors
Clinical are important in the classification of leukemia.
- Hx of myelodysplastic syndrome?
- Chemotherapy?
- Down syndrome?
Algorithms
There is a nice set of algorithms from D. Arber - that were presented at the 2009 USCAP.
Leukemia classification
AML:
- AML.
- AML with recurrent cytogenetic abnormalities.
- AML from MDS.
- AML in the setting of Down syndrome.
ALL:
- B cell.
- B cell with recurrent cytogenetic abnormalities.
- T cell.
AML with recurrent cytogenetic abnormalities
t(8;21)
- t(8;21)(q22;q22).[2]
IHC:
- CD34+, CD13+, MPO+ (cytoplasm), CD33+ (weak).
- CD56+, CD117+.
- Usu. assoc. with a bad prognosis.
Flow cytometry:
- CD19+, PAX5+, CD79a +/-.
inv(16)
- inv(16)(p13.1q22).[3]
- Assoc. with myeloid sarcoma.
Microscopic:
- Blast count usu. ~20% (low).
- Eosinophilic granules.
- Used to be classified as "M4" with eosinophilia.
IHC:
- CD2+ -- common.
See also
References
- ↑ D. Good. 21 March 2011.
- ↑ Berger, R. (1994). "Translocation t(8;21)(q22;q22): cytogenetics and molecular biology.". Nouv Rev Fr Hematol 36 Suppl 1: S67-9. PMID 8177719.
- ↑ Lu, CM.; Murata-Collins, JL.; Wang, E.; Siddiqi, I.; Lawrence, HJ. (Dec 2006). "Concurrent acute myeloid leukemia with inv(16)(p13.1q22) and chronic lymphocytic leukemia: molecular evidence of two separate diseases.". Am J Hematol 81 (12): 963-8. doi:10.1002/ajh.20716. PMID 16917916.