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Wbc
- 4. NEUTROPHIL Neutrophil Polymorphonuclear Leukocyte, PMN, PML “ Leukocyte” Granulocyte, Neutrophilic granulocyte “ Poly-” Polymorph www.freelivedoctor.com
- 45. MONOCLONAL “SPIKE” on SPE www.freelivedoctor.com
- 47. Multiple Myeloma: Skull X-ray www.freelivedoctor.com
- 53. M0 M2 www.freelivedoctor.com
- 55. M4-M5 AMML Normal “classic” monocyte www.freelivedoctor.com
- 59. Ring Sideroblasts and “BUDS” www.freelivedoctor.com
- 62. CORTEX ---SUB-capsular Sinus ---Follicles (Pri? Or second.?) ---PARA-follicular zone MEDULLA Blood flow? Lymph flow? www.freelivedoctor.com
- 70. LARGE CELL LYMPHOMA www.freelivedoctor.com
- 71. SMALL CELL LYMPHOMA www.freelivedoctor.com
- 72. “ CLEAVED” CELL LYMPHOMA www.freelivedoctor.com
- 73. “ Hairy” Lymphocyte www.freelivedoctor.com
- 82. STERNBERG-REED CELL www.freelivedoctor.com
- 85. METASTATIC SQUAMOUS CELL CARCINOMA www.freelivedoctor.com
Notas do Editor
- Many names, same cell
- ALL blasts look the same on routine stains, whether they are myeloblasts, lymphoblasts, monoblasts, etc.
- TOXIC GRANULES are EXAGGERATIONS of the marrow’s normal granularity, DOHLE bodies are fragments of remaining dilated rough ER
- Not only are basophils RARE to find normally, but pure “basophilia” is also VERY rare.
- Why would monocytosis be linked to granulomatous diseases? Answer: Monocytes are macrophages in circulation, and granulomatous diseaseas are macrophage diseases.
- EXTRAMEDULLARY HEMATOPOESIS is most common in the spleen, liver, and lymph nodes.
- If a CML had much more than 10% blasts, you might suspect that the patient was going into a “blast crisis”.
- This marrow is virtually 100% cellularity!!! This is the HALLMARK of CML, and all the cells are still marrow cells although blasts are INCREASED, i.e., more than 1-2 % This marrow is virtually 100% cellularity!!! This is the HALLMARK of CML, and all the cells are still marrow cells although blasts are INCREASED, i.e., more than 1-2 %
- This marrow is virtually 100% cellularity!!! This is the HALLMARK of CML, and all the cells are still marrow cells although blasts are INCREASED, i.e., more than 1-2 %. In this CML megakaryocytes are proliferating so what OTHER myeloproliferative disease could this be confused with? Ans: essential thrombocythemia (essential thrombocytosis)
- Note most of the marrow looks “fibrotic”. What stain could help you confirm that this is fibrous tissue? (trichrome)
- The most life saving thing you can learn today is how to recognize a blast! HUGE NUCLEUS NUCLEOLI (stain LIGHTER not DARKER than the rest of the nucleus on Wright stain), How many nucleoli does that one blast cell have? Answer: 3 NO cytoplasmic differentiation
- Many cells from CLL have a “smudge” or “basket” appearance
- Please those THREE diagnostic features of plasma cells, the malignant plasma cells of MM look like normal plasma cells usually.
- Normal on left, myeloma on right.
- Note the “lytic” lesions
- Blasts, blasts with AUER rods
- Acute promyelocytic leukemia, remember promyelocytes have BOTH nucleoli AND nonspecific granules, true BLASTS do NOT have granules.
- In AMML, M4, many of the peripheral leukemic cells look like monocytes, while in M5, Acute Monocytic Leukemia, MOST of them look like monocytes
- In M6, many of the cells may resemble erythroid cells, in M7, many of the cells may resemble megakaryocytes
- Know the difference between a myelo-”proliferative” and a myelo-”dysplastic” disease.
- BENIGN FOLLICULAR HYPERPLASIA. Larger and more numerous than normal follicles. MEDULLA may be compromised.
- BENIGN SINUS HISTIOCYTOSIS. The cortical area may be compromised. SINUS HISTIOCYTOSIS may be seen in reaction to cancer, even if there are NO tumor cells in the lymph node.
- “ HAIRY” cell leukemia/lymphoma consists of lymphocytes which look hairy.
- Most pathologists HATE lymphoma classifications with a passion!
- I HATE this slide.
- I HATE this slide even worse.
- Prognosis of HD disease is related directly of percentage of lymphocytes and inversely to number of RS cells.
- STERNBERG REED cells are called “lacunar” cells in one of the most common forms of HD called NODULAR SCLEROSING
- The subcapsular sinus of the lymph node is the FIRST place you will spot a metastatic tumor nest!
- Notice the “confluence” of WHITE pulp? Could this be lymphoma involvement? Ans: Yes Could this be granulomas? Ans: YES
- Portal hypertension, prominence of RED pulp
- Note all these are benign. The commonest MALIGNANT tumor primary to the spleen is a LYMPHOMA
- Hassal’s corpuscles are fused epithelial reticular cells