Hematology

• Pelger Huet


  2 lobe seg "Bilobed, Unilobed"
• Alder Reily


  decrease in mucopolysaccharides degradation.
• May Hegglins


  "Dohle bodies" and large platelets
• Chediak Higashi 


  lysosome defects, photophobia, albinism, frequent infections, large inclusion of neutrophils
• Different storage diseases

  1. Gaucher Cells
  2. Neimann Pick
• Gaucher Cells


  Glucocerebrosidase defficiency
• Neimann Pick


  inability to degrade sphingomyelin
• Different stains

  1. MPX
  2. Sudan Black
  3. PAS
  4. Nonspecific esterase
  5. TdT
  6. TRAP
• MPX


  AML - Positive

  ALL - Negative
• Sudan Black


  AML- Positive

  ALL- Negative
• PAS - non specific


  Granulocyte/Monocytes- Positive

  Lymphocyte- negative
• Nonspecific Esterase 


  Identify the monocytes and immature platelets = Positive dark granules
• TdT


  AML= Negative

  ALL= Poasitive
• TRAP 


  Hairy Cell Leukemia = Positive

  CLL- Negative
• How do we diagnose different leukemia?

  1. Cytogenetic Studies
  2. Flow cytometry
  3. Cytochemical stain
• Myeloproliferative disorder

  1. CML (Chronic Myelogenous Leukemia)
  2. Polycythemia Vera
  3. Essential Thrombocythemia
  4. Agnogenic Myeloid Metaplasia
  5. Myelofibrosis
• Chronic myelogenous Leukemia CML

  Philadelphia chromosome that can progress to AML
• Polycythemia Vera


  affect ALL cell lines

  Ruddy complexion

  therapeutic Phlebotomy is common treatment
• Myelofibrosis/ Agnogenic Myeloid metaplasia

  1. Bone marrow fibrosis
• Myelofibrosis/ Agnogenic Myeloid metaplasia

  1. Progressive splenomegaly
  2. Leucoerythroblastosis
  3. Dry tap
  4. Tear drop cell
• Where do the myeloproliferative disorder arise?

  Bone marrow / usually adults
• Sezary Syndrome


  cleft nucleus in lymphoid cells found in the peripheral blood of "leukemic phase" of mycosis fungoides.
• What causes Sezary Syndrome?

  healthy T cells turn into abnormal cells which multiply uncontrollably and eventually overpopulate SKIN, LYMPHNODES, and blood stream.
• Peripheral picture of Sezary syndrome?

  Small Lymph and Dark staining
• What is the Philadelphia Chromosome associated with?

  Chronic Myelogenous Leukemia
• How to identify myeloblast vs lymphoblasts?

  Cytochemical stains
• Different Leukemia

  1. Acute Lymphocytic Leukemia ALL
  2. ChroniC Lymphocytic Leukemia CLL
  3. Acute Myelogenous Leukemia AML
  4. Chronic Myeloid Leukemia CMl
• cells involved acute Lymphocytic Leukemia 


  Immature B or T cell
• cells involved Chronic lymphocytic leukemia.

  B cells
• Acute Lymphocytic Leukemia (Special Characteristics)


  >30% lymphoblasts
• Acute Lymphocytic Leukemia positive stains


  TdT
• Acute Lymphocytic Leukemia age group


  Children
• Chronic Lymphocytic Leukemia special characteristics 


  smudge cells
• Chronic Lymphocytic Leukemia positive stains


  add albumin to prevent cell breakage
• Chronic Lymphocytic Leukemia age group


  adults/ men
• Acute Myelogenous Leukemia cells involved 


  Immature Myeloid linage cells
• Acute myelogenous leukemia Special 


  auer rods
• Acute myelogenous leukemia positive stains

  MPX, Sudan bLACK
• Acute myelogenous leukemia age group


  adults
• Chronic Myeloid Leukemia cells involved

  Hematopoietic stem cells