Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell...
-
date post
22-Dec-2015 -
Category
Documents
-
view
215 -
download
1
Transcript of Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell...
![Page 1: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/1.jpg)
Week 11: Lymphoproliferative Disorders Multiple myelomaMultiple myeloma Plasma cellPlasma cell Monoclonal Monoclonal
gammopathygammopathy Bence-Jones proteinBence-Jones protein Protein ELPProtein ELP Hairy cell leukemiaHairy cell leukemia TRAPTRAP
LymphomaLymphoma Hodgkin’s diseaseHodgkin’s disease Reed-Sternberg cellReed-Sternberg cell Mycosis fungoidesMycosis fungoides Sezary cellSezary cell
![Page 2: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/2.jpg)
Multiple Myeloma
Plasma cell leukemiaPlasma cell leukemia Monoclonal gammopathy ELP pattern with Monoclonal gammopathy ELP pattern with
sharp sharp region spike region spike High ESR, rouleaux, Bence-Jones protein, High ESR, rouleaux, Bence-Jones protein,
Platelet dysfunctionPlatelet dysfunction Osteolytic (punched out) bone lesionsOsteolytic (punched out) bone lesions
![Page 3: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/3.jpg)
![Page 4: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/4.jpg)
![Page 5: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/5.jpg)
Myeloma cells in peritoneal fluid
![Page 6: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/6.jpg)
Rouleaux
![Page 7: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/7.jpg)
Other Plasma Cell Disorders
Waldenstrom’s macroglobulinemiaWaldenstrom’s macroglobulinemia IgMIgM Soft tissue involvementSoft tissue involvement CD 20 (B cell) but no CD 21 (mature B) CD 20 (B cell) but no CD 21 (mature B)
or PC 1 (plasma cell)or PC 1 (plasma cell) Heavy chain diseaseHeavy chain disease
Plasmacytoid lymphocytePlasmacytoid lymphocyte
![Page 8: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/8.jpg)
Unusual plasma cells
![Page 9: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/9.jpg)
Osteoblasts
![Page 10: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/10.jpg)
Hairy Cell Leukemia
Leukemic reticuloendotheliosisLeukemic reticuloendotheliosis Probably B cell originProbably B cell origin CD 19, 20, 22, 24 (B cell), 25, 11c CD 19, 20, 22, 24 (B cell), 25, 11c
(granulocyte), sIg, some CD 5 (pan-T)(granulocyte), sIg, some CD 5 (pan-T) Tartrate resistant acid phosphatase (TRAP)Tartrate resistant acid phosphatase (TRAP)
![Page 11: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/11.jpg)
Hairy CellLeukemia
![Page 12: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/12.jpg)
![Page 13: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/13.jpg)
LRE: Ruptured Spleen
![Page 14: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/14.jpg)
![Page 15: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/15.jpg)
![Page 16: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/16.jpg)
![Page 17: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/17.jpg)
![Page 18: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/18.jpg)
![Page 19: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/19.jpg)
Acid Phosphatase
Naphthol AS-BI phosphate ACP in acid pH > Free naphthol AS-BI + FastGarnet GBC
Magnesium > Maroon deposits
![Page 20: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/20.jpg)
Tartrate Resistant ACP: TRAP + Tartrate
![Page 21: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/21.jpg)
Non-Hodgkin’s Lymphoma Lymphocytes with clefted nucleiLymphocytes with clefted nuclei Sezary cells in mycosis fungoides have many cleftsSezary cells in mycosis fungoides have many clefts Rappaport classification based on morphology and Rappaport classification based on morphology and
differentiationdifferentiation Lukes-Collin classification with cell types identifiedLukes-Collin classification with cell types identified International Working Formulation with tumor International Working Formulation with tumor
aggressiveness and histologyaggressiveness and histology Revised European/American Lymphoma (REAL) Revised European/American Lymphoma (REAL)
classification is most recentclassification is most recent
![Page 22: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/22.jpg)
![Page 23: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/23.jpg)
![Page 24: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/24.jpg)
![Page 25: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/25.jpg)
![Page 26: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/26.jpg)
Lymphoma Cells
![Page 27: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/27.jpg)
![Page 28: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/28.jpg)
![Page 29: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/29.jpg)
![Page 30: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/30.jpg)
![Page 31: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/31.jpg)
![Page 32: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/32.jpg)
Bone Marrow: Focal Involvement
![Page 33: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/33.jpg)
WHO Classification of Acute Lymphoproliferative Syndromes
Precursor B Lymphoblastic Precursor B Lymphoblastic Leukemia/Lymphoma (ALL/LBL) -- ALL Leukemia/Lymphoma (ALL/LBL) -- ALL in children (80-85% of childhood ALL); in children (80-85% of childhood ALL); LBL in young adults and rare; FAB L1 or LBL in young adults and rare; FAB L1 or L2 blast morphologyL2 blast morphology
Precursor T ALL/LBL -- 15% of childhood Precursor T ALL/LBL -- 15% of childhood ALL and 25% of adult ALLALL and 25% of adult ALL
Burkitt Leukemia/Lymphoma (FAB L3)Burkitt Leukemia/Lymphoma (FAB L3)
![Page 34: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/34.jpg)
Mycosis Fungoides: T-cell Lymphoma of skin
![Page 35: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/35.jpg)
Skin Biopsy
Skin Imprint
Sezary Syndrome
![Page 36: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/36.jpg)
![Page 37: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/37.jpg)
![Page 38: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/38.jpg)
![Page 39: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/39.jpg)
PAS Positive: Sezary Syndrome
![Page 40: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/40.jpg)
![Page 41: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/41.jpg)
![Page 42: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/42.jpg)
Hodgkin’s Lymphoma
Reed-Sternberg cell (RS): lobated nuclei, Reed-Sternberg cell (RS): lobated nuclei, mutinucleate variants, lacunar cells, mutinucleate variants, lacunar cells, lymphocytic-histiocytic cell (LH)lymphocytic-histiocytic cell (LH)
RS: has CD 15 (granulo/mono) and CD 30 (B RS: has CD 15 (granulo/mono) and CD 30 (B cell)cell)
Lymphocyte predominant type CD 20 (B cell)Lymphocyte predominant type CD 20 (B cell) Clinical staging I through IV according to Clinical staging I through IV according to
number and location of tumorsnumber and location of tumors
![Page 43: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/43.jpg)
Reed-Sternberg Cell
![Page 44: Week 11: Lymphoproliferative Disorders Multiple myeloma Multiple myeloma Plasma cell Plasma cell Monoclonal gammopathy Monoclonal gammopathy Bence-Jones.](https://reader030.fdocuments.us/reader030/viewer/2022032704/56649d805503460f94a65303/html5/thumbnails/44.jpg)