Podcast
Questions and Answers
Which acute myeloid leukemia type is associated with translocation t(8:21)?
Which acute myeloid leukemia type is associated with translocation t(8:21)?
What is the associated condition with acute megakaryocytic leukemia (AML M7)?
What is the associated condition with acute megakaryocytic leukemia (AML M7)?
Which acute myeloid leukemia type is characterized by the presence of maximum Auer rods?
Which acute myeloid leukemia type is characterized by the presence of maximum Auer rods?
Which cytogenetic abnormality is specifically associated with acute myeloid leukemia type M4?
Which cytogenetic abnormality is specifically associated with acute myeloid leukemia type M4?
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What is the best prognostic factor for acute myeloid leukemia type M3?
What is the best prognostic factor for acute myeloid leukemia type M3?
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Which age group is associated with a better prognosis in Acute Lymphoblastic Leukemia (ALL)?
Which age group is associated with a better prognosis in Acute Lymphoblastic Leukemia (ALL)?
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What classification is associated with a worse prognosis in B-ALL?
What classification is associated with a worse prognosis in B-ALL?
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Which cytogenetic abnormality is most common in Acute Lymphoblastic Leukemia (ALL)?
Which cytogenetic abnormality is most common in Acute Lymphoblastic Leukemia (ALL)?
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Which of the following is NOT associated with a good prognosis in Acute Lymphoblastic Leukemia?
Which of the following is NOT associated with a good prognosis in Acute Lymphoblastic Leukemia?
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What marker is associated with T-ALL?
What marker is associated with T-ALL?
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Which feature is typically observed in Acute Myeloid Leukemia (AML)?
Which feature is typically observed in Acute Myeloid Leukemia (AML)?
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Which FAB classification indicates Acute Promyelocytic Leukemia?
Which FAB classification indicates Acute Promyelocytic Leukemia?
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Which population is associated with a worse prognosis in ALL?
Which population is associated with a worse prognosis in ALL?
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Which cytogenetic abnormality can lead to a diagnosis of leukemia even when the blast count is less than 20%?
Which cytogenetic abnormality can lead to a diagnosis of leukemia even when the blast count is less than 20%?
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What characteristic distinguishes myeloblasts from lymphoblasts?
What characteristic distinguishes myeloblasts from lymphoblasts?
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Which of the following markers is associated with myeloblasts?
Which of the following markers is associated with myeloblasts?
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What is a common clinical feature observed in Acute Lymphoblastic Leukemia (ALL)?
What is a common clinical feature observed in Acute Lymphoblastic Leukemia (ALL)?
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Which staining technique is typically positive in lymphoblasts?
Which staining technique is typically positive in lymphoblasts?
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Which chromatin feature helps differentiate myeloblasts from lymphoblasts?
Which chromatin feature helps differentiate myeloblasts from lymphoblasts?
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In Acute Myeloid Leukemia, what morphological features might be present?
In Acute Myeloid Leukemia, what morphological features might be present?
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What age group is most commonly affected by Acute Lymphoblastic Leukemia?
What age group is most commonly affected by Acute Lymphoblastic Leukemia?
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Study Notes
Normal Smears
- White Blood Cells (WBC) contain granulocytes (neutrophils, eosinophils, basophils) and agranulocytes (lymphocytes, monocytes).
- Peripheral smears typically show only mature cells.
- Red Blood Cells (RBC) are round with central pallor.
- Monocytes are the largest white blood cell, with a horse-shoe shaped nucleus.
- Lymphocytes are the smallest white blood cells, with a small central nucleus.
- Neutrophils have 3-5 lobes and granules in their cytoplasm.
- Eosinophils are binucleate and have brick red granules.
- Basophils have granules that obscure the nucleus, which are blue in color.
Bone Marrow Examination
- Bone marrow aspirates contain mature and immature cells.
- Fat globules are present.
WBC Disorders - Non-Neoplastic
- Normal white blood cell count (TLC): 4,000-11,000/mm².
- Neutrophils (40-70%), Lymphocytes (15-40%), Monocytes (2-8%), Eosinophils (1-6%), Basophils (<1%).
- Increased TLC (leukocytosis) indicates infection.
- Neutrophilia: associated with acute and bacterial infections, tissue necrosis.
- Lymphocytosis: associated with viral infection, chronic infection, tuberculosis.
- Basophilia: associated with myeloproliferative disorders (CML).
- Eosinophilia: associated with allergic reactions, parasitic infections, malignancies (Hodgkin's lymphoma), tropical pulmonary eosinophilia, chronic infections, inflammatory bowel disease, or malaria.
- Monocytosis: associated with chronic infections, inflammatory bowel disease, rickettsia, or malaria.
WBC Disorders - Neoplastic
- Leukemia: malignant cells in bone marrow or peripheral blood.
- Lymphoma: malignant cells in lymph nodes, tissues, spleen, etc.
- Acute Lymphocytic Leukemia (ALL) and Acute Myeloid Leukemia (AML).
- ALL: common in younger individuals (2-9 years).
- AML: average age of onset is 15-39 years.
Acute Leukemia
- Diagnostic criteria:
- WHO criteria: > 20% blasts in peripheral blood or bone marrow.
- FAB criteria: > 30% blasts in the peripheral blood or bone marrow (exceptions apply; count can be < 20% if one of three other features is present).
- Lymphoblast vs myeloblast: described by their cell size, cytoplasm, granules, Auer rods, and chromatin.
Additional Information
- Bone marrow biopsy: used for diagnosis and monitoring.
- Sites for bone marrow aspiration in adults: ASIS (anterior superior iliac spine), PSIS (posterior superior iliac spine), or iliac crest.
- Sites for bone marrow aspiration in children: anterior surface of the tibia or shin of the tibia.
- Dry Tap: a dry tap is when there is no marrow obtained during aspiration, which is often the case in aplastic anemia, myelofibrosis, hairy cell leukemia, or AML-M7.
- Bone marrow examination is usually followed by dry tap aspiration and then biopsy, if necessary.
- Chloroma: granulocytic sarcoma, found in myeloblastoma, MPO positive, associated with the orbit, is greenish in color.
- Myeloproliferative disorders (CML, Polycythemia vera, Essential thrombocytosis, myelofibrosis) with features and diagnostic criteria.
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Description
Explore the intricacies of white blood cells and their normal smear characteristics with this informative quiz. Delve into the details of WBC disorders, including the anatomy of granulocytes and agranulocytes, as well as the significance of bone marrow examinations. Test your knowledge of leukocyte classifications and their normal ranges.
