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91 Cards in this Set
- Front
- Back
Define lymphoid malignancy
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overproduction of various types of immature or mature lymphocytes
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Activated B cells produce daughter cells of the same type that develop into ________ or ______.
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memory cells, plasma cells
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Stages of B-lymphocyte development
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Develop in the bone marrow as early pre-B cells.
These mature into pre-B cells in the marrow and then progress to mature B-cells. Mature B-cells are released into circulation to travel to the peripheral lymphoid organs. |
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T-lymphocytes are produced in the _______ and stimulated to move to the ______.
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bone marrow, thymus
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CD7 is one of the earliest and most sensitive markers for ______.
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T-cell ALL
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The mature thymocyte will be either a _____ expressing ____ or ________ expressing _________.
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helper cell, cd4, suppressor, cd8
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Habitat of lymphocytes
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bone marrow, peripheral blood, lymph nodes, mucosal tissues, spleen, liver, skin, thymus
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Name the plasma cell neoplasms
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multiple myeloma, heavy chain diseases, amyloidosis, monoclonal gammopathy of undetermined significance, Waldenstrom's macroglobulinemia
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Symptoms of acute lymphoblastic leukemia
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bleeding abnormalities, weakness, flu-like symptoms
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Acute lymphoblastic leukemia is characterized by ______ onset of symptoms, usually no more than _______ duration
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abrubt, a few weeks
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Acute lymphoblastic leukemia involves the replacement of ________ leading to ______. This leads to complications including _____, ______ and _____.
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normal marrow elements, bone marrow failure, anemia, thrombocytopenia, granulocytopenia
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Laboratory evaluations necessary for acute lymphoblastic leukemia
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CBC, platelet count, WBC differential, peripheral blood smear examination, cytochemistry/cytogenetics/molecular diagnostics, bone marrow aspiration
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Laboratory results characteristic of ALL
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increased or normal leukocyte count, neutropenia, lymphoblasts, normocytic/normochromic anemia, thrombocytopenia, hypercellular bone marrow with >30% lymphoblasts
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L1 morphology
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small, uniform lymphoblasts
seen primarily in children |
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L2 morphology
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large, pleomorphic lymphoblasts
seen more frequently in adults |
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L3 morphology
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Burkitt's type (vacuolated and deeply basophilic cytoplasm)
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2 WHO subgroups of ALL
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Precursor B and T cell neoplasms (L1/L2)
Burkitt type ALL (L3) |
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B-cell lineage is defined by surface antigen _______ and/or cytoplasmic ______.
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CD19, CD22
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Pre-B-cell ALL is most common in ______. It usually presents with WBC count _________.
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children 3-5 years of age, less than 100,000/L.
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Pre-B-cell ALL usually involves the ______ and _____ but not _____.
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bone marrow, blood, organs
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T-cell ALL usually presents with _______ mass and ______ involvement.
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mediastinal, organ
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______ are affected more by T-cell ALL.
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Males
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T-cell ALL has what type of prognosis?
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Poor compared to pre-B ALL.
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What type of organ involvement may be encountered with T-cell ALL?
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hepatosplenomegaly, early meningeal involvement
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Precursor T-cells in ALL express what cell markers?
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TdT, CD4 and CD8
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T-cell lineage is defined by what cell markers?
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CD2, CD3, CD5, CD7
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What is the most common FAB classification for T-ALL?
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L1
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L1 morphology
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uniform population of small blasts, scant cytoplasm, nuclear patten is homogenous, nucleoli are inconspicuous
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L2 morphology
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characterized by cellular heterogeneity, nuclear clefting and indentation are common, indistinguishable morphologically from AML-M2
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L3 morphology
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cells are uniform population of relatively large blasts, basophilic moderate to abundant cytoplasm, nucleus is round to oval with no indentations
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Describe the early phase of lymphoproliferative disorders
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tumor cells are small in size, few in number and have prolonged cell survival
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Describe the transformation phase of lymphoproliferative disorders
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tumer cells have increased numbers and appear in extramedullary sites with big, immature cells
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________ is the most common lymphocytic leukemia in adults
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Chronic lymphocytic leukemia
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Chronic lymphocytic leukemia is most frequently a neoplasm of ____ lymphocytes.
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B
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Small cell lymphoma involves lymph nodes with little ____ and _____ involvement
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peripheral blood, bone marrow
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Cells involved in CLL are _____-lived and _______ dysfunctional lymphocytes
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long, immunologically
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Malignancy in CLL is an effect of failed _______.
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apoptosis
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Marrow replacement in CLL results in ____, ______, and _____.
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anemia, thrombocytopenia, neutropenia
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CLL is characterized by extreme adenopathy (T/F)
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True
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90% of all CLL cases occur in adults older than ________.
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50 years
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CLL is found mostly in males (T/F)
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True, CLL is found in twice as many males as females
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Signs and symptoms of CLL develop _______.
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gradually
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Laboratory features of CLL
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minimum of 10x10^9 WBC/L in peripheral blood, 30% lymphocytosis of bone marrow, mature-appearing lymphs, normocytic/normochromic anemia, normal or low reticulocytes,
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Normal blood has approximately _______ B-cells and _______ T-cells. There may be up to _____ NK cells.
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20%, 60-80%, 22%
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The most common chromosomal abnormality in B-cell CLL is ________, which may occur alone or with deletions/translocations of _______.
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trisomy 12, chromosome 13q14.
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B-prolymphocytic leukemia is characterized by prominent ______ without ________.
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splenomegaly, lymphadenopathy
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B-prolymphocytic leukemia is characterized by ______ prolymphocytes in the peripheral blood. WBC count is often ________.
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55-70%, >100x10^9 cells/L
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Small lymphocytic lymphoma is the _______ of CLL and may be described as diffuse _______ lymphoma
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nodal counterpart, non-Hodgkin's
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Mantle cell lymphoma arises from the ______ of the _____ zone of __________.
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centrocytes, mantle, lymphoid follicles
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Mantle cell lymphoma cells are of what lineage?
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B-cell
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In mantle cell lymphoma, peripheral white blood cells counts may exceed ________.
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200 x 10^9/L
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Mantle cell lymphoma has a distinct immunophenotype and typical chromosomal translocation of:
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t(11;14)(q13;q32)
Cyclin D1 staining on tissue section is positive |
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Small cleaved cell lymphoma is a ______ lymphoma with ______ lymphocytes
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Non-Hodgkin's, B
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In small cleaved cell lymphoma, circulating cells have ____ cytoplasm, are ______ in shape, and have irregular _______ transversing the nucleus
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scant, irregular, notches/clefts
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Hairy cell leukemia is a ____ lymphocyte ______ leukemia
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B, chronic
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Pancytopenia is unique to what leukemia?
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Hairy cell leukemia
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_____ and _____ are frequently observed in hairy cell leukemia.
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Splenomegaly, marrow fibrosis
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The most characteristic cytochemical feature of hairy cell leukemia
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Strong acid phosphatase reaction not inhibited by tartrate
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Describe the morphology of circulating lymphocytes in hairy cell leukemia
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Possess fine, hair-like, irregular cytoplasmic projections
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Sezary syndrome is characterized by abnormal circulating lymphocytes with a ____ staining and _______ nuclear chromatin pattern with numerous folds and grooves
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dark, hyperchromatic
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Sezary syndrome is the leukemic phase of ___________.
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the common cutaneous T-cell lymphoma mycosis fungoides
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Adult T-cell leukemia/lymphoma is caused by ______
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HTLV-1
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Morphology of lymphocytes in adult T-cell leukemia/lymphoma
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highly convoluted nuclear shape (often clover leaf), marked variation in cell size, very prominent nucleoli
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Hodgkin lymphoma is characterized morphologically by:
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a proliferative background of benign inflammatory cells interspersed with malignant cells and their variants
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______ is the most common type of malignancy in children
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Hodgkin lymphoma
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_______ must be present to diagnose Hodgkin's lymphoma
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Reed-Sternberg cells
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________ usually presents with one firm lymph node spreading in an orderly fashion throughout the lymph system
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Hodgkin's lymphoma
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Extranodal involvement in Hodgkin's lymphoma may include _________.
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liver, spleen, lung or bone marrow
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In non-Hodgkin lymphoma, _______ can be found circulating in peripheral blood
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malignant lymphoma cells
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Non-Hodgkin lymphoma normally affects patients between _____ and ____ years of age
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20, 40
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Non-Hodgkin lymphoma typically arises in ______ and is characterized by prominent _______.
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peripheral lymph nodes, lymphadenopathy
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Define plasma cell disorder
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condition in which one clone of plasma cells multiplies excessively and produces a large quantity of abnormal antibodies
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Multiple myeloma forms tumors in the ______ and produces a large quantity of abnormal antibodies that accumulate in the ______ or ______.
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bone marrow, blood, urine
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Multiple myeloma is usually seen in people under 40 years of age (T/F)
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False, multiple myeloma is usually seen in people over 40 years of age
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Plasmacytomas are most common in:
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pelvic bones, spine, ribs/skull, lungs, reproductive organs
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In multiple myeloma, abnormal antibodies frequently end up in the _____, sometimes causing _______.
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kidney, renal failure
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Abnormal antibody light chains in the urine are known as ______. These are seen in ______ and ______.
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Bence Jones proteins, multiple myeloma, Waldenstrom's macroglobulinemia
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Symptoms of multiple myeloma
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bone pain (especially spine or ribs), anemia, easily fractured bones, recurring bacterial infections, kidney failure, blood "thickening"
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Laboratory findings in multiple myeloma
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abnormal RBCs, anemia, abnormally high calcium, high erythrocyte sedimentation rate, biopsy proven plasmacytoma (>30% plasma cell in bone marrow), monoclonal protein (>3.5 g/dL serum IgG, >2.0 g/dL of serum IgA), low normal immunoglobulins
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In monoclonal gammopathies of undetermined significance, a large quantity of abnormal antibody is produced but plasma cells are not ______.
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cancerous
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MGUS does not require _____, but may progress to _______.
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treatment, multiple myeloma
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Waldenstrom's macroglobulinemia is characterized by the production of _____________ by the plasma cells.
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excessive quantities of macroglobulins
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Macroglobulinemia may result in ______ syndrome, which is characterized by _______.
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hyperviscosity, reduced blood flow to extremities, abnormal bleeding, fatigue, weakness, headache, dizziness, coma
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In macroglobulinemia, tiny blood vessels in ________ can become engorged and bleed, resulting in ________.
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the back of the eyes, damage to the retina and impaired eyesight
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Define cryoglobulin
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an abnormal antibody that precipitates in the blood when cooled below body temperature
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Define Raynaud's phenomenon
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hands and feet become very painful and turn white when exposed to cold, occurs with cryoglobulinemia
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Define heavy chain disease
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Neoplastic plasma cell dyscriasias characterized by overproduction of monoclonal immunoglobulin heavy chains
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IgG gamma heavy chain disease affects the ____, _____ and ____. It normally affects the _____ population.
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liver, spleen, lymph nodes, elderly
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IgA alpha heavy chain disease usually produces _______. It affects ___________.
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abdominal masses, younger individuals in the Mediterranean
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IgM mu heavy chain disease produces _______ plasma cells.
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vacuolated
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L1 and L2 lymphoblasts are differentiated by _____ and _____.
______ techniques serve to confirm diagnosis. |
N:C ratio, presence/absence of nucleoli, immunologic/cytogenetic
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