PATHOLOGY PRACTICALS-II LEUKEMIAS & MULTIPLE MYELOMA

MYELOBLAST 10-18 um diameter Round to oval nucleus 2-5 nucleoli in the nucleus Chromatin in dispersed Basophilic cytoplasm at time vacuolated Auer rods seen in the cytoplasm MPO POSITIVE CD13, CD14, CD15 and CD33 antigen POSITIVE

NORMOBLASTS MYELOBLAST 3

Myeloblasts in AML Myeloblasts with Auer rods 4

MYELOBLAST WITH AUER ROD 5

LYMPHOBLAST 10-18 um Cytoplasm is agranular Cytoplasm is moderately basophilic Chromatin is coarse 1-2 nucleoli MPO NEGATVE CD10.CD19,CD20 and CD22 antigen positive

MYELOBLASTS LYMPHOBLASTS 7

CHRONIC MYELOID LEUKEMIA Peripheral blood film shows- Segmented neutrophils Myelocytes, few myeloblasts (<10%) Basophilia Eosinophilia (Bimodal population of myeloid series of cells)

CML- peripheral blood smear show immature myeloid cells, band forms and segmented mature neutrophils 9

CML- peripheral blood smear shows myelocyte metamyelocyte, basophil and eosinophils 10

CHRONIC LYMPHOID LEUKEMIA Peripheral blood film shows- Absolute lymphocytosis (mature lymphocytes) upto 90% Smudge cells/ smear cells

CLL 12

Markedly elevated in peripheral blood smear in CLL MATURE LYMPHOCYTES Markedly elevated in peripheral blood smear in CLL 13

HAIRY CELL LEUKEMIA Peripheral blood film shows- Abnormal mononuclear cells with hairy projections from the cell membrane

15

HAIRY CELL LEUKEMIA Malignant cells are positive for TRAP (tartrate resistant acid phophatase)

HAIRY CELL TRAP TEST +VE HAIRY CELL LEUKAEMIA HAIRY CELL TRAP TEST +VE 17

Reed Sternberg cell Bilobed nuclei/owl-eyed nuclei with prominent inclusion like eosinophilic nucleoli. Abundant blue cytoplasm Surrounded by lymphocytes Seen in Hodgkin lymphoma CD 15 and CD 30 positive. Variants- lacunar histiocyte, popcorn cell

* * Burkitt’s lymphoma 7 yearAfrican child with swelling of jaw Tumor is ulcerated and draining Burkitt’s lymphoma Monotonous population of malignant lymphoid cells. Starry-sky pattern is due to tingle body laden macrophages (*) (containing the apoptotic tumor cell) * *

MULTIPLE MYELOMA The bone marrow shows: Plasma cells with basophilic cytoplasm, eccentric nucleus and coarse nuclear chromatin