Acute Leuke

mia 1. Acute Myelogenous Leukemia

-Typical pt- Elderly, 50 years old

Causes: related to marrow failure caused by replacement of normal marrow elements with leukemic blasts

Symptoms:

* Fatigue

* Infections

* Bleeding

* Palor

To Dx AML look for distinctive rodlike structures call Auer roods, which may be present in the myeloblast, which compose 20% of the bone marrow cellularity in AML

2. Chronic myelogenous leukemia (CML)

Typical pt: Adults 25-60

Dx- Diagnosis of CML can be done through blood smear examination, by the presence of Ph chromosome. This is the best way to distinguish CML from leukemoid RXN

Morphology:

* Elevated leukocyte count

* Circulating cells are neutrophils, basophils, eosinophils metamyelocytes and myolocytes

* Elevated platelets

Causes:

* Associated with the presence of a fusion gene call BCR-ABL due to a 9,22 translocation

* Chromosome 22 is referred to as the Philadelphia (Ph) chromosome

3. Polycythemia Vera

Causes: hallmark is excessive proliferation and maturation of erythroid , granulocytic, and megakaryocytic elements producing panmyelosis

Symptoms- the most obvious clinical sign and symptom is related to absolute increase in red cell mass

Morphology:

* Increase Blood volume and viscosity

* Congestion of all tissues and organs

* Hepatomegally

* Splenomegaly, due to vascular congestion

4. Acute disseminated Langerhans cell histiocytosis (Letterer-Siwe disease)

Typical pt: Children younger than 2 yrs of age

Signs: development of multifocal cutaneous lesions composed of langerhans cells

Symptoms:

* Hepatosplenomegaly

* Lymphadenopathy

* Pulmonary lesions

* Destructive osteolytic bone lesions

Histiocytosis:

* Proliferating Langerhans cells have human leukocyte antigen DR (HLA-DR) and they express CD1 antigen. These cells also have HX bodies or Birbeck’s granules in the cytoplasm.

5. Disseminated intravascular...