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Quality in Life: The quality of a persons life is directly related to their commitment to excellence

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Hyperuricemia- gout, renal impairment. Chronic Myeloid Leukemia: Chronic Myeloid Leukemia: ... MPS : M.F. - Gout. MPS : MF - Marrow fibrosis. MPS : MF ... – PowerPoint PPT presentation

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Title: Quality in Life: The quality of a persons life is directly related to their commitment to excellence


1
Quality in Life The quality of a persons
life is directly related to their commitment to
excellence regardless of their chosen field of
endeavor
2
HEMATO-ONCOLOGY
Neoplasia of Hemopoietic system
  • Dr. VM Shashidhar
  • Senior Lecturer in Pathology
  • Fiji School of Medicine

3
Normal Blood Film
4
Haematological Neoplasia
  • Leukemias - Acute Chronic
  • Lymphomas - Hodgkins Non-Hodgkins (T cell, B
    cell, histiocytic others)
  • Myeloproliferative syndromes (MPS)
  • Myelodysplastic syndromes (MDS)

5
Leukemia Classification
  • Acute Leukemias
  • Myeloid - M0, M1, M2, M3, M4, M5, M6, M7
  • Lymphoid - L1, L2, L3.
  • Chronic Leukemias
  • Myeloid - CML
  • Lymphoid- CLL, PLL, HCL,

6
Leukemia - Clinical Features
  • Anemia (low RBC)
  • Fever - Infections (low WBC)
  • Bleeding tendency (low PLT)
  • Tender bones, lymphadenopathy, organomegaly Gum
    hypertrophy etc. (organ infiltration)

7
AML-M5 - Gum Hypertrophy
8
AML- Marked Purpura
9
ALLCervical Lymphadenopathy
10
Mediastinal Lymphnodes-ALL
11
ALL-Acute Lymphocytic Leuk.
  • Common in Children.
  • FAB classification L1, L2 L3
  • B cell, Tcell histiocytic types.
  • CD10 ve, Pre B cell type common.
  • Lymphadenopathy, bleeding tendency
  • Moderate Hepatosplenomegaly

12
ALL-L1
13
ALL-L2
14
ALL-L3
15
AML-Acute Myeloid Leuk.
  • Malignancy of myeloid progenitor cells.
  • Adults common
  • Hepatosplenomegaly moderate
  • No significant lymphadenopathy
  • Bleeding tendency
  • Gum bleeding common in M5/M4
  • FAB classification - M0 to M7.

16
AML-Acute Myeloid Leuk.
  • M0 - AML No maturation (
  • M1 - AML Min.Maturation(3 Peroxidase ve)
  • M2 - AML With full maturation
  • M3 - A.Promyelocytic leukemia
  • M4 - A.Myelomonocytic leukemia
  • M5 - A.Monocytic L(a-Monocytic, b-M.blastic)
  • M6 - A. Erythroleukemia
  • M7 - A. Megakaryocytic leukemia.

17
AML-M0 - Undifferentiated
18
AML-M1 - without maturation
19
AML-M2 - with maturation
20
AML-M3 - Auer Rods
21
AML-M3 - Auer Rods
22
AML-M3 - Promyelocytic
23
AML-M4 - Myelomonocytic
24
AML-M5b - Monoblastic Leuk
25
AML-M6 Erythroleukemia
26
AML-M7 Megakaryocytic
27
Chronic Myeloid Leukemia
  • Middle age 40-60y
  • Philadelphia chromosome, t(922)
  • Leucocytosis (50x109/L), abnormal cells
  • Marked splenomegaly
  • Anemia, Bleeding
  • Hypermetabolism,
  • Hyperuricemia- gout, renal impairment.

28
Chronic Myeloid Leukemia
29
Chronic Myeloid Leukemia
30
Chronic Lymphocytic Leukemia
  • Elderly age
  • Marked lymphoid proliferation
  • Non functional, excess life span.
  • Spleen, lymph node liver enlargement
  • Common B cell (CD5 ve)
  • Immunodeficiency, infections.
  • Anemia, thrombocytopenia at later stages.
  • Rare types are HCL,PLL, T-CLL

31
CLL
32
CLL Blood Film
33
Hodgkins Lymphoma
  • Lymphadenopathy, painless, firm
  • Pel-Ebstein fever, Eosinophilia,
  • Reed-Sternberg cells - B lymphocytes
  • Histological Types
  • Lymphocyte predominant.
  • Nodular Sclerosis.
  • Mixed cellularity.
  • Lymphocyte depleted.

34
Hodgkins lymphoma
35
Hodgkins lymphoma cells
36
Non-Hodgkins Lymphoma
  • According to cell type
  • T cell NHL
  • B cell NHL
  • Miscellaneous NHL
  • According to Clinical grade
  • Low grade NHL
  • High grade NHL
  • Intermediate grade NHL
  • Ex Lennerts lymphoma is a low grade Tcell NHL.
  • Burkitts lymphoma is a high grade B cell
    NHL

37
Diffuse - - Follicular
NHL- Histologic types
38
Small Intermed. Large
NHL- Histologic types
39
Myeloma Bone Marrow
40
Burkitts Lymphoma L.N.
41
Myelodysplastic Syndromes
  • Excess proliferation with dysplasia
  • Ineffective Myelopoiesis - Marrow hyperplasia
    with pancytopenia.
  • FAB classification
  • RA Refractory Anemia (Blasts
  • RARS RA with Ring Sideroblasts (
  • RAEB RA with excess blasts (
  • RAEB in T RAEB in transformation (5)

42
MDS - Pseudo Pelger-Huët
43
MDS - Dysplastic Erythroblasts
44
MDS - Excess Marrow Iron (Perls stain)
45
MDS RARS - Ring Sideroblast
46
Myeloproliferative Syndromes
  • Excess proliferation of marrow cell lines.
  • Primary Secondary
  • Primary MPS
  • Polycythemia rubra vera (PV)
  • Chronic Myeloid Leukemia (CML)
  • Essential Thrombocythemia (ET)
  • Myelofibrosis (MF)

47
MPS - P. Rubra Vera (PV)
48
MPS E.T. Bleeding
49
BM PS
MPS E.T. Thrombocytosis
50
MPS M.F. Organomegaly
51
MPS M.F. - Gout
52
MPS MF - Marrow fibrosis
53
MPS MF - Reticulin stain
54
MPS MF - Radio Iron Study
55
MPS Classification
56
CML - Blood Film
Basophils
57
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