Question 1

Morphological differences between ALL and Burkitt-type ALL include which of the following?

Accepted Answer

A)  Cell size, nuclear shape, and nuclear chromatin 
B)  Cell size, cytoplasmic basophilia, and cellular heterogeneity 
C)  Nucleoli, cytoplasmic volume, and vacuolation 
D)  Cell size, cytoplasmic basophilia and vacuolation, and prominent nucleoli 
A)  Cell size, nuclear shape, and nuclear chromatin 
B)  Cell size, cytoplasmic basophilia, and cellular heterogeneity 
C)  Nucleoli, cytoplasmic volume, and vacuolation 
D)  Cell size, cytoplasmic basophilia and vacuolation, and prominent nucleoli D

Question 2

A diagnosis of CLL requires morphologic and phenotypic findings of which of the following?

Accepted Answer

A)  Variable absolute lymphocyte counts with few prolymphocytes and CD38+ 
B)  Sustained absolute lymphocyte counts with mature lymphocytes, few prolymphocytes, smudge cells, CD20+, and ZAP-70+ 
C)  Marked absolute lymphocytosis, anemia, and thrombocytopenia; prolymphocytes less than 10% 
D)  Sustained absolute lymphocyte counts; mature lymphocytes; CD3−, CD2+, CD4−, CD8−, CD7+, CD16+, CD56+/CD57− 
A)  Variable absolute lymphocyte counts with few prolymphocytes and CD38+ 
B)  Sustained absolute lymphocyte counts with mature lymphocytes, few prolymphocytes, smudge cells, CD20+, and ZAP-70+ 
C)  Marked absolute lymphocytosis, anemia, and thrombocytopenia; prolymphocytes less than 10% 
D)  Sustained absolute lymphocyte counts; mature lymphocytes; CD3−, CD2+, CD4−, CD8−, CD7+, CD16+, CD56+/CD57− B

Question 3

A 25-year-old male presents with an enlarged lymph node in his axillary region. Further testing confirms malignancy in the enlarged lymph node but nowhere else. In which stage of lymphoma, according to the Ann Arbor classification system, is the patient?

Accepted Answer

A)  Stage I 
B)  Stage II 
C)  Stage III 
D)  Stage IV 
A)  Stage I 
B)  Stage II 
C)  Stage III 
D)  Stage IV A

Question 4

Which of the following detects clonality in an unknown cell population?

Accepted Answer

A)  Absolute lymphocytosis using morphology 
B)  CD4-positive T cells 
C)  Kappa light chain only present on B cells 
D)  Both kappa and lambda light chains present on B cells 
A)  Absolute lymphocytosis using morphology 
B)  CD4-positive T cells 
C)  Kappa light chain only present on B cells 
D)  Both kappa and lambda light chains present on B cells

Question 5

A lymph node biopsy from a patient with lymphadenopathy is performed. Which of the following findings would support the diagnosis of a reactive proliferation rather than a malignant lymphoma?

Accepted Answer

A)  A mixed population of cells varying in size, shape, and color 
B)  Clonality 
C)  Presence of large, bizarre cells 
D)  Mitotic activity 
A)  A mixed population of cells varying in size, shape, and color 
B)  Clonality 
C)  Presence of large, bizarre cells 
D)  Mitotic activity

Question 6

A male of 65 years of age is seen at a local hospital with symptoms of enlarged lymph nodes and possible gastrointestinal tract problems. The peripheral blood smear revealed cells resembling diffuse large B-cell lymphoma. The FISH studies demonstrated the IgH/CCND1 translocation. What is the probable disease?

Accepted Answer

A)  MALT 
B)  MCL 
C)  Burkitt leukemia 
D)  Follicular lymphoma 
A)  MALT 
B)  MCL 
C)  Burkitt leukemia 
D)  Follicular lymphoma

Question 7

Neoplastic T-cells with irregular, convoluted, cerebriform nuclear outline are found in:

Accepted Answer

A)  Sézary syndrome 
B)  Mantle cell leukemia 
C)  Burkitt lymphoma 
D)  Follicular lymphoma 
A)  Sézary syndrome 
B)  Mantle cell leukemia 
C)  Burkitt lymphoma 
D)  Follicular lymphoma

Question 8

Which test should be included when distinguishing between diffuse large B-cell lymphoma and blastic mantle cell lymphoma?

Accepted Answer

A)  CD20 
B)  Light chain analysis 
C)  Cyclin-D1 stain 
D)  IgM heavy chain analysis 
A)  CD20 
B)  Light chain analysis 
C)  Cyclin-D1 stain 
D)  IgM heavy chain analysis

Question 9

List and describe the five subtypes of Hodgkin lymphoma, focusing on laboratory features.

Accepted Answer

• Lymphocyte rich (LR): 4+ lymphocytes,

Question 10

Identify the lab features of the following disorders:
a. Plasmacytoma
b. Plasma cell myeloma
c. MGUS
d. Waldenström's macroglobulinemia

Accepted Answer

a. Plasmacytoma: Localized tumor collect

Question 11

Which of the following lymphoproliferative disorders is most closely associated with Richter's transformation?

Accepted Answer

A)  CLL 
B)  PLL 
C)  Sézary syndrome 
D)  Hairy cell leukemia 
A)  CLL 
B)  PLL 
C)  Sézary syndrome 
D)  Hairy cell leukemia

Question 12

The presence of which of the following cell types confirms the diagnosis of Hodgkin lymphoma?

Accepted Answer

A)  Lymphocyte 
B)  Plasma 
C)  Reed-Sternberg 
D)  Cleaved Sézary 
A)  Lymphocyte 
B)  Plasma 
C)  Reed-Sternberg 
D)  Cleaved Sézary

Question 13

Differentiate ALL from Burkitt-type ALL morphologically.

Accepted Answer

ALL: Burkitt-type ALL
• Small or large,

Question 14

Hairy cell leukemia and chronic lymphocytic leukemia appear morphologically similar to the untrained eye. Which of the following tests would help differentiate the two?

Accepted Answer

A)  Immunophenotyping 
B)  Cytogenetic analysis 
C)  TRAP stain 
D)  PAS staining 
A)  Immunophenotyping 
B)  Cytogenetic analysis 
C)  TRAP stain 
D)  PAS staining

Question 15

Explain the major differences between Hodgkin and non-Hodgkin lymphomas.

Accepted Answer

HL differs from other lymphomas clinical

Question 16

Which of the Hodgkin lymphoma histologic subtypes is composed of numerous reactive small lymphocytes and rare tumor cells that grow in loose nodular aggregates or popcorn cells (i.e., L&H cells)?

Accepted Answer

A)  Classic HL 
B)  Nodular sclerosis 
C)  Mixed cellularity 
D)  Lymphocyte-predominant 
A)  Classic HL 
B)  Nodular sclerosis 
C)  Mixed cellularity 
D)  Lymphocyte-predominant

Question 17

Which of the following agents promotes the development of non-Hodgkin lymphoma through mucosa-associated lymphoid tissue (MALT) infiltration?

Accepted Answer

A)  BCL-2 translocation 
B)  Helicobacter pylori 
C)  Epstein-Barr virus 
D)  Ataxia telangiectasia 
A)  BCL-2 translocation 
B)  Helicobacter pylori 
C)  Epstein-Barr virus 
D)  Ataxia telangiectasia

Question 18

Patients newly diagnosed with CLL/SLL often present with:

Accepted Answer

A)  Fever 
B)  Bleeding 
C)  No apparent symptoms 
D)  Anemia 
A)  Fever 
B)  Bleeding 
C)  No apparent symptoms 
D)  Anemia

Question 19

A physician is working up a patient. Based on physical examination, history, and initial screening tests, the physician suspects anaplastic large cell lymphoma (ALCL), but still needs to rule out classical Hodgkin lymophoma (HL). Which of the following test results would confirm ALCL?

Accepted Answer

A)  CD15 positive, CD30 negative 
B)  CD20 positive, CD30 positive 
C)  CD2 negative, CD30 negative 
D)  CD3 positive, CD30 positive 
A)  CD15 positive, CD30 negative 
B)  CD20 positive, CD30 positive 
C)  CD2 negative, CD30 negative 
D)  CD3 positive, CD30 positive

Question 20

Which protein is identified as a free light chain in the urine?

Accepted Answer

A)  MGUS 
B)  Heavy chains 
C)  M spike 
D)  Bence-Jones 
A)  MGUS 
B)  Heavy chains 
C)  M spike 
D)  Bence-Jones

Exam 28: Mature Lymphoid Neoplasms

Morphological differences between ALL and Burkitt-type ALL include which of the following?

A diagnosis of CLL requires morphologic and phenotypic findings of which of the following?

A 25-year-old male presents with an enlarged lymph node in his axillary region. Further testing confirms malignancy in the enlarged lymph node but nowhere else. In which stage of lymphoma, according to the Ann Arbor classification system, is the patient?

Which of the following detects clonality in an unknown cell population?

A lymph node biopsy from a patient with lymphadenopathy is performed. Which of the following findings would support the diagnosis of a reactive proliferation rather than a malignant lymphoma?

Neoplastic T-cells with irregular, convoluted, cerebriform nuclear outline are found in:

Which test should be included when distinguishing between diffuse large B-cell lymphoma and blastic mantle cell lymphoma?

List and describe the five subtypes of Hodgkin lymphoma, focusing on laboratory features.

Identify the lab features of the following disorders: a. Plasmacytoma b. Plasma cell myeloma c. MGUS d. Waldenström's macroglobulinemia

Which of the following lymphoproliferative disorders is most closely associated with Richter's transformation?

The presence of which of the following cell types confirms the diagnosis of Hodgkin lymphoma?

Differentiate ALL from Burkitt-type ALL morphologically.

Hairy cell leukemia and chronic lymphocytic leukemia appear morphologically similar to the untrained eye. Which of the following tests would help differentiate the two?

Explain the major differences between Hodgkin and non-Hodgkin lymphomas.

Which of the Hodgkin lymphoma histologic subtypes is composed of numerous reactive small lymphocytes and rare tumor cells that grow in loose nodular aggregates or popcorn cells (i.e., L&H cells)?

Which of the following agents promotes the development of non-Hodgkin lymphoma through mucosa-associated lymphoid tissue (MALT) infiltration?

Patients newly diagnosed with CLL/SLL often present with:

A physician is working up a patient. Based on physical examination, history, and initial screening tests, the physician suspects anaplastic large cell lymphoma (ALCL), but still needs to rule out classical Hodgkin lymophoma (HL). Which of the following test results would confirm ALCL?

Which protein is identified as a free light chain in the urine?

Introduction

Cellular Homeostasis

Structure and Function of Hematopoietic Organs

Hematopoiesis

The Erythrocyte

Hemoglobin

Granulocytes and Monocytes

Lymphocytes

The Platelet

The Complete Blood Count and Peripheral Blood Smear Evaluation

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopathies: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Hypoproliferative Anemias

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Disorders of Leukocytes: Granulocytes and Monocytes

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Precursor Lymphoid Neoplasms

Hematopoietic Stem Cell Transplantation

Morphologic Analysis of Body Fluids in the Hematology

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hemostasis: Laboratory Testing and Instrumentation

Hematology Procedures

Bone Marrow Examination

Automation in Hematology

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Quality Assessment in the Hematology Laboratory

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