Question 1

Which of the following statements is correct regarding monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM)?

Accepted Answer

A)  MGUS has a low level of monoclonal spike without an underlying neoplasm, whereas MM has a monoclonal spike with an underlying neoplasm. 
B)  MGUS has a monoclonal spike that is IgM in nature, whereas MM has a monoclonal spike that is IgG in nature. 
C)  MGUS exhibits tumor localization, whereas MM exhibits tumor dissemination. 
D)  MGUS and MM are the same. 
A)  MGUS has a low level of monoclonal spike without an underlying neoplasm, whereas MM has a monoclonal spike with an underlying neoplasm. 
B)  MGUS has a monoclonal spike that is IgM in nature, whereas MM has a monoclonal spike that is IgG in nature. 
C)  MGUS exhibits tumor localization, whereas MM exhibits tumor dissemination. 
D)  MGUS and MM are the same.

Question 2

The specimen of choice to confirm a lymphoma is a:

Accepted Answer

A)  Bone marrow aspirate 
B)  Blood sample 
C)  Lymph node biopsy 
D)  Skin biopsy 
A)  Bone marrow aspirate 
B)  Blood sample 
C)  Lymph node biopsy 
D)  Skin biopsy

Question 3

Which of the following contributes to the pathogenesis of lymphoid neoplasms?

Accepted Answer

A)  Genetic anomalies 
B)  Inherited immunodeficiency syndromes 
C)  Viral infections 
D)  All of the above 
A)  Genetic anomalies 
B)  Inherited immunodeficiency syndromes 
C)  Viral infections 
D)  All of the above

Question 4

In the subgroups of chronic leukemic lymphoid malignancies, which are the key features of Sézary syndrome?

Accepted Answer

A)  CD3+, CD2+, CD5+, CD4+, CD8± 
B)  CD3+, CD2+, CD5+, CD4+, CD8±, CD7− 
C)  CD19+, CD5−, CD20+ strong intensity 
D)  CD22+, CD103+, CD11c+, CD25+ 
A)  CD3+, CD2+, CD5+, CD4+, CD8± 
B)  CD3+, CD2+, CD5+, CD4+, CD8±, CD7− 
C)  CD19+, CD5−, CD20+ strong intensity 
D)  CD22+, CD103+, CD11c+, CD25+

Question 5

The "starry sky" appearance of neoplastic cells in a lymph node biopsy are found in:

Accepted Answer

A)  Sezary syndrome 
B)  Hairy cell leukemia 
C)  Burkitt lymphoma 
D)  Follicular lymphoma 
A)  Sezary syndrome 
B)  Hairy cell leukemia 
C)  Burkitt lymphoma 
D)  Follicular lymphoma

Question 6

A bone marrow aspirate is performed for staging purposes on a patient with Hodgkin lymphoma. The results come back positive for infiltration by Reed Sternberg cells. This means that the patient is:

Accepted Answer

A)  In the early stages of the disease 
B)  In the late stages of the disease 
C)  Converting to non-Hodgkin lymphoma 
D)  Entering remission 
A)  In the early stages of the disease 
B)  In the late stages of the disease 
C)  Converting to non-Hodgkin lymphoma 
D)  Entering remission

Question 7

A patient's symptoms include visual impairment, headache, dizziness, and deafness. The peripheral blood smear reveals lymphoplasmacytic lymphoma. What would rule out the diagnosis of Waldenström's macroglobulinemia?

Accepted Answer

A)  Elevated plasma levels of IgM 
B)  Increased serum viscosity levels 
C)  Presence of monoclonal κ light chains 
D)  Plasma cell neoplasm with lytic bone lesions 
A)  Elevated plasma levels of IgM 
B)  Increased serum viscosity levels 
C)  Presence of monoclonal κ light chains 
D)  Plasma cell neoplasm with lytic bone lesions

Question 8

A technologist is reviewing a blood smear and notices 35% lymphocytes with azurophilic granules and nuclei with mature clumped chromatin. These cells are typical of those found in:

Accepted Answer

A)  Hairy cell leukemia 
B)  Sézary syndrome 
C)  Large granular lymphocyte leukemia 
D)  Chronic prolymphocytic leukemia 
A)  Hairy cell leukemia 
B)  Sézary syndrome 
C)  Large granular lymphocyte leukemia 
D)  Chronic prolymphocytic leukemia

Question 9

Which subgroup of CLL reveals pancytopenia, TRAP+, CD19+, CD5−, CD20+ strong intensity, CD22+, CD103+, CD11c+, and CD25+ with circulating hairy cells?

Accepted Answer

A)  B-cell chronic lymphocytic leukemia 
B)  T-cell PLL 
C)  Hairy cell leukemia 
D)  Sézary syndrome 
A)  B-cell chronic lymphocytic leukemia 
B)  T-cell PLL 
C)  Hairy cell leukemia 
D)  Sézary syndrome

Question 10

Large cells with abundant, intensely basophilic cytoplasm with prominent cytoplasmic vacuolization are identified on a peripheral smear. Multiple basophilic nucleoli are present. A starry sky appearance is seen with fields of basophilic leukemic blasts with benign macrophages that have ingested tumor cells. What leukemia should be suspected with this morphology?

Accepted Answer

A)  Acute undifferentiated leukemia 
B)  Acute lymphoblastic leukemia-Burkitt-type 
C)  Acute leukemia with lineage heterogeneity 
D)  Precursor T-cell leukemia 
A)  Acute undifferentiated leukemia 
B)  Acute lymphoblastic leukemia-Burkitt-type 
C)  Acute leukemia with lineage heterogeneity 
D)  Precursor T-cell leukemia

Question 11

An increase in paraprotein concentration of a single isoform is defined as:

Accepted Answer

A)  Immune response 
B)  Monoclonal gammopathy 
C)  Oligoclonal banding 
D)  Hyperparaproteinemia 
A)  Immune response 
B)  Monoclonal gammopathy 
C)  Oligoclonal banding 
D)  Hyperparaproteinemia

Question 12

A 15-year-old patient has an active infection with Epstein-Barr virus, which will lead to which of the following?

Accepted Answer

A)  Leukemia 
B)  Lymphoma 
C)  Multiple myeloma 
D)  Lymphadenopathy 
A)  Leukemia 
B)  Lymphoma 
C)  Multiple myeloma 
D)  Lymphadenopathy

Question 13

Describe the Ann Arbor staging system for malignant lymphoma.

Accepted Answer

The Ann Arbor classification system focu

Question 14

A technologist is reviewing a lymph node biopsy slide and notices a prominent lymphocytosis as well as the presence of a few tumor cells with the following characteristics: large, multilobated nucleus with delicate nuclear membranes; finely granular chromatin; and small, indistinct nucleoli. Based on this information, what is the likely diagnosis?

Accepted Answer

A)  Anaplastic large cell lymphoma 
B)  Lymphocyte rich Hodgkin lymphoma 
C)  Monoclonal gammopathy of undetermined significance 
D)  Lymphocyte-depleted Hodgkin lymphoma 
A)  Anaplastic large cell lymphoma 
B)  Lymphocyte rich Hodgkin lymphoma 
C)  Monoclonal gammopathy of undetermined significance 
D)  Lymphocyte-depleted Hodgkin lymphoma

Question 15

Which of the following laboratory tests would best help differentiate plasma cell myeloma and Waldenstrom's macroglobulinemia?

Accepted Answer

A)  Peripheral blood smear 
B)  Positive MYD88 L265P mutation 
C)  Bone marrow aspirate 
D)  Total protein measurement 
A)  Peripheral blood smear 
B)  Positive MYD88 L265P mutation 
C)  Bone marrow aspirate 
D)  Total protein measurement

Question 16

Explain the molecular and cytogenetic profile of a patient with Burkitt lymphoma.

Accepted Answer

Cytogenetic: Translocation of the MYC ge

Question 17

All of the following are consistent with a diagnosis of plasma cell myeloma except:

Accepted Answer

A)  Lytic bone lesions 
B)  Low calcium levels 
C)  Rouleaux on the peripheral smear 
D)  Clonal plasma cell infiltrates in the bone marrow 
A)  Lytic bone lesions 
B)  Low calcium levels 
C)  Rouleaux on the peripheral smear 
D)  Clonal plasma cell infiltrates in the bone marrow

Question 18

The presence of which of the following cells in peripheral circulation strongly indicates Sézary syndrome?

Accepted Answer

A)  Lymphocytes with nuclear clefting 
B)  Lymphocytes with cerebriform convoluted nuclei 
C)  Normal lymphocytes 
D)  Lymphocytes with bilobed nuclei 
A)  Lymphocytes with nuclear clefting 
B)  Lymphocytes with cerebriform convoluted nuclei 
C)  Normal lymphocytes 
D)  Lymphocytes with bilobed nuclei

Question 19

In plasma cell myeloma, the erythrocytes have a distinct abnormality in the peripheral blood. Which of the following is that abnormality?

Accepted Answer

A)  Rouleaux formation 
B)  Moth-eaten appearance 
C)  Agglutinates 
D)  Polychromasia 
A)  Rouleaux formation 
B)  Moth-eaten appearance 
C)  Agglutinates 
D)  Polychromasia

Question 20

Explain how environmental factors contribute to the pathogenesis of lymphoid neoplasms.

Accepted Answer

The Epstein-Barr virus infects B lymphoc

Exam 28: Mature Lymphoid Neoplasms

Which of the following statements is correct regarding monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM)?

The specimen of choice to confirm a lymphoma is a:

Which of the following contributes to the pathogenesis of lymphoid neoplasms?

In the subgroups of chronic leukemic lymphoid malignancies, which are the key features of Sézary syndrome?

The "starry sky" appearance of neoplastic cells in a lymph node biopsy are found in:

A bone marrow aspirate is performed for staging purposes on a patient with Hodgkin lymphoma. The results come back positive for infiltration by Reed Sternberg cells. This means that the patient is:

A patient's symptoms include visual impairment, headache, dizziness, and deafness. The peripheral blood smear reveals lymphoplasmacytic lymphoma. What would rule out the diagnosis of Waldenström's macroglobulinemia?

A technologist is reviewing a blood smear and notices 35% lymphocytes with azurophilic granules and nuclei with mature clumped chromatin. These cells are typical of those found in:

Which subgroup of CLL reveals pancytopenia, TRAP+, CD19+, CD5−, CD20+ strong intensity, CD22+, CD103+, CD11c+, and CD25+ with circulating hairy cells?

An increase in paraprotein concentration of a single isoform is defined as:

A 15-year-old patient has an active infection with Epstein-Barr virus, which will lead to which of the following?

Describe the Ann Arbor staging system for malignant lymphoma.

Which of the following laboratory tests would best help differentiate plasma cell myeloma and Waldenstrom's macroglobulinemia?

Explain the molecular and cytogenetic profile of a patient with Burkitt lymphoma.

All of the following are consistent with a diagnosis of plasma cell myeloma except:

The presence of which of the following cells in peripheral circulation strongly indicates Sézary syndrome?

In plasma cell myeloma, the erythrocytes have a distinct abnormality in the peripheral blood. Which of the following is that abnormality?

Explain how environmental factors contribute to the pathogenesis of lymphoid neoplasms.

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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