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Illustrated Pathology of the Bone Marrow
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 (ISBN-13: 9780511222764 | ISBN-10: 0511222769)




Index



AA see aplastic anemia (AA)

AA (secondary amyloidosis), 115

abnormal localization of immature myeloid precursor cells (ALIP), 45, 124

aCLL see atypical chronic lymphocytic leukemia (aCLL)

aCML see atypical chronic myeloid leukemia (aCML)

acquired granulocytopenias, 28

acquired red cell aplasia, 26

   etiology, 27

acute chest syndrome, etiology, 27

acute leukemias, 58–70

   and bone marrow necrosis, 129

   classification.HTM

     approaches, 58–9.HTM

     EGIL, 70.HTM

     FAB, 58, 59, 60.HTM

     WHO, 58, 59

   comorbidity, 26

   cytogenetic abnormalities, 11, 58

   diagnosis, approaches, 58–9

   diagnostic criteria, 58

   etiology, 12

   hypocellular, differential diagnosis, 22–3

   immunophenotypic markers, 10

   and polycythemia vera, 82

   remission criteria, 125–6

   residual, 125–6

   translocations, 11–12, 60

   treatment, bone marrow changes, 125–6

   see also biphenotypic acute leukemia

acute lymphoblastic leukemia (ALL), 59–62

   age differences, 62

   and bone marrow necrosis, 39, 41, 129

   classification.HTM

     FAB, 59.HTM

     WHO, 60

   cytochemistry, 8

   cytogenetic abnormalities, 11

   diagnostic criteria, 43

   gene rearrangements, 12

   hypoplastic, diagnostic features, 24

   molecular genetic abnormalities, 11

   prognosis, age differences, 62

   subtypes, 59

   see also precursor B-cell acute lymphoblastic leukemia (precursor-B-ALL); precursor T-cell acute lymphoblastic leukemia (precursor-T-ALL)

acute megakaryoblastic leukemia (AML M7), 64, 68

   classification, 68

   comorbidity, 64

   diagnostic criteria, 64

   and Down syndrome, 68

acute monoblastic/monocytic leukemia (AML M5), 64

   diagnostic criteria, 63–4

acute myelofibrosis see acute panmyelosis with myelofibrosis (APMF)

acute myeloid leukemia (AML), 62–5

   classification, 59.HTM

     FAB, 62–4.HTM

     WHO, 64–5

   cytochemistry, 8

   cytogenetic abnormalities, 11

   with inv(16)(p13q22), 65–6

   iron storage evaluation, 9

   and Kostmann syndrome, 28

   molecular genetic abnormalities, 11

   with 11q23 abnormalities, 66–7

   with recurrent genetic abnormalities, 65–70

   subtypes, 63

   with t(8;21), 65

   with t(11;17)(q23;q21), 66

   with t(16;16)(p13;q22), 65–6

   see also acute megakaryoblastic leukemia (AML M7); acute monoblastic/monocytic leukemia (AML M5); acute myeloid leukemia with maturation (AML M2); acute myeloid leukemia with minimal evidence of myeloid differentiation (AML M0); acute myeloid leukemia with multilineage dysplasia; acute myeloid leukemia not otherwise categorized; acute myeloid leukemia with predominant erythroid differentiation (AML M6); acute myeloid leukemia without maturation (AML M1); acute myelomonocytic leukemia (AML M4); acute promyelocytic leukemia (APL); therapy–related acute myeloid leukemia (t–AML)

acute myeloid leukemia with maturation (AML M2), 62

   classification, 63

   diagnostic criteria, 65

   subtypes, 65

acute myeloid leukemia with minimal evidence of myeloid differentiation (AML M0), 62

   diagnostic criteria, 62–3

acute myeloid leukemia with multilineage dysplasia, 67–8

   classification, 67

   diagnostic criteria, 67

acute myeloid leukemia not otherwise categorized 68–9

   classification, 68

acute myeloid leukemia with predominant erythroid differentiation (AML M6), 64, 69

   classification, 69

   diagnostic criteria, 64

acute myeloid leukemia without maturation (AML M1), 62

   classification, 63

acute myelomonocytic leukemia (AML M4), 63

   diagnostic criteria, 63

   subtypes, 63

   see also juvenile myelomonocytic leukemia (JMML)

acute myelomonocytic leukemia with eosinophilia (AML M4Eo)

   classification, 63

   translocations, 12

acute panmyelosis with myelofibrosis (APMF), 69

   diagnostic criteria, 68–9

   differential diagnosis, 51, 69

acute promyelocytic leukemia (APL), 63

   classification, 63

   diagnostic criteria, 66

   hypergranular variant, 63

   hypogranular variant, 63

   subtypes, 63

   translocations, 12

   treatment, bone marrow changes, 126–7

acute undifferentiated leukemia, 70

adults

   metastatic tumors, 120–1.HTM

     immunohistochemical studies, 120–1

adult T-cell leukemia/lymphoma (ATLL), 104

   in bone marrow, 104

   diagnostic criteria, 104

   occurrence, 104

   peripheral blood smears, 104

   symptoms, 104

adventitial reticular cells (ARCs)

   bone marrow reticulum cells, 7–8

   immunohistochemical stains, 8

AF4/MLL fusion proteins, biosynthesis, 12

age differences, acute lymphoblastic leukemia, 62

aggressive B-cell lymphomas, 101–5

   classification, 93

aggressive NK-cell leukemia, 103–4

   diagnostic criteria, 103–4

agnogenic myeloid metaplasia see chronic idiopathic myelofibrosis (CIMF)

agranulocytosis, and parvovirus infection, 27

AHCD (alpha heavy chain disease), 116

AL see primary amyloidosis (AL)

alcohol, 29

ALIP see abnormal localization of immature myeloid precursor cells (ALIP)

ALL1 gene see MLL gene

ALL see acute lymphoblastic leukemia (ALL)

all-trans-retinoic acid (ATRA), 12

   and bone marrow changes, 126–7

alpha heavy chain disease (AHCD), 116

amegakaryocytosis

   etiology, 29

   and parvovirus infection, 27

   treatment, 29

AML1/ETO fusion gene, 12, 65

AML1 gene, 12

   translocations, 12

AML1 protein, encoding, 12

AML see acute myeloid leukemia (AML)

AML M0 see acute myeloid leukemia with minimal evidence of myeloid differentiation (AML M0)

AML M1 see acute myeloid leukemia without maturation (AML M1)

AML M2 see acute myeloid leukemia with maturation (AML M2)

AML M3 see acute promyelocytic leukemia (APL)

AML M4 see acute myelomonocytic leukemia (AML M4)

AML M4Eo see acute myelomonocytic leukemia with eosinophilia (AML M4Eo)

AML M5 see acute monoblastic/monocytic leukemia (AML M5)

AML M6 see acute myeloid leukemia with predominant erythroid differentiation (AML M6)

AML M7 see acute megakaryoblastic leukemia (AML M7)

amyloid, electron micrographs, 116

amyloid deposition, in bone marrow, 116

amyloidosis, 115–16

   secondary, 115

   subtypes, 115

   see also primary amyloidosis (AL)

anaplastic myeloma, 113–15

   diagnostic criteria, 113

   prognosis, 113

anemias, 31

   comorbidity, 48

   Eastern–Dameshek, 24–5

   macrocytic, 31–2

   normocytic, 31

   sickle cell, 27

   see also aplastic anemia (AA); congenital dyserythropoietic anemias (CDAs); constitutional aplastic anemia; Diamond–Blackfan anemia (DBA); Fanconi anemia (FA); megaloblastic anemia; microcytic anemia; refractory anemia (RA)

angiogenesis, and tumor growth, 47

Annexin V, binding, 48

antibodies, as myelodysplastic syndrome markers 46

API2/MALT1 fusion genes, 98

APL see acute promyelocytic leukemia (APL)

aplasias, 22–9, 124–5

   chemotherapy-induced, 22

   see also constitutional aplastic anemia; granulocyte aplasia; megakaryocyte aplasia; paroxysmal nocturnal hemoglobinuria (PNH); red cell aplasia

aplastic anemia (AA), 22–4

   aspirate smears, 23

   core biopsies, 22, 23

   diagnostic criteria, 22

   differential diagnosis, 22–3, 24.HTM

     cytogenetic analyses, 24

   disease mimics, 22–3

   etiology, 22, 23

   severity grading, 23

   and toxic exposure, 22

   and viral infections, 22

   see also constitutional aplastic anemia

APMF see acute panmyelosis with myelofibrosis (APMF)

apoptosis evaluation

   by flow cytometry, myelodysplastic syndrome studies, 48

   by in-situ end labeling, myelodysplastic syndrome studies, 47

ARCs see adventitial reticular cells (ARCs)

aspirates see bone marrow aspirates

ATLL see adult T-cell leukemia/lymphoma (ATLL)

ATRA see all-trans-retinoic acid (ATRA)

atypical chronic lymphocytic leukemia (aCLL), 96–7

   diagnostic criteria, 96–7

   peripheral blood smears, 96

   use of term, 96

atypical chronic myeloid leukemia (aCML), 88–9

   bone marrow biopsies, 88

   characteristics, 88

   core biopsies, 89

   cytogenetic analyses, 89

   diagnostic criteria, 88–9

   differential diagnosis

   incidence, 88

   molecular genetic analyses, 89

   peripheral blood smears, 89

autoimmune myelofibrosis, 40

bacterial infections

   and bone marrow granulomas, 16

   and lymphocytosis, 35

basophilia, 35

   comorbidity, 35

   diagnosis, 35

B-cell lymphomas

   classification, 93

   diagnosis, 106–7

   and epithelioid granulomas, 16

   see also aggressive B-cell lymphomas; diffuse large B-cell lymphoma; intravascular large B-cell lymphoma; T-cell/histiocyte-rich large B-cell lymphoma

B-cell neoplasms

   classification, 93

   small lymphoid, 93

   see also aggressive B-cell lymphomas

B-cell prolymphocytic leukemia (B-PLL), 95–6

   bone marrow aspirates, 96

   characteristics, 95–6

   immunoglobulin heavy chain rearrangements, 96

   peripheral blood smears, 96

   translocations, 96

   use of term, 95

bcl-2, apoptosis inhibition, 48

BCR/ABL fusion gene, 12, 73

   p230 fusion protein, 76

   rearrangements, 73

   see also p190(BCR/ABL) fusion protein; Philadelphia chromosome; t(9;22)(q34;q11)

benign binucleated lymphocytosis, 35

benign plasma cells

   cytology, 111

   and reactive plasmacytosis, 110–11

   vs. malignant plasma cells, 110

benign plasmacytosis, and neoplastic expansion compared, 111

biopsy decalcification, 7

biphenotypic acute leukemia, 69–70

   classification, 70

   diagnostic criteria, 70

Birbeck granules, 20

B-lymphocytes, in lymphoid aggregates, 106–7

bone marrow

   amyloid deposition, 116

   differential cells counts, normal values, 6

   granulomas in, 16

   and leprosy, 16

   lymphoplasmacytic lymphoma, 117

   normal, 5–14

   plasma cell myeloma, 112–13

   post-transplant, cellularity, 125

   storage diseases, 18–20

bone marrow aspirates

   in metastatic tumor diagnosis, 119

   in myelodysplastic syndrome diagnosis, 44–5

bone marrow aspirate smears

   iron storage grading, 6–7

   stainable iron evaluation, 6–7

   stains.HTM

     iron, 7

bone marrow aspiration

   indications, 2

   and trephine core biopsies, 2

bone marrow biopsies

   indications, 2

   in metastatic tumor diagnosis, 119–20

   in myelodysplastic syndrome diagnosis, 43–4, 45–7

   stainable iron evaluation, 7

bone marrow cell lineages, normal values, age variations, 6

bone marrow cellularity

   estimates, 5

   hypocellularity, 22

   normal values, age variations, 5, 6

   post-transplant, 125

   ranges, 6

bone marrow changes

   erythroid hyperplasia with normocytic anemia, 31

   and growth factors, 128–9

   non-neoplastic, 39–42

   post-therapy, 124–30.HTM

     disease specific, 125–7.HTM

     myeloablative, 124, 125

bone marrow core biopsies, 6

   poorly prepared, 3

   well-prepared, 3

   see also trephine core biopsies

bone marrow evaluation

   ancillary techniques, 8

   cytochemistry, 8–9

   cytogenetic analyses, 10–12

   immunophenotyping, 9–10

   molecular genetic analyses, 10–12

   morphologic, 8

   multi-factorial approach

   of neoplastic processes, 5–14

   of proliferative processes, 5–14

   see also bone marrow aspiration; bone marrow biopsies

bone marrow examination see bone marrow evaluation

bone marrow extracellular stroma, evaluation, 7–8

bone marrow fibrosis, 39

   collagen type, 39, 40

   comorbidity, 39, 40, 64

   cytokine-induced, 39

   detection, 39

   etiology, 39

   evaluation, 6, 7–8

   grading, 8

   and hyperparathyroidism, 39

   post-therapy, 129–30

   and renal osteodystrophy, 39, 40

   reticulin type, 39, 40

bone marrow granulomas, 16

   associated diseases, 18

   etiology, 16, 17.HTM

     noninfectious, 16

   evaluation, 6

   and Hodgkin lymphoma, 16

   identification, 16

   infectious, 16

   Mycobacterium avium-intracellulare infection, 16, 17

   and non-Hodgkin lymphomas, 16

   post-therapy, 129

bone marrow necrosis, 39–40

   and acute lymphoblastic leukemia, 39, 41

   comorbidity, 39, 41, 129

   etiology, 39

   infection-induced, 129

   post-therapy, 39, 129

   total, 39–40

bone marrow reports, 14

   elements, 13

bone marrow reticulum cells, identification, 7–8

bone marrow transplantation, and bone marrow changes, 127

bone trabeculae

   abnormalities, 41–42

   evaluation, 41

   thickening, 41

   thinning, 41

Bordetella pertussis infection, 35

   and lymphocytosis, 35

Bouin’s fixative

B-PLL see B-cell prolymphocytic leukemia (B-PLL)

breast carcinomas, 120

brucellosis, and granulomas, 16

Burkitt-like lymphoma, 101–2

   characteristics, 101–2

   differential diagnosis, 102

   immunoglobulin heavy chain gene rearrangements, 102

Burkitt lymphoma, 101–2

   bone marrow biopsies, 62

   characteristics, 101–2

   classification, 60

   diagnostic criteria, 62

   differential diagnosis, 102

   immunoglobulin heavy chain gene rearrangements, 102

busulfan, and bone marrow changes, 127

carcinocythemia, 119, 120

carcinomas, 120

   breast, 120

   metastatic, 129

Castleman disease, differential diagnosis, 115

CBFβ/MYH11 fusion gene, 65–6

CD1a, expression, 20, 61

CD2, expression, 61

CD3, expression, 61

CD4, expression, 61

CD5, expression, 61

CD7, expression, 47, 61

CD8, expression, 61

CD9, expression, 61

CD10, expression, 60–1, 62

CD13, expression, 47, 60–1

CD15, expression, 61

CD19, expression, 60, 62

CD20, expression, 60, 61, 62

CD22, expression, 60, 62

CD33, expression, 47, 60–1

CD34

   as ALIP marker, 45–6

   applications, 47

   expression, 37, 47, 51, 60.HTM

     aberrant, 46.HTM

     in chronic myelogenous leukemia, 75–6

   immunostains, 37

CD38, expression, 60–1, 114

CD45, expression, 60

CD59, expression, 26

CD65, expression, 61

CD68, as marker, 46

CD79a

   expression, 60

   nuclear positivity, 61

CD117

   expression, 47

   as myelodysplastic syndrome marker, 46

CD138, staining, 114

CD163, as marker, 46

CDAs see congenital dyserythropoietic anemias (CDAs)

CEL see chronic eosinophilic leukemia (CEL)

cellularity see bone marrow cellularity

ceroid

   in histiocytes, 19

   staining, 19

Chediak–Higashi syndrome, 28

   granulocytes, 28

chemotherapy

   aplasia induction, 22

   and bone marrow changes, 124

childhood myelodysplastic syndromes see pediatric myelodysplastic syndromes

children

   chronic idiopathic myelofibrosis, 80

   metastatic tumors, 121–2.HTM

     diagnosis, 121–2.HTM

     immunohistochemical studies, 122

   myelodysplastic syndromes.HTM

     comorbidity, 54.HTM

     differential diagnosis, 54

   refractory anemia, 53

   refractory anemia with ringed sideroblasts, 53

chronic basophilic leukemia, 78

   differential diagnosis, 78

chronic eosinophilic leukemia (CEL), 77–8

   cytogenetic abnormalities, 77

   diagnostic criteria, 77

   differential diagnosis, 77

   symptoms, 77

chronic granulocytic leukemia see chronic myelogenous leukemia (CML)

chronic idiopathic myelofibrosis (CIMF), 78

   bone marrow biopsies, 78–9

   characteristics, 78

   in children, 80

   comorbidity, 79

   cytogenetic analyses, 80

   diagnostic criteria, 78, 79–80

   differential diagnosis, 78–9, 80.HTM

     complications, 79

   disease progression, 79

   grading, 80

   immunohistochemistry, 79

   incidence, 78

   intravascular hematopoiesis, 79

   with myeloid metaplasia, 78–83

   phases, 79

   prognosis, 80

   survival, 80

chronic lymphocytic leukemia (CLL), 94–5

   bone marrow aspirates, 94

   bone marrow biopsies, 94, 95

   characteristics, 94

   comorbidity, 26, 94

   diagnostic criteria, 94

   differential diagnosis, 94

   immunoglobulin heavy chain gene rearrangements 94

   immunophenotyping, 10

   large cell transformations, 94–5

   molecular studies, 94

   occurrence, 94

   peripheral blood smears, 95

   prolymphocytic transformations, 94–5, 96

   use of term, 94

   see also atypical chronic lymphocytic leukemia (aCLL)

chronic lymphoproliferative disorders, 93–107

   detection methods, 95

   molecular abnormalities, 95

chronic myelogenous leukemia (CML), 73

   blast transformations, 76

   bone marrow biopsies, 74, 76

   core biopsies, 74, 75

   diagnostic criteria, 73–5

   differential diagnosis, 34, 91

   etiology, 73

   immunophenotyping, 76

   α-interferon treatment, 76

   megakaryocytes, 74

   and monocytosis, 76

   occurrence, 73

   peripheral blood smears, 74

   phases, 75–6.HTM

     accelerated, 75.HTM

     classification

   phenotypic variability, 76

   and Philadelphia chromosome, 73, 74

   Philadelphia chromosome-negative, 76

   and pseudo-Gaucher macrophages, 19–20

   residual, detection, 127

   treatment, bone marrow changes, 127

   see also atypical chronic myeloid leukemia (aCML); neutrophilic chronic myelogenous leukemia (CML-N)

chronic myeloid leukemia see chronic myelogenous leukemia (CML)

chronic myelomonocytic leukemia (CMML), 89–91

   bone marrow aspirates, 90

   core biopsies, 90

   diagnosis, 89–90

   differential diagnosis, 90–1

   with eosinophilia, 91

   markers, 46, 90

   peripheral blood smears, 90

   subtypes, 89, 90

   translocations, 12

   see also juvenile myelomonocytic leukemia (JMML)

chronic myeloproliferative disorders (CMPDs), 73–84

   and bone marrow fibrosis, 39

   characteristics, 73

   classification, 73

   diagnosis, 73

   disease progression, 73

chronic neutrophilic leukemia (CNL), 76–7

   differential diagnosis, 76–7

   disease progression, 77

chymase, 85

CIMF see chronic idiopathic myelofibrosis (CIMF)

c-KIT gene, mutations, 85

CLL see chronic lymphocytic leukemia (CLL)

clockface chromatin, 110, 113

clonality, markers, 12

CML see chronic myelogenous leukemia (CML)

CML-N see neutrophilic chronic myelogenous leukemia (CML-N)

CMML see chronic myelomonocytic leukemia (CMML)

c-Mp1 gene

   expression, 83, 84

   mutations, 28–9

CMPDs see chronic myeloproliferative disorders (CMPDs)

C-MYC gene, translocations, 62

CNL see chronic neutrophilic leukemia (CNL)

collagens, staining, 7–8

congenital dyserythropoietic anemias (CDAs), 32–3

   bone marrow aspirates, 33

   bone marrow biopsies, 33

   diagnosis, 32–3

   etiology, 33

   hereditary erythroblastic multinuclearity with a positive acidified serum lysis test, 33

   types of, 32.HTM

     differential diagnoses, 32–3

congenital granulocyte aplasia, 28

   etiology, 28

   maturation arrest, 28

congenital neutropenia, marrow granulopoiesis, 28

congenital polycythemias, 81–2

congenital red cell aplasia, 26

constitutional aplastic anemia, 24–5

   cytogenetic abnormalities, 25

   Eastern–Dameshek anemia, 24–5

   see also Fanconi anemia

core binding factor, 11–12

   formation, 12

Crow–Fukase disease see POEMS syndrome

cyclic neutropenia, 28

cytochemical stains, 9

cytochemistry, in bone marrow evaluation, 8–9

cytogenetic abnormalities

   in acute leukemias, 11, 58

   in acute lymphoblastic leukemia, 11

   in acute myeloid leukemia, 11

   in juvenile myelomonocytic leukemia, 54

   in myelodysplasia, 11

   in myelodysplastic syndrome with eosinophilia, 52

   in myelodysplastic syndromes, 44

cytogenetic analyses

   in aplastic anemia evaluation, 24

   in atypical chronic myeloid leukemia evaluation, 89

   in bone marrow evaluation, 10–12

   in chronic idiopathic myelofibrosis evaluation, 80

   in myelodysplastic syndrome evaluation, 48

   in plasma cell disorders, 115

cytokines, bone marrow fibrosis induction, 39

cytomegalovirus infection, and fibrin ring granulomas 16

DBA see Diamond–Blackfan anemia (DBA)

delayed engraftment, and bone marrow changes, 124–5

Diamond–Blackfan anemia (DBA), 26

   diagnosis, 26

dichlorothiazide, 29

diepoxybutane, 24

diffuse large B-cell lymphoma, 101

   diagnosis, 101

   morphology discordance, 101

Down syndrome, and acute megakaryoblastic leukemia, 68

Dutcher bodies, 110, 117

dyserythropoiesis, 48, 49

   in erythroid hyperplasia, 31

dyskeratosis congenita, 28

Eastern–Dameshek anemia, 24–5

EBV (Epstein–Barr virus), 18

EDTA (ethylenediaminetetraacetic acid)

EGIL (European Group for the Immunological Classification of Leukaemias), 70

ehrlichiosis, and granulomas, 16

eosinophilia, 34–5

   comorbidity, 34–5

   etiology, 34

   see also acute myelomonocytic leukemia with eosinophilia (AML M4Eo); chronic eosinophilic leukemia (CEL); hypereosinophilic syndrome (HES); myelodysplastic syndrome with eosinophilia (MDS-Eos)

epithelioid granulomas, 17

   and B-cell lymphomas, 16

   characteristics, 16

   evaluation, 16

   and Hodgkin lymphoma, 16

   and peripheral T-cell lymphoma, 16

EPO (erythropoietin), 36

Epstein–Barr virus (EBV), and hemophagocytosis, 18

erythroblasts

   evaluation, 5

   iron in, 6–7

   localization, 5–6

erythroid hyperplasia, 25, 31, 33

   aspirate smears, 32

   dyserythropoiesis in, 31

   etiology, 31, 33–4

   with macrocytic anemia, 31–2.HTM

     diagnosis, 31–2.HTM

     etiology, 31

   with microcytic anemia, 33.HTM

     etiology, 33

   with normocytic anemia, 31.HTM

     bone marrow changes, 31.HTM

     etiology, 31.HTM

     and iron deficiency, 31

erythroid precursors, 7

erythroleukemia see acute myeloid leukemia with predominant erythroid differentiation (AML M6)

erythropoietin (EPO), hyperplasia induction, 36

essential thrombocythemia (ET), 83–4

   ancillary studies, 83

   bone marrow aspirates, 83

   and chronic idiopathic myelofibrosis, 78

   complications, 83

   core biopsies, 83

   cytogenetic abnormalities, 83, 84

   diagnostic criteria, 83

   differential diagnosis, 78–9, 84

   occurrence, 83

   peripheral blood smears, 83

estrogen, 29

ET see essential thrombocythemia (ET)

ethylenediaminetetraacetic acid (EDTA)

European Consensus Conference, 80

European Group for the Immunological Classification of Leukaemias (EGIL), 70

extraosseous plasmacytoma, 115

   localization, 115

   prognosis, 115

FA see Fanconi anemia (FA)

FAB classification see French–American–British (FAB) classification

familial erythrocytosis (primary familial and congenital polycythemia), 81–2

familial polycythemias, 81–2

Fanconi anemia (FA), 24–5, 28

   cellular defects, 24

   chromosomal breakage study, 25

   cytogenetic abnormalities, 25

   diagnosis, 24

   disease progress, 24–5

   incidence, 24

   residual maturing erythroblasts, 25

Fas, apoptosis induction, 48

fibrin ring granulomas, and cytomegalovirus infection, 16

fibroblasts, proliferation, 39

fibrosis see bone marrow fibrosis

flame cells, 110

flow cytometry

   advantages, 9, 10

   forward scatter vs. side scatter, 47

   gating techniques, 47

   in immunophenotyping, 9

   in lymphoplasmacytic lymphoma evaluation, 117

   markers, 10

   in multidrug resistance studies, 47–8

   in myelodysplastic syndrome diagnosis, apoptosis evaluation, 48

   paroxysmal nocturnal hemoglobinuria studies, 26

   in plasma cell myeloma evaluation, 114–15

   reviews, 9

folate deficiency, 31

follicular lymphoma, 99–100

   in bone marrow, 99

   characteristics, 99

   cytogenetic studies, 100

   diagnosis, 99–100

   grading, 99

   immunoglobulin heavy chain rearrangements, 100

   immunophenotyping, 100

   molecular genetic studies, 100

   peripheral blood smears, 99

French–American–British (FAB) classification

   acute leukemias, 58, 59, 60

   acute lymphoblastic leukemia, 59

   acute myeloid leukemia, 62–4

   diagnostic criteria, 43

   limitations, 43, 52

   of myelodysplastic syndromes, 43, 44

fuchsin, 19

fungi, and bone marrow granulomas, 16

gamma heavy chain disease (GHCD), 116

Gaucher cells, 16, 19

   staining, 18–19

Gaucher disease, 19

   diagnosis, 18–19

G-CSF see granulocyte colony-stimulating factor (G-CSF)

gelatinous transformation see serous fat atrophy

germ cell tumors, mediastinal, 20

GHCD (gamma heavy chain disease), 116

Giemsa stains, 85

GM-CSF see granulocyte–macrophage colony-stimulating factor (GM-CSF)

Gomori silver stain, 7, 8

granulocyte aplasia, 28

   see also congenital granulocyte aplasia

granulocyte colony-stimulating factor (G-CSF)

   and bone marrow changes, 128–9

   hyperplasia induction, 36, 37.HTM

     diagnostic issues, 36–7

granulocyte–macrophage colony-stimulating factor (GM-CSF)

   and bone marrow changes, 128–9

   hyperplasia induction, 36.HTM

     diagnostic issues, 36–7

granulocytes, in Chediak–Higashi syndrome, 28

granulocytic hyperplasia

   differential diagnosis, 34

   etiology, 34

granulomas

   fibrin ring, 16

   post-therapy, 129

   sarcoidal, 18

   types of, 16

   see also bone marrow granulomas; epithelioid granulomas; lipogranulomas

granulomatous disorders, 16–20

growth factors

   and bone marrow changes, 128–9

   and hyperplasias, 36–7

   megakaryocytic, 37

   see also granulocyte colony-stimulating factor (G-CSF); granulocyte–macrophage colony-stimulating factor (GM-CSF)

hairy cell leukemia (HCL), 97–8

   aplastic anemia simulation, 23–4

   bone marrow aspirates, 97

   bone marrow biopsies, 97

   cytochemistry, 9

   diagnosis, 97

   diagnostic criteria, 97

   diagnostic issues, 98

   occurrence, 97

   peripheral blood smears, 97

   variants, 98

HCL see hairy cell leukemia (HCL)

hematogones

   differential diagnosis, 126

   hyperplasia, 126

   use of term, 124

hematologic malignancies, paraffin section immunohistochemistry, 11

hematopoietic stem cell transplantation, and bone marrow changes, 124

hematuria, and paroxysmal nocturnal hemoglobinuria, 25

hemoglobin E disease, and microcytic anemia, 33

hemoglobin staining, 32

hemophagocytic syndromes, 17–18

   infection-associated, 19, 27

   interpretation, 20

hemophagocytosis

   etiology, viral, 18

   identification, 18

   lymphoma-associated, 18

   and T-cell malignant neoplasms, 18

hemosiderin, in bone marrow biopsies, 7

HEMPAS (hereditary erythroblastic multinuclearity with a positive acidified serum lysis test), 33

hepatitis infection, with reactive plasmacytosis, 110–11

hereditary erythroblastic multinuclearity with a positive acidified serum lysis test (HEMPAS), 33

HES see hypereosinophilic syndrome (HES)

histiocytes

   accumulation, 6

   ceroid in, 19

   iron in

   sea-blue, 19

   see also T-cell/histiocyte-rich large B-cell lymphoma

histiocytic disorders, 16–20

   nonleukemic, 20

histiocytic sarcoma, 20

   markers, 20

   occurrence, 20

   presentation, 20

histiocytosis X see Langerhans cell histiocytosis

HIV/AIDS

   plasma cells in, 110–11

   and POEMS syndrome, 115

   and thrombocytopenia, 35–6

h-MDS see hypoplastic myelodysplastic syndrome (h-MDS)

Hodgkin lymphoma, 105–7

   in bone marrow, 105

   and bone marrow granulomas, 16

   and bone marrow necrosis, 129

   diagnostic criteria, 105–6

   differential diagnosis, 106

   and epithelioid granulomas, 16

   see also non-Hodgkin lymphomas

hof, 110, 113

HRX gene see MLL gene

human herpes virus-6, 27

hydroxyurea, and bone marrow changes, 127

hypereosinophilic syndrome (HES), 77–8

   diagnostic criteria, 77

   differential diagnosis, 77

   symptoms, 77

hyperparathyroidism, and bone marrow fibrosis, 39

hyperplasias, 31–7

   and erythropoietin treatment, 36

   and granulocyte colony-stimulating factor treatment, 36, 37

   and granulocyte-macrophage colony-stimulating factor treatment, 36

   and growth factors, 36–7.HTM

     diagnostic issues, 36–7.HTM

     early acting, 37.HTM

     immunohistology, 37

   non-neoplastic, etiology, 31

   transient bone marrow, 31

   white blood cell, 34–7

   see also erythroid hyperplasia; mast cell hyperplasia; megakaryocytic hyperplasias

hypocellularity, etiology, 22

hypoplastic myelodysplastic syndrome (h-MDS), 46, 52

   diagnosis, 52

   prevalence, 52

   with refractory anemia, 52

IAHS (infection-associated hemophagocytic syndrome), 54

idiopathic thrombocytopenic purpura (ITP), 35

   core biopsies, 36

IgH (immunoglobulin heavy chain), 115

IHC see immunohistochemistry (IHC)

IL-3 (interleukin, 3) 37

imatinib mesylate, and bone marrow changes, 127

immunodeficiency syndromes

   and Mycorbacterium avium-intracellulare infection, 16

   see also HIV/AIDS

immunoglobulin heavy chain (IgH), translocations, 115

immunoglobulins, rearrangements, 12

immunohistochemical stains, 8

immunohistochemistry (IHC)

   advantages, 10

   applications, 10

   disadvantages, 10

   in immunophenotyping, 10

   markers, 10

   in plasma cell disorders, 113–15

   see also paraffin section immunohistochemistry

immunoperoxidase stains, 27

immunophenotyping

   antibody panels, 10

   applications, 9

   in bone marrow evaluation, 9–10

   flow cytometry, 9

   immunohistochemistry, 10

immunosecretory disorders, 110–17

   range, 110

indolent myeloma, 113

   diagnostic criteria, 113

infection-associated hemophagocytic syndrome (IAHS), and juvenile myelomonocytic leukemia compared, 54

infections

   and bone marrow necrosis, 129

   cytomegalovirus, 16

   hepatitis, 110–11

   parasitic, 34

   see also bacterial infections; parvovirus infection; viral infections

in situ end labeling (ISEL), applications, 47

α-interferon

   and bone marrow changes, 127

   in chronic myelogenous leukemia treatment, 76

interleukin, 3 (IL-3) 37

International Prognostic Scoring System (IPSS), 48

intravascular large B-cell lymphoma, 101

   diagnosis, 101

   symptoms, 101

inv(14)(q11;q32) 102–3

inv(16) 12, 66

inv(16)(p13q22) 12, 65–6

inversions

   inv(14)(q11;q32) 102–3

   inv(16) 12, 66

   inv(16)(p13q22) 12, 65–6

IPSS (International Prognostic Scoring System), 48

iron, evaluation of stainable, 6–7

iron deficiency, and erythroid hyperplasia with microcytic anemia, 33

iron staining, 7, 8, 9

iron storage

   grading, 6–7, 8

   underestimates, 7

ISEL (in situ end labeling), 47

ITP see idiopathic thrombocytopenic purpura (ITP)

juvenile myelomonocytic leukemia (JMML), 54, 91

   classification issues, 52–3

   cytogenetic abnormalities, 54

   diagnosis, 53

   diagnostic criteria, 53–4

   incidence, 53

   and infection-associated hemophagocytic syndrome compared, 54

karyotype analyses, 10–11

Kawasaki disease, 27

keratin, and metastatic tumors, 120–1

Kostmann syndrome, 28

   and acute myeloid leukemia, 28

Langerhans cell histiocytosis, 20

   occurrence, 20

   symptoms, 20

LAP (leukocyte alkaline phosphatase), 53, 74

large granular lymphocytic leukemia

   in bone marrow, 103

   occurrence, 103

   peripheral blood smears, 103

   see also T-cell large granular lymphocytic leukemia

Lennert lymphoma, 16

leprosy, and bone marrow, 16

leukemias

   karyotype analyses, 10–11

   see also acute leukemias

leukocyte alkaline phosphatase (LAP), 53, 74

leukopenia, and chronic idiopathic myelofibrosis, 78

light chains

   immunohistochemistry, 114

   stains, 114

   see also monoclonal light chain deposition diseases

lipid stains, 19

lipogranulomas, 17

   characteristics, 16

LNGFR (low-affinity nerve growth factor receptor), 8

lobular carcinoma of the breast, 120

low-affinity nerve growth factor receptor (LNGFR), immunohistochemical stains, 8

LPL see lymphoplasmacytic lymphoma (LPL)

lymphoblastic leukemia/lymphoma, 102

   diagnostic criteria, 102

   see also acute lymphoblastic leukemia (ALL)

lymphocytes

   B lymphocytes, 106–7

   occurrence, 5

   T lymphocytes, 5–6

lymphocytic hyperplasia, 85

lymphocytosis, 35

   B-cell.HTM

     diagnosis, 35.HTM

     occurrence, 35.HTM

     peripheral blood smears, 35

   benign binucleated, 35

   T-cell, etiology, 35

lymphoid aggregates, 5–6, 7, 106–7

   analytical issues, 107

   B lymphocytes in, 106–7

   characteristics, 106

   occurrence, 106

lymphoid neoplasms

   classification, 9

   malignancy diagnosis, 12

lymphoid precursor cells

   occurrence, 5

   see also hematogones

lymphomas

   Lennert, 16

   malignant, 93–7

   see also B-cell lymphomas; Burkitt-like lymphoma; Burkitt lymphoma; follicular lymphoma; Hodgkin lymphoma; lymphoblastic leukemia/lymphoma; lymphoplasmacytic lymphoma (LPL); mantle cell lymphoma; marginal zone lymphomas; small lymphocytic lymphoma; T-cell lymphomas

lymphoplasmacytic lymphoma (LPL), 97, 110–17

   ancillary studies, 117

   in bone marrow, 117

   characteristics, 116

   classification, 110

   differential diagnosis, 117

   flow cytometry, 117

   immunohistochemical studies, 117

   incidence, 116

   use of term, 116–17

lymphoproliferative disorders

   bone marrow studies, 93

   classification, 93

   cytogenetic studies, 93

   detection methods, 93, 95

   diagnosis, 93

   molecular genetic studies, 93

   see also chronic lymphoproliferative disorders

M0 see acute myeloid leukemia with minimal evidence of myeloid differentiation (AML M0)

M1 see acute myeloid leukemia without maturation (AML M1)

M2 see acute myeloid leukemia with maturation (AML M2)

M3 see acute promyelocytic leukemia (APL)

M4 see acute myelomonocytic leukemia (AML M4)

M4Eo see acute myelomonocytic leukemia with eosinophilia (AML M4Eo)

M5 see acute monoblastic/monocytic leukemia (AML M5)

M6 see acute myeloid leukemia with predominant erythroid differentiation (AML M6)

M7 see acute megakaryoblastic leukemia (AML M7)

macrocytic anemia, with erythroid hyperplasia, 31–2

macrophages, pseudo-Gaucher, 16, 19–20

MAI (Mycobacterium avium–intracellulare), 16, 17

malignant histiocytosis

   use of term, 20

   see also histiocytic sarcoma

malignant lymphoma, 93–107

malignant melanoma, 120

   bone marrow aspirates, 120

mantle cell lymphoma, 100–1

   in bone marrow, 100

   diagnosis, 100–1

   immunoglobulin heavy chain gene rearrangements, 100–1

   in peripheral blood, 100

marginal zone lymphomas, 98

   of bone marrow, 99

   diagnosis, 98–9

   etiology, 98

   lymphocyte formation, 98

   peripheral blood smears, 98

   types of, 98

Masson’s stain, 8

mast cell diseases

   classification, 84

   isolated forms, 85

mast cell hyperplasia, 35

   diagnostic issues, 35

   etiology, 35

mast cell leukemia, prognosis, 85

mastocytosis (systemic) see systemic mastocytosis

MDR1 gene, 47–8

MDS see myelodysplastic syndromes (MDS)

MDS-Eos see myelodysplastic syndrome with eosinophilia (MDS-Eos)

MDS-f see myelodysplastic syndrome with fibrosis (MDS-f)

MDS-h (myelodysplastic syndrome with hypocellular marrow), 46–7

MDS/MPD disorders see myelodysplastic/myeloproliferative (MDS/MPD) disorders

megakaryocyte aplasia, 28–9

   incidence, 28

   and thrombocytopenia with absent radius syndrome, 28–9

megakaryocytes

   abnormal, in myelodysplastic syndromes, 45

   CD34 expression, aberrant, 46

   in chronic myelogenous leukemia, 74

   evaluation, 5

   in immune thrombocytopenic purpura, 36

   localization, 5–6

   in megaloblastic anemia, 32

   micromegakaryocytes, 46

   naked nuclei, 35–6

   nucleus hypersegmentation, 32

megakaryocytic hyperplasias, 35–6

   comorbidity, 36

   etiology, 35

megaloblastic anemia

   core biopsies, 32

   hyperlobulated large megakaryocytes, 32

mesenchymal cells, evaluation, 7–8

metastatic neoplasms, 120, 121

metastatic tumors, 119–2

   in adults, 120–1.HTM

     immunohistochemical studies, 120–1

   blood abnormalities, 119

   bone marrow aspirates, 119

   bone marrow biopsies, 119–20

   cells, 120

   in children, 121–2.HTM

     diagnosis, 121–2.HTM

     immunohistochemical studies, 122

   diagnosis, 119

   and keratin, 120–1

   markers, 120–1

   and peripheral blood, 119

   see also carcinomas; malignant melanoma

methylene blue, 19

MF see myelofibrosis (MF)

MGUS see monoclonal gammopathy of undetermined significance (MGUS)

MHCD (mu heavy chain disease), 116

microcytic anemia

   with erythroid hyperplasia, 33

   and hemoglobin E disease, 33

   and thalassemias, 33

micromegakaryocytes, immunohistology, 46

mitomycin C, 24

mixed chronic lymphocytic leukemia/prolymphocytic leukemia, 96–7

   diagnostic criteria, 97

   use of term, 96

MLL gene

   abnormalities, 67

   functions, 12

   translocations, 12, 61, 66–7

molecular genetic abnormalities

   in acute lymphoblastic leukemia, 11

   in acute myeloid leukemia, 11

   in myelodysplasia, 11

   in myelodysplastic syndromes, 44

molecular genetic analyses

   in atypical chronic myeloid leukemia, 89

   in bone marrow evaluation, 10–12

monoclonal gammopathy of undetermined significance (MGUS), 110, 111

   diagnostic criteria, 111, 113

   differential diagnosis, 110

   disease progression, 111

   immunohistologic evaluation, 111

   incidence, 111

   use of term, 111

monoclonal heavy chain deposition diseases, 116

   differential diagnosis, 116

monoclonal light chain deposition diseases, 116

   differential diagnosis, 116

monocytosis, 34

   and chronic myelogenous leukemia, 76

   diagnosis, 34

   etiology, 34

monosomy 7 syndrome, incidence, 53

morula cells, 110

Mott cells, 110

MPDs see myeloproliferative disorders (MPDs)

mu heavy chain disease (MHCD), 116

multidrug resistance, studies, 47–8

multiple myeloma see plasma cell myeloma (PCM)

Mycobacterium avium–intracellulare (MAI), granuloma infection, 16, 17

mycosis fungoides, 104–5

   cytogenetic abnormalities, 105

   diagnostic criteria, 104–5

   occurrence, 104

myeloablative therapy, and bone marrow changes, 124, 125

myelodysplasia

   comorbidity, 26

   cytogenetic abnormalities, 11

   diagnostic criteria, 33–4

   etiology, 12

   molecular genetic abnormalities, 11

   and parvovirus infection, 27

myelodysplastic/myeloproliferative (MDS/MPD) disorders, 88–91

   characteristics, 88

   mixed, otherwise not classifiable, 91.HTM

     use of term, 91

myelodysplastic syndrome with eosinophilia (MDS-Eos), 52

   cytogenetic abnormalities, 52

   diagnosis, 52

   incidence, 52

myelodysplastic syndrome with fibrosis (MDS-f), 46, 51

   diagnostic criteria, 51

   differential diagnosis, 51, 79

   immunohistology, 46–7

   incidence, 51

   prognosis, 51

myelodysplastic syndrome with hypocellular marrow (MDS-h), immunohistology, 46–7

myelodysplastic syndromes (MDS), 43–54

   abnormal megakaryocytes, 45

   apoptosis studies, 47

   bone marrow aspirates, 44–5

   bone marrow biopsies, 43–4, 45–7

   characterization, 43

   children.HTM

     comorbidity, 54.HTM

     differential diagnosis, 54

   classification, 43, 44

   cytogenetic abnormalities, 44

   cytogenetic analyses, 48

   diagnosis, 43–8

   diagnostic criteria, 43

   differential diagnosis, 22–3, 52–4

   disease progress, 43

   flow cytometry, 47–8.HTM

     apoptosis evaluation, 47–8

   hypoplastic, diagnostic features, 24

   immunohistology, 46–7

   International Prognostic Scoring System, 48

   karyotype analyses, 10–11

   markers, 46

   molecular genetic abnormalities, 44

   with 17p abnormalities, 50

   peripheral blood analyses, 44

   primary, 43

   subtypes, 48–54

   survival rates, 43

   see also hypoplastic myelodysplastic syndrome (h-MDS); pediatric myelodysplastic syndromes; therapy-related myelodysplastic syndrome (t-MDS)

myelofibrosis (MF)

   grading, 80

   see also acute panmyelosis with myelofibrosis (APMF); chronic idiopathic myelofibrosis (CIMF)

myeloid cells, evaluation, 5

myeloid metaplasia

   and bone marrow fibrosis, 39

   with chronic idiopathic myelofibrosis, 78–83

myeloid neoplasms, classification, 9

myeloid precursors, 7, 34

myeloma

   and bone changes, 113

   cytogenetic abnormalities, 115

   immunohistochemistry, 114

   markers, 114

   prognosis, 114

   translocations, 115

   see also anaplastic myeloma; indolent myeloma; non-secretory myeloma; osteosclerotic myeloma; plasma cell myeloma (PCM); smoldering myeloma

myeloperoxidase stains, 8, 32

myelophthisis, 28

myeloproliferative disorders (MPDs)

   differential diagnosis, 52–4

   see also chronic myeloproliferative disorders (CMPDs)

myelosclerosis see chronic idiopathic myelofibrosis (CIMF)

α-naphthyl butyrate esterase, in cytochemistry, 8

necrosis see bone marrow necrosis

necrotic cells, classification issues, 39–40

neoplasms

   and bone marrow fibrosis, 39

   lymphoblastic, immunophenotyping, 9

   metastatic, 120, 121

   NK-cell lymphoid, 102

   small B-cell lymphoid, 93

   T-cell malignant, 18

   see also B-cell neoplasms; lymphoid neoplasms

neoplastic cells, evaluation, 6

neoplastic expansion, and benign plasmacytosis compared 111

neoplastic plasma cells, cytology, 111

neoplastic processes, bone marrow evaluation, 5–14

nerve growth factor receptor (NGFR)

   low-affinity, 8

   positivity, 7–8

neutropenia, 27, 44

neutrophilia, 34

   etiology, 34

neutrophilic chronic myeloid leukemia (CML-N), 76

neutrophils, 34

   abnormal, 44

   hypolobated, 44

NF1 gene, mutations, 54

NGFR see nerve growth factor receptor (NGFR)

Niemann–Pick cells, staining, 19

Niemann–Pick disease, 19

   diagnosis, 18–19

NK-cell lymphoid neoplasms

   immunophenotyping, 102

   see also aggressive NK-cell leukemia

non-Hodgkin lymphomas

   and bone marrow granulomas, 16

   and bone marrow necrosis, 129

non-leukemic histiocytic disorders, 20

non-secretory myeloma, 113

   diagnostic criteria, 113

normocytic anemia, with erythroid hyperplasia, 31

osteoblastic proliferations, evaluation, 6

osteopenia, evaluation, 6

osteoporosis, and bone trabeculae thinning, 41

osteosclerotic lesions, comorbidity, 41–2

osteosclerotic myeloma, 115

   in POEMS syndrome, 115

17p, abnormalities, 47

p53

   function loss, 47

   overexpression, 51

p190(BCR/ABL) fusion protein, 73

   expression, 76

p210 fusion protein, 73

p230(BCR/ABL) fusion protein, expression, 76

Paget’s disease

   and bone trabeculae thickening, 41

   evaluation, 6

pancytopenia, 25, 31

paraffin section immunohistochemistry

   antibodies, 11

   limitations, 10

parasitic infection, and eosinophilia, 34

paroxysmal nocturnal hemoglobinuria (PNH) 25–6

   bone marrow biopsies, 25

   comorbidity, 25, 26

   diagnosis, 26

   etiology, 25–6

   flow cytometry, 26

   symptoms, 25

parvovirus B19, 27

parvovirus infection, 26, 27

   and agranulocytosis, 27

   and amegakaryocytosis, 27

   chronic, 27

   and myelodysplasia, 27

   and red cell aplasia, 28

parvovirus-related erythroblastopenia, 26–7

   diagnosis, 27

   occurrence, 26–7

PAS staining see periodic acid-Schiff (PAS) staining

PCL see plasma cell leukemia (PCL)

PCM see plasma cell myeloma (PCM)

PCR (polymerase chain reaction), 12

PDGFRβ gene, chromosomal abnormalities, 90–1

pediatric myelodysplastic syndromes, 52–4

   classification, 53

   comorbidity, 54

periodic acid-Schiff (PAS) staining, 8, 16, 17, 18–19

peripheral blood, plasma cell myeloma, 112

peripheral blood analyses, in myelodysplastic syndrome diagnosis, 44

peripheral T-cell lymphoma

   diagnosis, 105

   and epithelioid granulomas, 16

PFCP (primary familial and congenital polycythemia), 81–2

phenytoin, 27

Philadelphia chromosome, 60–1, 73

   and chronic myelogenous leukemia, 73, 74

   see also BCR/ABL fusion gene; t(9;22)(q34;q11)

PIG-A gene, mutations, 25–6

plasma cell disorders, 110–17

   cytogenetic analyses, 115

   immunohistochemistry, 113–15

   range, 110

plasma cell leukemia (PCL), 113

   diagnostic criteria, 113

   prognosis, 110, 113

   subtypes, 113

   use of term, 112

plasma cell myeloma (PCM), 111–15

   in bone marrow, 112–13

   bone marrow core biopsies, 112

   diagnostic criteria, 112–13

   differential diagnosis, 110–11

   dysplastic features, 113

   flow cytometry, 114–15

   incidence, 111–12

   markers, 114–15

   in peripheral blood, 112

   prognosis, 112

   and rouleaux, 112

   variants, 113

plasma cells

   benign vs. malignant, cytologic features, 110

   circulating, 112

   in HIV/AIDS infection, 110–11

   inclusions, 110

   localization, 110

   proliferation markers, 114

   staining, 110, 114

   see also benign plasma cells

plasmacytic morphology, 113

PML/RARα fusion proteins, 12

PNH see paroxysmal nocturnal hemoglobinuria (PNH)

POEMS syndrome, 41–2, 115

   differential diagnosis, 115

   symptoms, 115

polyclonal plasmacytosis see reactive plasmacytosis

polycythemia vera (PV), 80–3

   and acute leukemias, 82

   characteristics, 80

   core biopsies, 81

   cytogenetic analysis, 82–3

   diagnostic criteria, 33, 80–1, 82

   disease progression, 81, 82

   phases.HTM

     erythrocytotic, 80–1.HTM

     spent, 80, 81

   see also post-polycythemic myeloid metaplasia (PPMM)

Polycythemia Vera Study Group (PVSG), 83

polymerase chain reaction (PCR), applications, 12

post-polycythemic myeloid metaplasia (PPMM), 80–1

   disease progression, 81

precursor B-cell acute lymphoblastic leukemia (precursor-B-ALL)

   bone marrow biopsies, 60, 62

   classification, 60

   diagnostic criteria, 60–1

   immunohistochemistry, 61

   immunophenotypes, 61

   markers, 60

   recurrent, differential diagnosis, 126

   residual, 126.HTM

     differential diagnosis, 126

   subtypes, 60–1

precursor T-cell acute lymphoblastic leukemia (precursor-T-ALL)

   classification, 60

   diagnostic criteria, 61–2

   immunophenotypes, 61

   subtypes, 61–2

prednisone, 29

primary amyloidosis (AL)

   diagnostic criteria, 115–16

   differential diagnosis, 116

primary familial and congenital polycythemia (PFCP), differential diagnosis, 81–2

primary hemophagocytic lymphohistiocytosis, etiology, 17

primary idiopathic myelofibrosis see chronic idiopathic myelofibrosis (CIMF)

proliferative processes, bone marrow evaluation, 5–14

promyelocytes, maturation arrest, 28

proteinaceous edema, bone marrow core biopsies, 24

Prussian blue (stain), 6–7, 8–9

pseudo-Chediak–Higashi granules, 44, 88

pseudo-Gaucher histiocytes, 74

pseudo-Gaucher macrophages, 16

   and chronic myeloid leukemia, 19–20

pseudoleukemia, use of term, 32

pseudo-Pelger–Huët cells, 44

PV see polycythemia vera (PV)

PVSG (Polycythemia Vera Study Group), 83

11q23

   abnormalities, 66–7

   deletion, 96

   translocations, 12

   see also MLL gene

13q14, deletions, 96, 115

14q32, translocations, 115

17q, 91

Q fever, and granulomas, 16

5q– syndrome, 50

   diagnostic criteria, 50

   prognosis, 50

RA see refractory anemia (RA)

radiotherapy, and bone marrow changes, 124

RAEB see refractory anemia with excess of blasts (RAEB)

RAEB-T see refractory anemia with excess of blasts in transformation (RAEB-T)

RARS see refractory anemia with ringed sideroblasts (RARS)

RARα gene, 12

   abnormalities, 66

RAS gene, mutations, 54, 91

RAS signaling pathway, activation, 12

RCMD see refractory cytopenia with multilineage dysplasia (RCMD)

reactive plasmacytosis

   and benign plasma cells, 110–11

   differential diagnosis, 110–11

   with hepatitis infection, 110–11

Realistic Pathologic Classification, 58, 68

   acute megakaryoblastic leukemia, 68

   acute myeloid leukemia, 59

red cell aplasia, 26–7

   congenital, 26

   and parvovirus infection, 28

   see also acquired red cell aplasia

refractory anemia (RA), 48–9

   in children, 53

   comorbidity, 48

   diagnosis, 48–9

   disease progress, 43

   with hypoplastic myelodysplastic syndrome, 52

   with ringed sideroblasts, 91

   survival rates, 49

refractory anemia with excess of blasts (RAEB), 49–50

   diagnostic criteria, 49–50

   subtypes, 50

refractory anemia with excess of blasts in transformation (RAEB-T), 50

   diagnostic criteria, 50

refractory anemia with ringed sideroblasts (RARS), 48–9

   in children, 53

   comorbidity, 48

   diagnosis, 48–9

   disease progress, 43

   survival rates, 49

refractory cytopenia with multilineage dysplasia (RCMD), 49

   diagnostic criteria, 49

renal osteodystrophy, and bone marrow fibrosis, 39, 40

reticulin, 7–8

retinoic acid, translocations, 12

Richter syndrome, 94–5

Romanovsky stains, 19

rouleaux, and plasma cell myeloma, 112

Russell bodies, 110

sarcomas

   pediatric, 121–2

   see also histiocytic sarcoma

sea-blue histiocytes, 19

secondary amyloidosis (AA), clinical significance, 115

secondary hemophagocytosis, 17

secondary polycythemia, 82

serous degeneration see serous fat atrophy

serous fat atrophy, 40–1

   comorbidity, 41

   detection, 41

   etiology, 40–1

   evaluation, 6

Sézary syndrome, 104–5

   cytogenetic abnormalities, 105

   diagnostic criteria, 104–5

   occurrence, 104

   peripheral blood smears, 104

Shwachman–Diamond syndrome, 28

sickle cell anemia, and parvovirus, infection, 27

sideroblasts, ringed, 9, 91

silver stains, 39

sinus histiocytosis, occurrence, 20

small B-cell lymphoid neoplasms, classification, 93

small B-cell proliferations, 93–8

   immunophenotyping, 94

small lymphocytic lymphoma

   use of term, 94

   see also chronic lymphocytic leukemia (CLL)

smoldering myeloma, 113

   diagnostic criteria, 113

solitary plasmacytoma of bone, 115

   disease progression, 115

   symptoms, 115

stainable iron, evaluation, 6–7

storage diseases, 18–20

   diagnosis, 18

Sudan black B (stain), 8

systemic mastocytosis, 84–5

   characteristics, 84

   comorbidity, 84

   diagnosis, 85

   diagnostic criteria, 84–5

t(1;19)(q23;p13) 61

t(1;22)(p13;q13) 68

t(3;21)(q26;q22) 12

t(4;11)(q21;q23) 12, 61

t(4;14)(p16;q32) 115

t(5;12)(q33;p13) 12, 77, 90–1

t(8;14)(q24;q32) 62

t(8;21) 12

t(8;21)(q22;q22) 12, 65

t(9;11)(p22;q23) 12, 66–7

t(9;12)(q32;p13) 12

t(9;22)(q32;q11) 12

t(9;22)(q34;q11) 60–1, 73

   see also BCR/ABL fusion gene; Philadelphia chromosome

t(11;14)(q13;q32) 96, 115

t(11;17)(q23;q21) 66

t(12;21) 12

t(12;21)(p13;q22) 12, 61

t(14;14)(q11;q32) 102–3

t(14;16)(q32;q23) 115

t(15;17)(q22;q11.2) 12

t(15;17)(q22;q12) 66

t(16;16)(p13;q22) 12, 65–6

t-AML see therapy-related acute myeloid leukemia (t-AML)

TAR (thrombocytopenia with absent radius) syndrome 28–9

tartrate-resistant acid phosphatase (TRAP), 85

   in hairy cell leukemia diagnosis, 97

   staining, 9

T-cell/histiocyte-rich large B-cell lymphoma, 101

   characteristics, 101

   diagnosis, 101

T-cell large granular lymphocytic leukemia, 103–4

   diagnostic criteria, 103

T-cell lymphomas

   angioimmunoblastic, 105

   immunophenotyping, 102

   peripheral, 105

   see also adult T-cell leukemia/lymphoma (ATLL); peripheral T-cell lymphoma

T-cell malignant neoplasms, and hemophagocytosis, 18

T-cell prolymphocytic leukemia (T-PLL), 102–3

   diagnostic criteria, 102–3

   immunophenotyping, 102

   subtypes, 102

   symptoms, 102

T-cell receptors, gene rearrangements, 12

TdT see terminal deoxynucleotidyl transferase (TdT)

TEL gene, chromosomal abnormalities, 90–1

TEL/PDGFRβ fusion genes, 12

terminal deoxynucleotidyl transferase (TdT)

   detection, 10

   expression, 60, 61

   nuclear positivity, 61

thalassemias, and microcytic anemia, 33

therapy-related acute myeloid leukemia (t-AML), 67–8

   alkylating agent-related, 67

   diagnostic criteria, 67

   prognosis, 67–8

   subtypes, 67

   topoisomerase II inhibitor-related, 67

therapy-related myelodysplastic syndrome (t-MDS), 51

   differential diagnosis, 51

   immunohistology, 46–7

   subtypes, 51

thrombocythemia, 91

thrombocytopenia

   and chronic idiopathic myelofibrosis, 78

   differential diagnosis, 78–9

   etiology, 35–6

   and HIV/AIDS infection, 35–6

   and megakaryocytic hyperplasias, 35

thrombocytopenia with absent radius (TAR) syndrome, and megakaryocyte aplasia, 28–9

thrombocytopenic purpura

   immune-mediated, 27

   see also idiopathic thrombocytopenic purpura (ITP)

thrombocytosis

   and megakaryocytic hyperplasias, 35.HTM

     comorbidity, 36

thymoma, 26

T lymphocytes, localization, 5–6

t-MDS see therapy-related myelodysplastic syndrome (t-MDS)

toluidine blue, 85

toxic exposure, and aplastic anemia, 22

T-PLL see T-cell prolymphocytic leukemia (T-PLL)

transcription factor proteins, encoding, 11–12

transient erythroblastopenia of childhood, 27

translocations

   in acute leukemias, 11–12, 60

   chromosome band, 11q23 12

   14q32 115

   retinoic acid, 12

   t(1;19)(q23;p13) 61

   t(1;22)(p13;q13) 68

   t(3;21)(q26;q22) 12

   t(4;11)(q21;q23) 12, 61

   t(4;14)(p16;q32) 115

   t(5;12)(q33;p13) 12, 77, 90–1

   t(8;14)(q24;q32) 62

   t(8;21) 12

   t(8;21)(q22;q22) 12, 65

   t(9;11)(p22;q23) 12, 66–7

   t(9;12)(q32;p13) 12

   t(9;22)(q32;q11) 12

   t(9;22)(q34;q11) 60–1, 73

   t(11;14)(q13;q32) 96, 115

   t(11;17)(q23;q21) 66

   t(12;21) 12

   t(12;21)(p13;q22) 12, 61

   t(14;14)(q11;q32) 102–3

   t(14;16)(q32;q23) 115

   t(15;17)(q22;q11.2) 12

   t(15;17)(q22;q12) 66

   t(16;16)(p13;q22) 12, 65–6

   and tyrosine kinase fusion protein development, 12

TRAP see tartrate-resistant acid phosphatase (TRAP)

trephine core biopsies

   advantages

   and bone marrow aspiration, 2

trichrome stains, 8, 39

trisomy, 3 98

true histiocytic lymphoma see histiocytic sarcoma

tumor cells, diagnostic issues

tumor growth, determinants, 47

tyrosine kinase fusion protein, development, 12

viral infections

   and aplastic anemia, 22

   and bone marrow granulomas, 16

   and lymphocytosis, 35

vitamin B12 deficiency, 31

Waldenstrom macroglobulinemia (WM)

   use of term, 116–7

   see also lymphoplasmacytic lymphoma (LPL)

white blood cell hyperplasias, 34–7

WHO see World Health Organization (WHO)

WM see Waldenstrom macroglobulinemia (WM)

World Health Organization (WHO)

   acute leukemia classification, 58, 59

   acute lymphoblastic leukemia classification, 60

   acute myeloid leukemia classification, 64–5

   acute myeloid leukemia not otherwise categorized classification, 68

   acute panmyelosis with myelofibrosis classification 68–9

   biphenotypic acute leukemia classification, 70

   Classification of Neoplastic Diseases of the Hematopoietic and Lymphoid Tissues, 58

   diagnostic criteria, 43

   follicular lymphoma grading, 99

   juvenile myelomonocytic leukemia classification, 52–3

   mast cell disease classification, 84

   myelodysplastic syndrome classification, 43, 44

Wright–Giemsa stains, 110

X-linked sideroblastic anemias, 53


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