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Q1: Leucocyte benign disorders //Describe the lab. features used to diagnose IM •

4- Describe the morphological abnormalities in peripheral blood and bone marrow smear found in Refractory cytopenia with multilineage dysplasia?

• 5- Describe the BM picture of AML, M6 , How can you confirm the diagnosis •

6- Describe hematologic findings in AML-M3 ? •

7-what is the diagnostic approach to acute leukemia?

8- Describe the pathogenesis of chronic idiopathic myelofibrosis?

Answer 1

Raise total WBC count due to elevation of any lineage is called leukocyte benign disorders.

Q.1. Leukocytes benign disorders are:

1. Leukocytosis

2. Leukopenia

3. Neutrophilia

4. Neutropenia

5. Eosinophilia

6. Basophilia

7. Monocytosis

8. Lymphocytosis

Q.4. Peripheral Blood:

RBC : mild to moderate degree of macrocytic or dimorphic anaemia.

WBC: Normal or low total lekocyte count.

Platelets: thrombocytopenia, large hypogranular platelets.

Bone Marrow:

Cellularity: Hypercellular

Iron stores: increases with ring sideroblasts.

Erythropoiesis: presence of ringed sideroblasts bin iron stain and dysplastic change in erythroid precursor.

Myelopoiesis: hyperplasia with dysgranulopoesis.

Megakaryopoesis: Dysmegakaryopoesis.

Question 5:

Erythrolekemia:

More than 50% of erythroid precursors in bone marrow of all nucleated cells and more than 20% of myeloblasts in non erythroid population.

The nucleolus are clustered together and may be stretched or comma shaped.

Diagnosis can be confirmed by a bone marrow biopsy with a differential count of all nucleated cells. If the blast are more than 20% of non erythroid cells then the diagnosis is AML- M6.

6. Hematological findings in AML-M3:

RBC : Normocytic Normochromic

WBC : can be increased or decrease or normal

Neutropenia , Blasts increases.

Auer Rods are seen

Question 7: Diagnosis of Acute leukemia:

MPO, SBB : Positive

PAS + : M5 M6 M7

NSE + M4, M5

CD 34 Is stem cell marker

For Erythroblast: glycophorin A and B.

For Megakaryoblast: CD 41, CD 61

Question 8: pathogenesis:

Most of them show JAK2 Mutations, which is characterized by a proliferation of predominant megakaryocytes and granulocytes in the bone marrow. Fully developed disease results in reactive bone marrow fibrosis and replaces hematopoietic cells leading to cytopenia and extramedullary hematopoiesis.