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Leukemias and Lymphomas
Chapters 19 - 22
14
Medical
Undergraduate 2
12/31/2006

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Term
FAB MO
Definition
AML - not otherwise categorized.

Myeloid leukemia with minimal differentiation.

Dependent on immunological identification of myeloid antigens.

MPO, PAS, NSE negative.
See image
http://www.med-ed.virginia.edu/courses/
path/innes/wcd/myeloid1.cfm
Term
FAB M1
Definition
Acute Myeloblastic Leukemia without maturation.
Blasts and promyelocytes predominate.
Auer rods present.
Leukocytosis > 100,000/ul.
http://www.med-ed.virginia.edu/courses/
path/innes/wcd/myeloid1.cfm
Term
FAB M2
Definition
AML with maturation.
Most common (20-40%) type of AML.
Leukocytosis > 300,000/ul.
>50% myeloblasts & promyelocytes.
Auer rods frequent.
MPO pos, NSE and PAS generally neg.

http://www.med-ed.virginia.edu/courses/
path/innes/wcd/myeloid1.cfm
Term
FAB M3
Definition
Acute Promyelocytic Leukemia (APL)
Abnormal promyelocytes with numerous primary type granules. Auer rods frequent and often multiple.
Often causes DIC.
Chromosomal abnormality t(15;17) unique to APL.
http://www.med-ed.virginia.edu/courses/
path/innes/wcd/myeloid1.cfm
Term
FAB M4
Definition
AMML Acute Myelomonocytic Leukemia.
Differentiation in both myeloid and monocytic lines.
Monocytes and promonocytes represent > 20%, but < 80% .
Monocytosis of > 5x10/L.
WBC > 100,000/ul (circulating blasts).
M4e variant in which eosinophils >5% and abnormal.
http://www.med-ed.virginia.edu/courses/
path/innes/wcd/myeloid1.cfm
Term
FAB M5
Definition
AMoL Acute Monocytic Leukemia.
Uncommon, <15% of all leukemias.
M5a - poorly differentiated form, >80% of cells are monoblasts (acute monoblastic). Median age 16 yr.
M5b - well-differentiated(acute monocytic) >80% of cells are monoblasts, promono-, and monocytes. Median age 49 yr.
http://www.med-ed.virginia.edu/courses/
path/innes/wcd/myeloid1.cfm
Term
FAB M6
Definition
AEL Acute Erythroblastic Leukemia, also
DiGuglielmo leukemia.
Rare and difficult to diagnose.
>50% of the nucleated marrow cells are abnormal NRBCs.
Leukemic red cells are frequently bizarre with extreme dysplastic features: giant forms, multinucleation, cytoplasmic vacuoles.
Blasts MPO neg, often pos for NSE.
http://www.med-ed.virginia.edu/courses/
path/innes/wcd/myeloid1.cfm
Term
FAB M7
Definition
Acute Megakaryoblastic Leukemia.
Rare - 3-5% of cases of AML.
Thrombocytopenia.
M7 blasts are MPO neg, +/- pos PAS & NSE.
Factor VIII-related protein usually found in megakaryoblast cytoplasm.
Poor prognosis.

http://www.med-ed.virginia.edu/courses/
path/innes/wcd/myeloid1.cfm
Term
Eosinophilic leukemia
Definition
Eosinophilic leukemia is a rare variant of acute myeloid leukemia in which blasts and immature eosinophils proliferate.
Should be distinguished from CML with large numbers of eosinophils.
Blood: >60% of WBCs may be eosinophils
CNS involvement appears to be common.
Fatal within a year.
Term
Basophilic Leukemia
Definition
Basophilic or mast cell leukemia
Rarest of all leukemias
WBC >30,000/ul, >50% basophils
Often infiltration of skin by mast cells
Assoc with t(6;9) and abn 12p.
See image
http://www.med-ed.virginia.edu/courses/
path/innes/wcd/myeloid1.cfm
Term
FAB L1
Definition
Acute Lymphoblastic Leukemia or ALL.
85% of ALLs are L1 type, 70% of children with ALL are Type L1.

L1 blasts are small w/coarse chromatin.
Nucleus round and regular.
Nucleoli inconspicuous.
Cytoplasm scanty or invisible.
Auer rods are never observed.
MPO is always negative.

http://www.med-ed.virginia.edu/ courses/path/innes/wcd/lymphoid.cfm
Term
Acute Lymphoblastic Leukemias
Definition
Three subsets:
FAB L1 children.
FAB L2 older children & adults.
FAB L3 secondary to Burkitt's lymphoma.

The morphology of lymphoblasts is quite variable and this variation forms the basis of the FAB classification.

Nuclei round-oval nuclei with coarse chromatin.
Nucleoli small and inconspicuous.
Cytoplasm basophilic, sparse in volume, usually without granules.
Auer rods are never observed.

The three FAB ALL types have largely been replaced by immunologic classification.
Term
FAB L2
Definition
27% of children with ALL are Type L2.

L2 blasts large and heterogeneous.
Nuclei irregular and often clefted.
One or more large nucleoli.
Cytoplasm abundant, may contain vacuoles.
PAS pos. NSE is usually negative. MPO is always negative.

http://www.med-ed.virginia.edu/ courses/path/innes/wcd/lymphoid.cfm
Term
FAB L3
Definition
B-cell Burkitt's lymphoma type of ALL.
Rare in children and adults.
L3 blasts large and homogeneous.
Nuclei are regular and round-oval in shape.
One or more prominent nucleoli.
Cytoplasm moderate amount; contains prominent vacuoles.
L3 leukemias are surface immunoglobulin (SIg) positive and of B cell lineage.

http://www.med-ed.virginia.edu/ courses/path/innes/wcd/lymphoid.cfm
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