MLS Hematology Quiz

A 50-year old male was admitted to the hospital with acute leukemia.  Lab findings include: MPO, sIG, and CD2 negative.  PAS blocking pattern and TdT positive.  T(9:22) also positive.  These results are consistent with:

• AML
• CLL in lymphoblastic transformation
• T-cell ALL
• CML in lymphoblastic transformation

30-year old male with leukemia admitted due to cervical lymphadenopathy.  Laboratory findings included the following: LAP 11, WBC 40,000/μL, PLT 53,000/μL, and a normochromic/normocytic anemia.  Ph was positive.  Diff contained 48% basos, 13% blasts, 3% eos, 2% monos, 4% lymphs, with the rest being PMNs or early myeloid cells.  Bone marrow showed 95% cellularity with 50% (some MPO & SBB positivity).  These results are most consistent with:

• AML
• Erythroleukemia
• CML
• CML in blast transformation

Terminal deoxynucleotyidyl transferase (TdT) is a marker found on:

• Hairy cells
• Myeloblasts
• Monoblasts
• Lymphoblasts

Multipotent stem cells are capable of producing:

• Daughter cells of only one cell line
• Only T lymphs and B lymphs
• Erythropoietin, throbopoietin, and leukopoietin
• Lymphoid and myeloid cells

The term "shift to the left" refers to:

• A microscope adjustment
• Immature cell forms in the peripheral blood
• A trend on a Levy-Jennings chart
• A calibration adjustment on an instrument

Specific (secondary granules) of the neutrophil:

• Appear first at the myelocyte stage
• Contain lysosomal enzymes
• Are formed on the mitochondria
• Are derived from azurophilic (primary) granules

Bone marrow exam reveals hypercellular marrow with cells that stain positively with anti-TdT, anti-CD3, and anti-CD7 antibodies; however, the lymphoblasts are negative for sIgs, CD19, CD10, Fc, and complement receptors.  The most likely diagnosis is?

• Null-cell ALL
• CLL
• T-ALL
• Hairy cell leukemia

Which of the following leukemias is characterized by immature cells that are SBB+ with discrete, fine granules, MPO-, PAS +/-, NS+++, and muramidase+?

• Acute lymphocytic
• Chronic lymphocytic
• Acute myelocytic
• Acute myelomonocytic

Which of the following markers, typically detected in normal myeloid cells, are expressed on the surface of hairy cell leukemia lymps?

• CD3
• CD8
• CD11c
• CD103

In flow cytometric analysis, low-angle or forward scatter of a laser-light beam provides information that pertains to a cell's:

• Volume
• Viability
• Granularity
• Lineage