Adv heme BOC study questions

Best describes the BM criteria for dx of acute myelomonocytic leukemia (AMML)

20% blasts, neutrophil precursors, and monocytes

What defines acute myelogenous leukemia w minimal differentiation

>20% blasts lacking cytochemical evidence of myeloid differentiation

At least what % of promyelocytes must be present for dx of prolymphocytic leukemia

>55%

Common form of childhood leukemia

ALL

Increased levels of TdT activity are indicative of

ALL

A block in the differentiation or maturation of and an accumulation of immature hematopoietic progenitors is a hallmark for

AML

A differential cell count of 50-90% myeloblast in a peripheral blood smear is typical of which of the following

AML

Auer rods most likley present in which of the following

AML

The BM in the terminal stage of erythroleukemia is often indistinguishable from that seen in

AML

Main groups of AML in the WHO classification system

AML, NOS

Elevation of the total granulocyte count above 7x10^3/uL is termed

Absolute neutrophilic leukocytosis

CLL

Accumulation of monocolonal B cells

A 41-year-old male arrived at the clinic with complaints of fatigue, malaise, and overall discomfort. Upon testing, the patient's CBC results were notably abnormal with 30% blasts present along with anemia and thrombocytopenia. Bone marrow and cytochemical staining were subsequently performed. The cytochemical stains noted negative reactions to Myeloperoxidase and Sudan Black B but a positive reaction to alpha-naphthyl acetate. Which of the following conditions is most likely seen? A. Acute erythroleukemia B. Acute monocytic leukemia C. Acute promyelocytic leukemia D. Acute lymphocytic leukemia

B. Acute monocytic leukemia Explain: Acute Monocytic Leukemia is most likely present due to the positive reaction of alpha-naphthyl acetate stain. This is a type of nonspecific esterase stain which are known to positively identify monoblastic cells. Specific esterase stains would stain myelocytic cells positively. Both Acute Erythroleukemia and Acute Lymphocytic Leukemia would stain negative with all three stains mentioned in the case. Acute Promyelocytic Leukemia would stain positive with Myeloperoxidase and Sudan Black B but would stain negatively with alpha-naphthyl acetate.

The photomicrograph is a representative field from a peripheral blood smear. Which of the following MCV values correlates best with the peripheral blood picture? A. 68 fL B. 82 fL C. 105 fL D. 149 fL

C. 109 fL Explain: Most of the cells observed in the peripheral blood smear are slightly larger than normal red blood cells. This is based on the fact that the majority of the red blood cells are larger than the nucleus of the small lymphocyte in the field, which can be used as a reference for the normal size of a red blood cell. These red blood cells are classified as macrocytes. The reference interval for MCV is 80-100 fL. An MCV value below 80 fL correlates with a finding of microcytes; an MCV value above 100 fL correlates with a finding of macrocytes. 105 fL is the best option since the red blood cells are only slightly larger than the nucleus of the small lymphocyte. An MCV of 68 fL correlates with a finding of microcytes. An MCV of 82 fL correlates with a finding of normocytes. An MCV of 149 fL correlates with very large macrocytes, much larger than those seen in this peripheral blood smear.

What is the lower reference limit for progressive motility of spermatozoa when performing a semen analysis? A. 12% B. 22% C. 32% D. 40%

C. 32% Explain: WTO grades sperm motility as progressive motility (PM), nonprogressive motility (NP), and immotility (IM). PM is defined as sperm moving linearly or in a large circle, NP is sperm moving without progression, and IM represents sperm with no movement. The lower reference limit for progressive motility is 32%. The lower reference limit for total motility (progressive + non-progressive) is 40 %.

A 72-year-old patient has a routine check-up and CBC. The CBC shows a high absolute neutrophil count of 28,000/µl, with slightly elevated bands, a few immature myeloid cells, and slight toxic granulation. Upon further examination of the patient, hepatomegaly and splenomegaly are noted. Because of the splenomegaly and the lack of obvious infection, a bone marrow exam is performed which shows hypercellularity of the granulocytes. Molecular testing yields a CSF3R mutation. The most likely diagnosis is: A. Pelger-Huet anomaly B. Chronic myelogenous leukemia (CML) C. Chronic neutrophilic leukemia (CNL) D. Primary myelofibrosis (PMF)

C. Chronic neutrophilic leukemia Explain: Chronic Neutrophilic Leukemia (CNL) is a rare myeloproliferative disorder seen in older adults. They typically have high neutrophil counts, although there is not a profound shift to the left. Toxic granulation of the neutrophils can also sometimes be seen. Bone marrow exam is as noted above, but the differential diagnosis is the CSF3R mutation which distinguishes it from both CML and PMF and non-neoplastic disorders such as Pelger-Huet. Pelger-Huet anomaly is a benign condition characterized by bi-lobed neutrophils. CML shows hyperproliferation of the myeloid lines, but molecular analysis yields the bcr/abl translocation. PMF is usually characterized by marrow fibrosis and megakaryocyte proliferation. however, a leukoerythroblastosis can also sometimes be seen. There are a number of mutations associated with PMF, but not CSF3R.

The image (immature granulocyte: promyelo or metamyelo) is a stained smear of cerebrospinal fluid. The cells present in this field may indicate what condition? A. Allergic rxn B. Bacterial meningitis C. Leukemia w/ CNS involvement D. Viral meningitis

C. Leukemia w/ CNS involvement Explain: Allergic reactions, bacterial/viral meningitis do not cause the presence of blasts to be noted in the CSF. Leukemia with CNS involvement will show immature cells, similarly to the peripheral blood smear. An allergic reaction will show predominantly eosinophils. Bacterial meningitis will show mainly neutrophils. A broad spectrum of lymphocytes and monocytes would be present in a case of viral meningitis.

Anticoagulant drugs, which are direct thrombin inhibitors (such as argatroban and bivalirudin), can prolong which of the following clot-based assay/s? A. Ecarin clotting time only (ECT) B. Activated thromboplastin time (aPTT) only C. PT and aPTT D. PT, aPTT, and Ecarin clotting time

C. PT and aPTT Explain: The correct answer is all three assays: PT, aPTT, and ECT. Direct thrombin inhibitors will prolong all of these tests since thrombin converts fibrinogen into fibrin, a step that occurs in all three tests. The aPTT and ECT are more useful in determining effectiveness and dosage, although they are not routinely done for this purpose.

The Philidelphia chromosome is formed by a translocation between

Chromosome 22 and 9

Hairy cell leukemia

Chronic leukemia of lymphocytic origin

All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with

Chronic myelocytic leukemia

Type of morphologically abnormal cells proliferate in acute myelogenous leukemia w inv (16)

Eosinophils

Which of the following conditions is a myeloproliferative neoplasm

Essential thrombocytopenia

Morphologic variants of plasma cells

Flame cells

Neutropenia is usually associated with

Viral infections

Dwarf or micro megakaryocytes may be found in the peripheral blood of patients with

primary myelofibrosis

Genetic alteration w favorable prognosis in pre-B-ALL

t(12;21)

Which of the following features define chronic myelogenous leukemia

t(9;22)

Supportive of myeloproliferative disorder

Granulocytosis

The M:E ratio in AML

High

The M:E ratio in CML is usually

High

Most common immunoglobulin in plasma cell myeloma

IgG

Biochemical abnormalities characteristics of PV include

Increased serum B12 binding capacity

Which of the following is most closely associated with Chronic myelomonocytic leukemia

Lysozymuria

Which disorder is a category in the WHO classification of myelodysplastic syndrome/myeloproliferative neoplasms

Juvenile myelomonocytic leukemia (JMML)

The absence of intermediate maturing cells between blasts and mature neutrophil commonly seen in AML and myelodysplastic syndromes is called

Leukemic hiatus

Elevation of the total WBC above 11x10^3/ul is termed

Leukocytosis

A BM shows foam cells range from 20-100 um in size, vacuolated cytoplasm w sphingomyelin and is faintly PAS+. This cell type is characteristic of what

Niemann-Pick disease

WHO classification, myelomonocytic leukemia would be AML

Not otherwise specified

What is true about ALL

Primitive lymphoid appearing cells accumulate in BM

WHO classification of myelodysplastic syndrome

Refractory thrombocytopenia

Elevation of the lymphocyte percentage above 45% is termed

Relative lymphocytosis

Leukemic phase of T cell lymphoma marked by what abnormality

Sezary cell

A useful chemical test for dx of HCL

Tartrate-resistant acid phosphatase test

Which of the following translocation most seen in Burkitt lymphoma the

t(8;14)

Characteristic of Hodgkin lymphoma

Bimodal age distribution

Which of the following smear techniques has the advantage of providing the best WBC distribution when performed correctly? A. Coverslip technique B. Spun technique C. Manual wedge technique D. Semi-automated wedge technique

A. Cover slip technique Explain: The coverslip technique is an older procedure that is rarely used for peripheral blood smears anymore. However, when performed properly, it produces an excellent distribution of leukocytes compared to spun or wedge techniques.

Which of the erythrocyte inclusions listed below would appear on a Wright-stained peripheral blood smear as round, smooth, almost pyknotic, dark-purple staining bodies ranging in size from 0.5 to 1.0 micron in diameter and usually occurring singly in erythrocytes? A. Howell-Jolly bodies B. Heinz bodies C. Basophilic stippling D. Pappenheimer bodies

A. Howell-Jolly bodies Explain: Howell-Jolly bodies appear on a Wright-stained peripheral blood smear as round, smooth, almost pyknotic, dark-purple staining bodies ranging in size from 0.5 to 1.0 micron in diameter and usually occurring singly in erythrocytes. Heinz bodies are formed from denatured globin and do not stain with Wright's stain. They can be identified with a supravital stain such as New Methylene Blue and will appear as single or multiple bodies bound to the membrane. Basophilic stippling will present as blue or purple coarse or fine granules distributed evenly throughout the cell. Pappenheimer bodies will appear as light blue, fine, irregular granules in clusters, often at the periphery of the cell.

What is the nucleated cell present in the following image (Large cell 30 um with basophillic cytoplasm and a single nucleus; resembles a plasma cell) A. Osteoblast B. Megakaryocyte C. Osteoclast D. Macrophage

A. Osteoblast Explain: Osteoblasts are large cells (up to 30 µm). They resemble plasma cells; however, the perinuclear halo is detached from the nucleus and found in the cytoplasm. The nucleus has a finer chromatin pattern. The cytoplasm is less basophilic than plasma cells. Osteoblasts are typically found in groups. They are commonly seen in children and metabolic bone diseases. Mature megakaryocytes are large cells up to 100 µm in diameter. These cells have an abundance of acidophilic, granular cytoplasm. The nucleus is large and multi-lobulated with no visible nucleoli. Osteoclasts are larger than osteoblasts (up to 100 µm). Osteoclasts can be multinucleated with discrete nuclei, and the cytoplasm can be acidophilic or basophilic. They can resemble megakaryocytes. However, the megakaryocyte has a single, large multi-lobulated nucleus. Macrophages are monocytes that have entered the tissues. Macrophages can range from 15-80 µm. The nucleus is round with a reticular appearance, and nucleoli are present. The blue-gray cytoplasm has irregular edges and vacuoles.

A patient with multiple myeloma is admitted to the hospital due to a flare-up of symptoms. Her physician orders a complete blood count with differential. The peripheral blood smear is shown. Which morphology is consistent with the findings in this case? (Image: stacked RBC) A. Rouleaux B. Agglutination C. Polychromasia D. Hypochromia

A. Rouleaux Explain: The red blood cells present in this image have a "stacked coins" formation. This is known as rouleaux formation, which is highly associated with conditions where increased serum proteins, particularly fibrinogen and globulins, are present. This stacking is also the mechanism for increased sedimentation rates, as associated with multiple myeloma and other inflammatory conditions. Plasma cell disorders such as multiple myeloma are characterized by a clonal population of plasma cells that produce a monoclonal protein (M protein, or paraprotein), causing the red blood cells to stick together and form rouleaux. Agglutination is the clumping of erythrocytes due to interactions of membrane antigens and antibodies (immunoglobulins). Polychromasia refers to the presence of varying RBC color. Polychromasia usually indicates the presence of reticulocytes. Hypochromia refers to RBC's with a larger than normal central pallor. Normal RBCs have one-third central pallor, whereas hypochromic cells have greater than one-third central pallor. This is usually indicated by a low MCHC on the CBC.

A peripheral blood smear with many myeloid cells was presented for morphology review (see image: Toxic grans in a seg neutrophil). Toxic granulation and vacuoles in the neutrophil most likely represent which of the following conditions? A. Septicemia B. Viral infection C. TB D. Active allergies

A. Septicemia Explain: The intended response is septicemia. Cytoplasmic vacuoles in monocytes and granulocytes correlate with septicemia with a sensitivity >95%. A relative and/or absolute lymphocytosis is the usual finding in viral infections. Monocytosis is often associated with tuberculosis, but toxic vacuolization is not a consistent finding. Eosinophilia is often associated with allergies and certain parasitic infections.

What is a typical finding for determining the endpoint for the initial or iron-depletion phase of treatment for hereditary hemochromatosis (HH)? A. The serum ferritin decreases to b/w 20 and 50 ng/mL B. The hepatic iron index returns to normal C. The transferrin saturation drops below 20% D. The serum iron falls to below 35 ug/dL

A. The serum ferritin decreases to b/w 20 and 50 ng/mL Explain: Hereditary hemochromatosis is a disease that causes increased absorption of iron which leads to excess iron storage in the bone marrow, heart, and liver. The end of the initial phase of HH treatment is considered when the serum ferritin decreases to between 20 and 50 ng/mL. Ferritin levels will decrease rapidly as storage iron is depleted. Serum ferritin is an inexpensive, non-invasive laboratory test. The hepatic iron index is a calculation of the iron concentration in the liver and a sensitive indicator for determining the degree of excess iron deposition in the liver. However, this is an invasive and costly procedure which requires a liver biopsy. Transferrin saturation and serum iron will eventually decrease after iron stores have been depleted, however, they will not be the first indicators of successful treatment of HH.

In comparison to malignant lymphocytes, reactive lymphs

Are morphologically more variable throughout the smear

What accounts for the frequent smudge cell in CLL

Artifact due to fragile cells

A 3-year old girl was brought to the ER with a temperature of 103ºF, lethargy, and cervical rigidity. Three tubes of cloudy CSF were delivered to the Lab, and preliminary test results showed: WBC: 4,500/µL Differential: 88% neutrophilsGlucose: 15 mg/dL 12% lymphocytesProtein: 140 mg/dLGram stain: No organisms observed From these results, what preliminary diagnosis SHOULD the physician consider? A. Brain tumor B. Bacterial meningitis C. Viral meningitis D. Subdural hematoma

B. Bacterial meningitis Explain: Due to the elevated white blood cell count along with a strong percentage of neutrophils, a bacterial infection should be suspected. Though there are no organisms seen on the gram stain, a bacterial infection is still very possible as the bacterial count in the spinal fluid may be low. A viral meningitis would be more closely associated with an increased quantity of lymphocytes. Brain tumors and subdural hematomas would not be associated with these laboratory findings.

Which of the following types of anemia can be described as an inherited bone marrow failure syndrome with patients developing dystrophic nails and white patches in the mouth? A. Fanconi anemia B. Dyskeratosis congenita C. Chronic acquired pure red cell aplasia D. Diamond-Blackfan anemia

B. Dyskeratosis congenita Explain: Dyskeratosis congenita (DC) can be described as a bone marrow failure syndrome that is inherited. Many patients with DC develop aplastic anemia. DC patients also develop physical abnormalities such as leukoplakia in the mouth and tongue along with dystrophic nails. These physical characteristics help differentiate DC from Fanconi anemia.The physical characteristics listed (dystrophic nails and white patches in the mouth) are not associated with Fanconi anemia.Chronic acquired pure red cell aplastic is an acquired disorder, not an inherited one.Persons with Diamond-Blackfan anemia only have red cell aplasia. They tend to have normal WBC and platelet counts which excludes bone marrow failure.

All of the following are true concerning the Erythrocyte Sedimentation Rate (ESR) EXCEPT: A. ESR can be used to follow the course of the disease B. ESR is decreased during inflammatory conditions C. Highest ESR values are usually seen in MM D. ESR values are increased in rheumatoid conditions

B. ESR is decreased during inflammatory conditions Explain: Erythrocyte sedimentation rate (ESR) is a nonspecific laboratory test used to detect and follow a wide range of inflammatory conditions. Red blood cells have a net negative charge on their plasma membranes which causes them to repel each other and resist rouleaux formation. However, when the concentration of positively charged plasma proteins such as fibrinogen, ß-globulins, and immunoglobulins increases, the repulsive forces are weakened, and rouleaux formation occurs. Rouleaux causes the RBCs to settle quicker. Plasma cell myelomas cause an increase in immunoglobulins that also enhances rouleaux formation and increases the ESR. Inflammatory conditions such as infections and rheumatoid arthritis cause a rise in these positively charged plasma proteins, thereby increasing the ESR.

Which finding best distinguishes immune hemolytic anemia from other hemolytic anemias? A. Rouleaux B. Positive DAT C. Splenomegaly D. Increased erythrocyte count

B. Positive DAT Explain: In the group of disorders referred to as immune hemolytic anemias, erythrocytes are destroyed too early by an immune-mediated process that results from antibodies, complement, or both attaching to the red cell membrane. The presence of immune hemolytic anemia is confirmed by a positive DAT (direct antiglobulin test). Rouleaux is the formation of red cells that are stacked and appear like a stack of coins. This is a characteristic finding in multiple myeloma. Splenomegaly, or an enlarged spleen, may be found in Gaucher's disease or in polycythemia vera. It is not found in immune hemolytic anemia. Increased erythrocyte count is not a finding in immune hemolytic anemia.

Which of the following stages of neutrophilic granulocyte cellular development is at the second stage from the least mature stage? A. Band neutrophil B. Promyelocyte C. Metamyelocyte D. Myeloblast

B. Promyelocyte Explain: The second stage of neutrophilic maturation is the promyelocyte stage. The correct sequence in the neutrophilic granulocyte maturation is myeloblast, promyelocyte, myelocyte, metamyelocyte, band (stab) neutrophil, segmented neutrophil. Band neutrophil is at the fifth stage of development. Metamyelocyte is at the fourth stage of development. Myeloblast is at the first stage of development.

A WBC differential count on CSF should be performed using the following technique: A. Wet mount of sample from collection tube B. Stained smear of cytocentrifuged specimen C. Directly from hemocytometer chamber count D. Directly from stained hemocytometer count

B. Stained smear of cytocentrifuged specimen Explain: Differential counts on CSF should be performed on stained smears made from a cytocentrifuged specimen. The cytocentrifugation process distributes the cellular elements in a monolayer, making it easy to distinguish the cells' morphology when observed under the microscope. Cell type cannot be reliably assessed on unstained specimens or from the hemocytometer.

Decrease platelet production can be caused by a lack of or decreased amount of which of the following? A. EPO B. TPO C. vWF D. FVIII

B. TPO (thrombopoietin) Explain: A lack of or decrease in the amount of thrombopoietin (TPO) can lead to a decrease in the production of platelets. TPO is produced in the liver and the kidney, so diseases that impact those organs can lead to decreased TPO, which in turn can lead to decreased platelet production.Erythropoietin is produced by the kidneys and is a hormone that stimulates the production of red blood cells.While vWF is produced by megakaryocytes (and some other tissues), a lack of vWF would not contribute to decreased platelet production. Factor VIII plays no role in the production of platelets.

Which of the following is most closely assoc. w chronic myogenous leukemia

BCR/ABL fusion gene

Eosinophilia is commonly found in which of the following disorder? A. Pernicious anemia B. Liver disease C. Parasitic infections D. Infectious mononucleosis

C. Parasitic infections Explain: Eosinophilia is most commonly seen as a result of allergic reactions, medication reactions, and parasitic infections. Pernicious anemia is characterized by macrocytic erythrocytes (MCV>100). It is caused by an absence of intrinsic factor that leads to cobalamin deficiency. Liver disease leads to nonmegaloblastic anemia. Hemolysis can occur and also impaired bone marrow response, folate deficiency and blood loss. Infectious mononucleosis is a viral infection characterized by a large percentage of reactive lymphocytes on the peripheral blood smear.

What are the cells that are indicated by the arrows in this peripheral blood smear image (smaller darker red spheres)? A. Echinocytes B. Elliptocytes C. Spherocytes D. Stomatocytes

C. Spherocytes Explain: The cells indicated by the arrows in the image are spherocytes. Spherocytes are red blood cells that have decreased surface to volume ratio and therefore appear smaller with a deeper pink color. Spherocytes have lost their bi-concave shape and are spherical in shape, hence the name. Spherocytes can be caused by damage to the RBC membrane. Echinocytes are crenated red blood cells and have short projections around the periphery of the cell. They can be caused by an osmotic imbalance or can be artifacts. Elliptocytes are elongated RBCs with a narrow oval shape. They are caused by a membrane defect. Stomatocytes have a slit-like area of pallor and can be caused by increased sodium and decreased potassium concentrations within the RBC.

Which markers, typically detected in normal myeloid cells, are expressed on surface of HCL lymphocytes

CD10

Cell surface marker for aggressive subtype of CLL

CD38

Immunohistochemical patterns is for CLL/SLL

CD5+/CD23+

CLL mostly express which cell markers

CD5, CD19, CD20, CD21

Autoimmune hemolytic anemia is often a complication of

CLL

Which of the following 2 malignancies represent different clinical manifestations of the same disease

CLL and small lymphocytic lymphoma

Increased numbers of basophils are often seen in

CML

All of the following are associated with Hgb C disease, EXCEPT? A. Hgb C crystal B. Target cells C. Lysine sub for glutamic acid at 6th position of the beta chain D. Fast mobility of Hgb C at pH 8.6

D. Fast mobility of Hgb C at pH 8.6 Explain: Hemoglobin C has a high positive charge and therefore has slow mobility on electrophoresis using alkaline gel. Hemoglobin C migrates with hemoglobin A2 and hemoglobin E on cellulose acetate electrophoresis at pH 8.6. Target cells indicate an excess membrane to hemoglobin ratio and are a common finding in many forms of anemia, including Hemoglobin C disease. Hemoglobin C crystals form in patients with Hemoglobin C disease because the hemoglobin is unstable and forms crystals when oxygenated, cells are dehydrated, or in hypertonic solutions. Hemoglobin C is formed due to a mutation causing glutamic acid to be substituted by lysine at the sixth position of the beta chain.

The alkaline hemoglobin electrophoresis pattern shown on the right includes controls for A, S, and C; and A and F above and below the patient results. (NOTE: ASC and AF are labeled for the controls and do not indicate the migration order.) The patient was tested in duplicate, and the results are in lanes 3 and 4. The patient lanes (3 and 4) displayed in these hemoglobin electrophoresis patterns are consistent with what diagnosis? A. HbSA B. HbSC C. HbSD D. HbS//HPFH

D. HbS/HPFH Explain: The patient lanes 3 & 4 shows nearly equal bands in the "S" and "F" positions. In HbS/HPFH, there would be two bands on alkaline electrophoresis, one would be in the S position. Hereditary Persistence of Fetal Hemoglobin (HPFH) will result in a band in the F position. This is consistent with HbS/HPFH. In alkaline hemoglobin electrophoresis, the sample is applied closest to the cathode (negatively charged electrode). Once current is applied, the hemoglobins move toward the anode (positively charged electrode). Based on the hemoglobin controls shown in the alkaline electrophoresis, hemoglobin A is the fastest moving hemoglobin and is represented by the band closest to the anode in lanes 1, 2, 5 & 6. Hemoglobin F is the next fastest and is represented by the band second closest to the anode in lanes 2 & 5. Hemoglobin S is next and is represented by the second band in lanes 1 & 6. Hemoglobin C is the slowest hemoglobin and is represented by the band closest to the cathode in lanes 1 & 6. In HbSA, there would be bands in the A and S positions on alkaline electrophoresis. In HbSD, there would be one band on the alkaline electrophoresis pattern. Hemoglobin D migrates with S in alkaline electrophoresis.

The image (cell with nucleus divided) is a stained smear of cerebrospinal fluid. The cell in this slide could be caused by what condition? A. Viral meningitis B. Allergic rxn C. Cerebral hemorrhage D. Metastasis

D. Metastasis Explain: The nucleus in this cell is abnormal and appears to have divided. This finding correlates with the presence of metastasis in the CSF. A broad spectrum of lymphocytes and monocytes would be present in a case of viral meningitis. An allergic reaction will show predominantly eosinophils. Cerebral hemorrhage would show predominantly RBCs.

Closely associated with acute promyelocytic leukemia

DIC

What's associated with acute megakaryoblastic leukemia

Down syndrome

Abnormalities found in erythroleukemia include

Megaloblastic development

Characteristic of hairy cell leukemia

Mononucelar cells w ruffled edges

Morphological characteristics associated w HCL

Uneven cytoplasmic margins

Which of the following is characteristic of myelodysplastic syndrome

Unilineage or multilineage dyspoiesis

CLL marker w poor prognosis

ZAP-70

Cytogenetic abnormalities are associated with a more stable clinical course of MDS

del 5q