Leukemias and Lymphomas

[username456789]

I've got a big exam on Monday and we just "learned" today about all the Leukemias and Lymphomas and it's a HUGE jumbled mess in my brain. Does anyone have any good suggestions on how to sort this all out pretty quickly?!
Thanks.

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[wAyRadikull]

You have a good two days so I would suggest going through the WBC disorders and Lymph Node disorders in RR path if you have it. Goljan really does a great job breaking things down into categories and has excellent tables to supplement the text.

 

[username456789]

You have a good two days so I would suggest going through the WBC disorders and Lymph Node disorders in RR path if you have it. Goljan really does a great job breaking things down into categories and has excellent tables to supplement the text.

I do have it, haven't looked at it much yet.

I have other stuff I need to study obviously, so I can't take the whole weekend just to get this stuff down, but do you think it's manageable to do tonight and maybe some of tomorrow?

 

[wAyRadikull]

Yeah its definitely doable, as long as you have SOME idea. As long as you've mildly payed attention in class, Goljan will help you fine tune it and help you memorize it. I just flipped through it real quick for you and it is roughly 30 pages, so you can easily finish a chapter tonight and one tomorrow in the AM. Good luck to you man and let me know how it goes.

 

[AnnaBananax]

What helped me keep some of this stuff straight was making sure I had a really solid understanding of the differentiation pattern of blood cells and learning the diagram on page 599 of Robbins 8th edition...if you really understand what diseases happen at which step in development, it's must easier to reason through what you see in a node/peripheral smear...also, knowing which cell surface markers are associated with which cell lines/diseases makes a huge difference in deciphering clinical vignettes...sometimes you don't need anything else

Good luck!

 

[Inuranic]

Leukemia = bad cells float around in the blood.

Lymphoma = bad cells focus in on lymph tissues.

And boom goes the dynamite.

But seriously, Rapid Review is your friend for this. First Aid helps a lot too.

 

[njbmd]

I've got a big exam on Monday and we just "learned" today about all the Leukemias and Lymphomas and it's a HUGE jumbled mess in my brain. Does anyone have any good suggestions on how to sort this all out pretty quickly?!
Thanks.

This is what my outline looked like:

White Cell Disorders
-Nonneoplastic- things like leukomoid reaction etc.
-Neoplastic/Neoplasms- leukemias and lymphomas under this one with all of the following under this category:

Lymphoid Neoplasms-Precursor B and T Cell Lymphoblastic
-Burkitt's
- and all of the other lymphoid neoplasms like the plasma cell proliferations and others (with each one do a short description of what's involved - the cell type etc)
Myeloid Neoplasms (Then under the Myeloid Neoplasms all of the following:
Acute Myelogenous Leukemia (you can list all of the subsets and their characteristics)
Chronic Myeloproliferative Disorders
-Chronic Myelogenous Leukemias
-Polycythemia Vera (this doesn't go with the leukemias and lymphomas but it's a chronic myeloid Dysplastic Disorder
-Myelodysplastic Dysplastic Syndromes - this one isn't a leukemia but it's a chronic myeloid dysplastic disorder

At my school, this seriies of lectures was presented Myeloid versus Lymphoid neoplastic disorders with the leukemias and lymphomas discussed under their various categories.

Then, when we used BRS Pathology as a summary of this stuff, we could use our outline and we knew where everything would fit. Overall, the key to this stuff is to organize it and know were each entity fits in the scheme of things and which cells are involved. BRS is good for showing the photos with the outlines but we still had to do some organization as above.

Actually, once you get everything organized, you have done have of the learning. Good luck.

 

[username456789]

This is what my outline looked like:

White Cell Disorders
-Nonneoplastic- things like leukomoid reaction etc.
-Neoplastic/Neoplasms- leukemias and lymphomas under this one with all of the following under this category:

Lymphoid Neoplasms-Precursor B and T Cell Lymphoblastic
-Burkitt's
- and all of the other lymphoid neoplasms like the plasma cell proliferations and others (with each one do a short description of what's involved - the cell type etc)
Myeloid Neoplasms (Then under the Myeloid Neoplasms all of the following:
Acute Myelogenous Leukemia (you can list all of the subsets and their characteristics)
Chronic Myeloproliferative Disorders
-Chronic Myelogenous Leukemias
-Polycythemia Vera (this doesn't go with the leukemias and lymphomas but it's a chronic myeloid Dysplastic Disorder
-Myelodysplastic Dysplastic Syndromes - this one isn't a leukemia but it's a chronic myeloid dysplastic disorder

At my school, this seriies of lectures was presented Myeloid versus Lymphoid neoplastic disorders with the leukemias and lymphomas discussed under their various categories.

Then, when we used BRS Pathology as a summary of this stuff, we could use our outline and we knew where everything would fit. Overall, the key to this stuff is to organize it and know were each entity fits in the scheme of things and which cells are involved. BRS is good for showing the photos with the outlines but we still had to do some organization as above.

Actually, once you get everything organized, you have done have of the learning. Good luck.

Thanks everyone so far. I did a lot of the stuff last night and this morning and I'm starting to get a grasp on it.

One thing that kind of concerns me (for the boards, not for this exam) is that we covered the Leukemias and the Lymphomas in two 1-hour lectures, with no mention anywhere in the note set/lecture of things like polycythemia and various other things I came across while reading Rapid Review Path. I feel like there's probably a ton of things out there in general that I just won't have learned this year when it comes time to study for Step I later this year.

 

[njbmd]

Thanks everyone so far. I did a lot of the stuff last night and this morning and I'm starting to get a grasp on it.

One thing that kind of concerns me (for the boards, not for this exam) is that we covered the Leukemias and the Lymphomas in two 1-hour lectures, with no mention anywhere in the note set/lecture of things like polycythemia and various other things I came across while reading Rapid Review Path. I feel like there's probably a ton of things out there in general that I just won't have learned this year when it comes time to study for Step I later this year.

You can probably pick up those things in BRS Path (I liked this much better than Rapid Review) as long as you have this stuff organized in your mind. There wasn't much in Path that BRS didn't cover that was on Step I. It was simply the best and most comprehensive review for this subject. It's the bomb especially the pictures. Like I said, having these hemo diseases organized is half of the learning battle.

 

[azntxn]

lymphoma - only in lymph nodes, no bone marrow involvement (if bone marrow is involved -> leukemia)

leukemia - involve bone marrow, blood, lymph nodes; lymphomas can become leukemias (SLL -> CLL)

 

[NRAI2001]

Thanks everyone so far. I did a lot of the stuff last night and this morning and I'm starting to get a grasp on it.

One thing that kind of concerns me (for the boards, not for this exam) is that we covered the Leukemias and the Lymphomas in two 1-hour lectures, with no mention anywhere in the note set/lecture of things like polycythemia and various other things I came across while reading Rapid Review Path. I feel like there's probably a ton of things out there in general that I just won't have learned this year when it comes time to study for Step I later this year.

Two 1 hr lectures?? Are you taking path? Or is this for an immunology course?

RR is awesome for the heme-onco section; but its a beast.. not recommended if you re an MS1 and this test is for immuno.

 

[username456789]

Two 1 hr lectures?? Are you taking path? Or is this for an immunology course?

Yes, this is for Path. It was ridiculous.

 

[G'ville Nole]

lymphoma - only in lymph nodes, no bone marrow involvement (if bone marrow is involved -> leukemia)

Small point of clarification. Lymphoma can indeed have bone marrow involvement; this finding comprises the majority of patients with Ann Arbor Stage IV lymphoma.

Neoplastic cells in the peripheral blood (leukemia) vs predominantly lymph nodes is probably the safest distinction to make.

 

[physics junkie]

Thanks everyone so far. I did a lot of the stuff last night and this morning and I'm starting to get a grasp on it.

One thing that kind of concerns me (for the boards, not for this exam) is that we covered the Leukemias and the Lymphomas in two 1-hour lectures, with no mention anywhere in the note set/lecture of things like polycythemia and various other things I came across while reading Rapid Review Path. I feel like there's probably a ton of things out there in general that I just won't have learned this year when it comes time to study for Step I later this year.

We had 7 hours for WBC's...and then 2 hours of lab. My school is "lecture-happy" though. We had 14(not a typo) hours of general neoplasia.

 

[Ruination]

Small point of clarification. Lymphoma can indeed have bone marrow involvement; this finding comprises the majority of patients with Ann Arbor Stage IV lymphoma.

This is correct.

The way I think about it is this:

Lymphomas-- involve solid organs or lymph nodes; these may or may not also have bone marrow involvement (they are still called lymphomas though).

Leukemias-- neoplastic cells predominantly found in the marrow and peripheral blood. In order to be a leukemia, you need to have neoplastic cells in the marrow. In order to be an acute leukemia, you need more than 20% blasts in the blood or bone marrow. Lymphomas can be seen circulating in the peripheral blood in the absence of marrow involvement.

I think of lymphomas like this:

Smaller cell size:
1) SLL
2) Mantle cell
3) Follicular
4) Marginal zone (i.e MALToma)
5) Hairy cell

Intermediate cell size:
1) B or T-cell Lymphoblastic lymphoma
2) Burkitt

Large:
1) Diffuse large B-cell

Other T-cell lymphomas are probably beyond the scope of what you need to know as a medical student

A few common leukemias:
1) Acute myeloid leukemia (there are lots of subtypes)
2) Acute B or T- cell lymphoblastic leukemia
3) CLL
4) Chronic Myeloid leukemia.

Hope this was somewhat helpful. Good luck.