All posts by peferguson

PathMD Quizes, Clinical

Blood Bank – 02

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1. The patient is a 2-year-old boy who was admitted to the hospital for treatment of intra-abdominal wounds secondary to
blunt trauma. He has no history of transfusion. His admission hematocrit was 43.2% but his hemoglobin/hematocrit
later fell to as low as 8.6/25.3. A blood sample was sent to the Blood Bank for a type and cross match evaluation.

Blood Bank Panel
Blood Bank Panel


Blood Bank - Set #2Observe the results of the patient’s antibody screen and antibody identification panel. What is the putative identity of the patient’s antibody or antibodies?
2. The patient is a 2-year-old boy who was admitted to the hospital for treatment of intra-abdominal wounds secondary to blunt trauma. He has no history of transfusion. His admission hematocrit was 43.2% but his hemoglobin/hematocrit later fell to as low as 8.6/25.3. A blood sample was sent to the Blood Bank for a type and crossmatch evaluation.

Blood Bank - Set #2Which of the following serological techniques is a useful tool in definitively identifying antibodies of the type found in this patient?
3. The patient is a 2-year-old boy who was admitted to the hospital for treatment of intra-abdominal wounds secondary to blunt trauma. He has no history of transfusion. His admission hematocrit was 43.2% but his hemoglobin/hematocrit later fell to as low as 8.6/25.3. A blood sample was sent to the Blood Bank for a type and crossmatch evaluation.

Blood Bank - Set #2What is the name of the molecule which carries the antigen to which this patient’s immune response is directed?
4. The patient is a 2-year-old boy who was admitted to the hospital for treatment of intra-abdominal wounds secondary to blunt trauma. He has no history of transfusion. His admission hematocrit was 43.2% but his hemoglobin/hematocrit later fell to as low as 8.6/25.3. A blood sample was sent to the Blood Bank for a type and crossmatch evaluation.

Blood Bank - Set #2Which statement best describes the clinical relevance of the type of antibody found in this patient?
5. The patient is a 2-year-old boy who was admitted to the hospital for treatment of intra-abdominal wounds secondary to blunt trauma. He has no history of transfusion. His admission hematocrit was 43.2% but his hemoglobin/hematocrit later fell to as low as 8.6/25.3. A blood sample was sent to the Blood Bank for a type and crossmatch evaluation.

Blood Bank - Set #2Which statement most accurately describes the manner in which patients with this antibody should be transfused?

 

N - Z Antibodies, Cervix, Head & Neck

p16

p16 is a marker primary used as a surrogate marker for high risk HPV infection.  The physiologic role of p16 when it is expressed leads to cell cycle arrest.  Normal levels are below the threshold for detection by immunohistochemical methods (IHC).  Sometimes occasional non-proliferating epithelial cells may express p16 by IHC (these cells are usually in the upper aspects of the stratified epithelium.

Continue reading p16 →

Organ Systems, Bone Marrow, WHO Classification, MDS/MPN, MPN

Chronic Neutrophilic Leukemia (CNL)

Diagnostic Criteria
  • Activating CSF3R mutation (usually T618I or T615A)
  • WBC ≥ 25,000 (at least 80% neutrophils + bands, <10% neutrophil precursors)
    • No dysgranulopoiesis or monocytosis (<1,000/μL)
  • Bone marrow hypercellularity
    • <5% blasts
    • Increased granulopoiesis
    • No evidence of dysgranulopoiesis
  • No molecular abnormalities or diagnostic characteristics of another MPN or MPN/MDS

If a CSF3R mutation is NOT identified, the diagnosis of CNL can still be made if other reactive causes are excluded or other evidence of clonality is identified (persistent for at least 3 months). Continue reading Chronic Neutrophilic Leukemia (CNL) →

Organ Systems, Bone Marrow, MDS

Ring Sideroblasts

General
  • Many cases of myelodysplasia (MDS-RS) and MDS/MPN with ring sideroblasts and thrombocytosis (MDS/MPN-RS-T) are associated with SF3B1 mutations.
    • SF3B1 – splicosome gene, often comuted with JAK2 in cases of MDS/MPN-RS-T (less frequently CALR and MPL)
    • Only 5% RS is required to diagnosis MDS-RS if a SF3B1 mutation is identified.  If no mutation, then the 15% RS threshold remains.
Photomicrographs
Ringed Sideroblasts in MDS
Ringed Sideroblasts in MDS
Ringed Sideroblasts in MDS
Ringed Sideroblasts in MDS
Organ Systems, Renal

Clear Cell Renal Cell Carcinoma

Clear cell renal cell carcinoma is the most common malignant renal neoplasm (70–80% of renal cancers).  These tumors are associated with a deletion in chromosomes 3p.    The von Hippel-Lindau (VHL) gene lies in the deleted region, and is thought to act as a tumor suppressor gene in both the sporadic and familial forms of this tumor.  In difficult cases to classify histologically, knowledge of genetic abnormalities within the tumor can be important to sub-classifying renal carcinomas.

Continue reading Clear Cell Renal Cell Carcinoma →

Organ Systems, Renal

Papillary Renal Cell Carcinoma

Papillary renal cell carcinoma represents approximately 10–15% renal neoplasms, and the name describes its characteristic papillary histology.  From a molecular standpoint, tumors are associated with trisomy 7, trisomy 17, and loss of chromosome Y (trisomy 7 in the familial form).  In contrast to clear cell renal cell carcinoma these tumors are NOT associated with 3p deletions.

Continue reading Papillary Renal Cell Carcinoma →