ABPath Hematopathology 3 — Questions and Answers
Question 1: t(15;17) with PML-RARA fusion characterizes which subtype of acute myeloid leukemia?
- Acute promyelocytic leukemia (Correct answer)
- AML with t(8;21)
- Acute erythroid leukemia
- Acute megakaryoblastic leukemia
Correct answer: Acute promyelocytic leukemia
APL is defined by t(15;17)/PML-RARA and responds to ATRA therapy.
Question 2: The t(8;14) translocation involving MYC is the classic cytogenetic finding in:
- Burkitt lymphoma (Correct answer)
- Follicular lymphoma
- Mantle cell lymphoma
- Chronic lymphocytic leukemia
Correct answer: Burkitt lymphoma
Burkitt lymphoma harbors MYC translocation, most commonly t(8;14).
Question 3: A 'starry-sky' pattern on histology with a near-100% Ki-67 proliferation index suggests:
- Burkitt lymphoma (Correct answer)
- Small lymphocytic lymphoma
- Marginal zone lymphoma
- Hairy cell leukemia
Correct answer: Burkitt lymphoma
Tingible-body macrophages create the starry-sky look, and Ki-67 approaches 100% in Burkitt lymphoma.
Question 4: Hairy cell leukemia is characteristically positive for which mutation?
- BRAF V600E (Correct answer)
- JAK2 V617F
- NPM1
- FLT3-ITD
Correct answer: BRAF V600E
BRAF V600E is present in essentially all hairy cell leukemia cases.
Question 5: TRAP (tartrate-resistant acid phosphatase) positivity and cytoplasmic projections point to which leukemia?
- Hairy cell leukemia (Correct answer)
- Chronic myeloid leukemia
- Adult T-cell leukemia
- Prolymphocytic leukemia
Correct answer: Hairy cell leukemia
Hairy cell leukemia classically shows TRAP positivity and hairy cytoplasmic projections.
Question 6: The t(14;18) translocation leading to BCL2 overexpression is most associated with:
- Follicular lymphoma (Correct answer)
- Burkitt lymphoma
- Mantle cell lymphoma
- Anaplastic large cell lymphoma
Correct answer: Follicular lymphoma
t(14;18) juxtaposes BCL2 with the IgH locus, blocking apoptosis in follicular lymphoma.
Question 7: Cyclin D1 overexpression from t(11;14) is diagnostic of which lymphoma?
- Mantle cell lymphoma (Correct answer)
- Follicular lymphoma
- Marginal zone lymphoma
- Diffuse large B-cell lymphoma
Correct answer: Mantle cell lymphoma
t(11;14) drives cyclin D1 (CCND1) overexpression, defining mantle cell lymphoma.
ABPath Hematopathology 3
t(15;17) with PML-RARA fusion characterizes which subtype of acute myeloid leukemia?