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A 63 year old male patient came with C/O fatigue
& weakness over past 1 months. On investigations peripheral smear showed below finding.

Which is most likely genetic change
associated with the patient?
a. t(9,22)
b. t(15,17)
c. t (11, 14)
d. t(11, 18)

Correct Answer B
Explanation
T(9,22): This translocation results in the Philadelphia chromosome, associated with chronic myeloid leukemia (CML) and some types of acute lymphoblastic leukemia (ALL).
T(15,17): This translocation is associated with acute promyelocytic leukemia (APL), a subtype of acute myeloid leukemia (AML).
T(11,14): This translocation is often seen in mantle cell lymphoma, a type of non-Hodgkin lymphoma.
T(14,18): This translocation is common in follicular lymphoma, another type of non-Hodgkin lymphoma.

The Image Shows - Auer Rods
Auer rods: cytoplasmic inclusions in leukemic cells, notably AML.
Appearance: elongated, needle-like, red/pink staining with Wright/Giemsa.
Composition: crystallized/granules, enzymes (myeloperoxidase, lysosomal), granulocyte proteins.Associated
Conditions: acute myeloid leukemia (AML), myeloblastic (M1, M2, M3), "faggot cells" in APL.
Clinical Significance: diagnostic for AML, indicates blast differentiation/nature.
Potential Complications: may cause DIC, severe clotting disorder in AML patients


Other Images Described in the Video
Classical Reed Sternberg Cells seen in Hodgkin’s Lymphoma
→ RS Like Cells ( Infectious mononucleosis / Solid Cancers / Immunoblastic Lymphoma)

Buttock Cells Follicular Lymphoma (NHL)

Starry Sky Appearance Seen Burkitt’s Lymphoma (NHL)

Hairy Cell Leukemia
Phase contrast microscopy – Hairy projections from tumor cell

Anaplastic Large Cell Lymphoma
→ Hallmark Cells - Horse shaped nucleus*

Cutaneous T Cell Lymphoma
→ Cerebriform nuclei / clef nucleus (Sezary Cell)

Langerhans cell histiocytosis
Langerhans Cells (Birbeck granules)

Adult T Cell Leukemia
→Flower Cell

Smudge Cells / Basket Cell / Parachute Cells seen in Chronic Lymphocytic Leukemia
→ Convent Girl Appearance

Pseudo-gaucher Cells seen in CML
- histiocytes with plump, blue, lamellar cyto- plasm that resemble the glucocerebroside-stuffed histiocytes seen in Gaucher disease.x`
→ Peripheral smear – College girl / Flower garden (No maturation arrest)

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