Chronic Myeloid Leukemia
Is a myeloproliferative disorder characterized by increased proliferation of the granulocytic cell line without the loss of their capacity to differentiate


#The_pathogenesis
حصل  chromosomal translocation من الكرموسوم 9 الى الكرموسوم 22 والذي يسمى ايضاً Philadelphia chromosome ( هو انتقال جينات من الكرموسوم 9 الى الكرموسوم 22 )
فكون oncogene الذي عمل activation لل tyrosine kinase فأثر على نخاع العظم فصارت الخلايا تنتج بشكل كبير جداً

وتمثل نسبة هذا النوع من السرطان 20% فقط


✓ The CML Occurs in 2 different phases
- Chronic phase or crisis
- blast phase or crisis


ونفرق بينهم من خلال الاتي
❁ Chronic phase (CP)
• Leukocytosis (usually 12 - 1,000 x 10⁹/L, median: ~ 80 x 10⁹/L)
• < 2% blasts in blood
• < 5% blasts in bone marrow


❁ Blast phase (BP)
• ≥ 20% blasts in marrow or blood or the presence of an extramedullary proliferation of blasts

اي ان الخلايا immature تكون اكثر من mature بعكس في المرحلة المزمنة تكون immature cell قليلة جداً

#Microscopic 

#Diagnosis 👉🏻  Chronic myeloid ( myelogenous ) leukemia
In the chronic phase

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Segmented neutrophils

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Band neutrophils

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Bisophillic

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Myelocytes

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Promyelocyte

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Myeloblast

#Microscopic 

#Diagnosis 👉🏻  Chronic myeloid leukemia
In the blast phase

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Basophil

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Promyelocytes

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Band neutrophils

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Myeloblast

#Microscopic 

#Diagnosis 👉🏻  Chronic eosinophilic leukemia


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Eosinophil
والتي تكون حقها الحبيبات حمراء اللون

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Myelocytes

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Binucleate eosinophil

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Normoblast
والتي تكون قبل ما تتحول الى erythrocyte

#Microscopic 

#Diagnosis 👉🏻  plasma cell of multiple myeloma


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Plasma cells

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Pale zone

#The_features
- blue cytoplasm
- eccentric nucleus
- perinuclear pale zone or halo

#Microscopic 

#Diagnosis 👉🏻  myeloma

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Plasma cell

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Rouleaux
والتي تطلع ال ESR مرتفع جداً عند المريض

#Microscopic 

#Diagnosis 👉🏻  myeloma
In the state neoplastic plasma cell

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Neoplastic Plasma cell ( mononucleate )

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Neoplastic Plasma cell ( binucleate )

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Vacuoles

#The_features
- Neoplastic plasma cell ( large size ) occasionally binucleate or mononucleate
- Small Vacuoles in the nucleus and cytoplasm
- blue cytoplasm

The second lab DONE  ✓