Andy Nguyen, M.D. / UT-Medical School at Houston, Pathology/ Last Revision on: 1/28/2013
Cancer Synoptic Case Summary
_x__
Peripheral blood smear
_x__ Bone
marrow aspiration
_x__ Bone
marrow aspirate clot (cell block)
_x__ Bone
marrow core (trephine) biopsy
_x__ Bone
marrow core touch preparation (imprint)
_x__
Aspiration
_x__
Biopsy
_x__ Posterior iliac
crest
_x__
Posterior iliac crest
Histologic Type
***Select one from the list at the end
___
Performed, see separate report: ___________________
Cytogenetic Studies
___ Performed, see separate report: ___________________
Fluorescence In
Situ Hybridization
___ Performed, see separate report:
___________________
___ Performed, see separate report: ___________________
++++++
LIST OF HISTOLOGIC TYPE
___ Mastocytosis (specify type): ____
___ AML with maturation
___ Acute myelomonocytic
leukemia
___ Acute monoblastic/monocytic leukemia
___ Acute erythroid
leukemia
___ Acute megakaryocytic leukemia
___ Acute basophilic leukemia
___ Acute panmyelosis
with myelofibrosis
___ Transient abnormal myelopoiesis
___ Myeloid leukemia associated with Down
syndrome
___ Acute undifferentiated leukemia
___ Mixed phenotype acute leukemia with t(9;22)(q34;q11.2);
BCR-ABL1
___ Mixed phenotype acute leukemia with t(v;11q23);
MLL rearranged
___ Mixed phenotype acute leukemia, B/myeloid, NOS
___ Mixed phenotype acute leukemia, T/myeloid, NOS
___ Mixed phenotype acute leukemia, NOS, rare types (specify
type): _____________
___ Natural killer (NK) cell
lymphoblastic leukemia/lymphoma
Other Myeloid Leukemias
___ Blastic plasmacytoid
dendritic cell neoplasm
___ B lymphoblastic leukemia/lymphoma with t(9;22)(q34;q11.2);
BCR-ABL1
___ B lymphoblastic leukemia/lymphoma with t(v;11q23);
MLL rearranged
___ B lymphoblastic leukemia/lymphoma with t(12;21)(p13;q22);
TEL-AML1 (ETV6-RUNX1)
___ B lymphoblastic leukemia/lymphoma with hyperdiploidy
___ B lymphoblastic leukemia/lymphoma with hypodiploidy
(hypodiploid ALL)
___ B lymphoblastic leukemia/lymphoma with t(5;14)(q31;q32);
IL3-IGH
___ B lymphoblastic leukemia/lymphoma with t(1;19)(q23;p13.3);
E2A-PBX1 (TCF3-PBX1)
___ Chronic lymphocytic leukemia/small
lymphocytic lymphoma
___ B-cell prolymphocytic leukemia
___ Splenic B-cell marginal zone
lymphoma
___ Lymphoplasmacytic lymphoma
___ Plasma cell myeloma
___ Extranodal marginal zone lymphoma of
mucosa-associated lymphoid tissue (MALT lymphoma)
___ Follicular lymphoma
___ Mantle cell lymphoma
___ Diffuse large B-cell lymphoma (DLBCL), NOS
___ T cell/histiocyte-rich large B-cell
lymphoma
___ Primary cutaneous DLBCL, leg type
___ Epstein-Barr virus (EBV)-positive DLBCL of the elderly
___ DLBCL associated with chronic inflammation
___ Lymphomatoid granulomatosis
___ Anaplastic
lymphoma kinase (ALK)-positive large B-cell lymphoma
___ Plasmablastic lymphoma
___ Large B-cell lymphoma arising in HHV8-associated multicentric Castleman disease
___ B-cell lymphoma, NOS
___ Other (specify):
____________________________
___ T-cell lymphoma, subtype cannot be determined (Note: not a
category within the WHO classification)
___ T-cell prolymphocytic leukemia
___ T-cell large granular lymphocytic leukemia
___ Chronic lymphoproliferative
disorder of NK cells
___ Aggressive NK-cell leukemia
___ Adult T-cell leukemia/lymphoma
___ Extranodal NK/T-cell lymphoma, nasal
type
___ Enteropathy-associated T-cell
lymphoma
___ Hepatosplenic T-cell lymphoma
___ Mycosis fungoides
___ Peripheral T-cell lymphoma, NOS
___ Angioimmunoblastic T-cell lymphoma
___ Anaplastic
large cell lymphoma, ALK-positive
___ Anaplastic
large cell lymphoma, ALK-negative
Hodgkin Lymphoma
___ Nodular lymphocyte predominant Hodgkin lymphoma
___ Classical Hodgkin lymphoma
Histiocytic and Dendritic
Cell Neoplasms
___ Histiocytic sarcoma
___ Langerhans cell histiocytosis
___ Langerhans cell sarcoma
___ Interdigitating dendritic
cell sarcoma
___ Follicular dendritic cell sarcoma
___ Disseminated juvenile xanthogranuloma
___ Histiocytic neoplasm, NOS
Posttransplant Lymphoproliferative
Disorders (PTLD)
Early lesions:
___ Plasmacytic hyperplasia
___ Infectious mononucleosis-like PTLD
___ Polymorphic PTLD
___ Monomorphic PTLD (B- and T/NK-cell
types)
Specify subtype: ________________________
___ Classical Hodgkin lymphoma type PTLD
___ Other (specify):
____________________________
++++++++