Handbook of Hematologic Pathology (Diagnostic Pathology, 2)

790 Pages·2000·191.86 MB·English

by  Harold Schumacher

WILLI
~~iversiotfy M iss
MARCEL
MARCEL DEKKIENRC,. NEWY ORK BASEL
DEKKER
ISBN: 0-8247-0170-4
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Copyright 0 2000 by Marcel Dekker, Inc. All Rights Reserved.
Neither this book nor any part may be reproduced or transmitted in any form or by any means, electronic
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retrieval system, without permission in writing from the publisher.
Current printing (last digit):
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PRINTED IN THE UNITED STATES OF AMERICA
In loving memory of my parents, Catherine and Philip
Harold R. Sc~~mac~er
To Vannie, William, and Megan,
whose patience and acceptance of the time to write these pages
will forever be appreciated.
~illiamA. Rock, Jr.
To my wife, Ann, and in loving memory of my father, Morris
Sanford A. Stass
This Page Intentionally Left Blank
This book should capture the intereosft a large audience engaged in or dependent on laboratory
hematology, including medical technologists, medical students, hematologists, and hematopa-
thologists. It should be helpful to those preparingfo r boards related to hematology. In addition,
it offers a source of rapid review for individuals who have been working outside hematology
for a while and who wish to return to the field with up-to-date knowledge. Furthermore, the
book provides an expeditious source of cross-training that will be especially valuableto medi-
cal technologists who are required to be competent in various areaos f the laboratory.
This book was written by authors who apply every day what they write about in their
chapters. Theory is fine and needs to be understood, but learning and knowing how to apply
the information to the patient’s situation is one of the major goals of this text. This goal is
achieved through direct discussiono f the issues and theory and application of the information
by using case histories. The approach is not to solve all the reader’s problems, but rather to
show how to gather information abouta problem and how to deal withi t. Individual variations
in approaches are expected, since everyone will have different experiences and new methods
and technologies become available every day. What this booisk designed to achievei s to help
the reader develop a method to look at a problem and to think about diagnosing and fixing
what can be fixed.
We have stressed certain basic approaches or themes throughout the book that should
appeal to a wide segment of the medical community. These include the simplicity of style,
ease of readability, current information, ready application of the information to a working
laboratory, and other practical applications.T o further emphasize applications some case stud-
ies are offered at the end of each chapter to allowt her eadert ob ecomei nvolvedi nt he
pragmatic use of the new knowledge acquired.
This book reflects the varied backgrounds of the editors, Dr. Schumacher began his career
in clinical hematology/oncology with a special interest in leukemias and ultimately migrated
to laboratory hematology. Dr. Rock began his career in morphologic atherosclerosis afonudn d
a home as a clinical pathologist and developing practical experience and knowledge in the
field of applied coagulation. Dr. Stass began his career in bone marrow pathology and the
study of hematology and malignancies and eventually emergeda s a cancer center director. As
editors, we selected a group of authors who are experts in their fields. The editors thank them
for a job well done.
The editors have directed their efforts toward the diagnosis and management of hematolog-
icalp roblems,u tilizingp ractical,c urrent,a ndr elevantl aboratoryi nvestigativep rocedures.
However, we have also emphasized pertinent clinical information in those areas where such
knowledge is a necessary adjunct to diagnosis.
W
vi Preface
The book further directs medical technologists, hematopathologists, and hematologists on
how to utilize blood, plasma, serum, inst~mentationb, one marrow, lymph nodes, and splenic
tissue to establish a diagnosis.
Finally, the book emphasizes practical technical information to aidi n the operation of an
efficient hematology laboratory involved in hematological procedures. The editors anticipate
the reader will enjoy a book directed toward a pracantidc aul seful sourceo f laboratory hemato-
logical information.
~aroldR . Schu~ache~
~illiamA . Rock, Jr.
Sanford A. Stass
We are indebted to a number of people who through their efforts, support, and cooperation
made this book possible.
Harold R. Schumacher would like to give a very special thanks to our secretaries Pat
Hathaway and Roland Randolph, and Pauline Harris, administrative coordinator, who commu-
nicated with many of the contributors, the editor, and the staff.
Special thanks to our fellows in hematopathology, Ferrnina Mazzella and Carmelita Al-
vares, who helped us read and edit many of the chapters.
Further thankst o the pathology residentsa t our institutions who provided new information
and procedures that were important to our presenting a timely content.
In addition, our gratitude is extended to Dr. Paul Steele, who gave advice and counsel in
molecular hematology; Dr. Ruth Blough, in cytogenetics; and Dr. Paul Hurtubise, in flow
cytometric analysis.
William A. Rock, Jr., would like to thank the medical technologists (pa~icul~lDya n
Haun and Pam Moore) in the Hematology and Coagulation Laboratories at Charity Hospital,
New Orleans, Louisiana, and University Hospital, Jackson, Mississippi, who were eager to
push the envelope in developing new procedures in coagulation and assuringt hat they worked
consistently. He is also grateful to the Pathology Residents at Charity Hospital, New Orleans,
Louisiana, and University Hospital, Jackson, Mississipwpih, o struggled tirelessly to implement
the new approaches and proceduresf or bleeding and clotting problems.
Finally, Dr. Rock thanks Dr. Alain Marengo-Rowe, whose encouragement and conviction
were an inspiration to aggressively assault the coagulation problem, to l e a a bout it, and to
struggle with the difficult cases, as well as Dr. Frederick G. Schechter, who first opened for
me the door to the direct laboratory application of coagulation theory to the more complex
patient coagulophathies; Dr. Douglas Triplett, whose thoughtful support was an inspiration to
continue writing, and Dr. Jack Perry Strong, for without his confidence and trust none of this
would have happened.
Lastly, a very special thanks to Elizabeth Curione, production editor at Marcel Dekker,
Inc., for her tenacity of purpose and encouragement. We all enjoyed working with her.
vii
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Preface V
Acknowledgments vii
...
Contributors X111
1 Peripheral Blood and Bone Marrow 1
Fermina Maria Mazzella and Gerard0 Perrotta
2 Benign Lymph Node Lesions 27
Robert J. Ha~tsock
3 Pathology of the Spleen 53
Hernani D. Cualing
4 The Non-Hodgkin’s Lymphomas and Plasma Cell Dyscrasias 75
Lynne V. Abruzzo and L. Jefrey Medeiros
5 Hodgkrin’ S Disease 121
Lynne V. Abruzzo, L. Jefrey Medeiros, and Kojo S.J. ~lenitoba-Johnson
6 Histiocytosis and Lipid Storage Diseases 145
Salwa Shabbir Sheikh and David F. Gamin
7 Benign Disorders of Leukocytes 171
Gene L. Gulati, Zoran Gatalica, and Bong H,H yun
8 Acute Leukemia and Myelodysplastic Syndromes 193
Mark D. Brissette and James D. Cotelingam
9 Chronic Leukemias 223
Scott J. Graham and James D.C otelingam
10 Myeloproliferative Disorders 257
Powers Peterson
11 Anemia: Approach to Diagnosis 275
~illiamF , Baker, Jr.
ix