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The significance of morphology in differential diagnosis of lymphoproliferative disorders.
Kaválková, Adriana ; Fátorová, Ilona (advisor) ; Pešková, Eliška (referee)
This work deals with lymphoproliferative diseases in which morphology can contribute to diagnosis and speed up the diagnostic process. The cytomorphological examination is performed whenever any hematopathology is suspected. Cell morphology is assessed from both peripheral blood and bone marrow aspirates. We evaluate many parameters during microscopic examination of the cells: size, shape and deposition of the nucleus, chromatin structure, presence of nuclei, cytoplasm volume and colour, the presence of granules, vacuole, etc. The most common finding in peripheral blood is reactive lymphocytosis and often the presence of cellular atypia: e.g. visible nucleus, a distinct fine structure of chromatin, heterogeneity of the nucleus. Lymphoproliferation can be manifested by non-specific clinical and laboratory findings, which are sometimes difficult to properly evaluate. Therefore should be the results of other laboratory tests and clinical picture taken into account too. Morphology continues to play an important role in the process of recognizing leukaemias and lymphomas. In today's classification responds morphology seldom to the question what disease we looking at. However, the examination is still far more accessible and usually faster than follow-up laboratory methods and has its place in the chain...
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Prognostic significance of atypical leukemic cell morphology in chronic lymphocytic leukemia.
Fučíková, Nikola ; Smolej, Lukáš (advisor) ; Vrbacký, Filip (referee)
CHARLES UNIVERSITY IN PRAGUE Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Study program: Health Care Bioanalytics Candidate: Bc. Nikola Fučíková Supervisor: doc. MUDr. Lukáš Smolej, Ph.D. Title of diploma thesis: Prognostic significance of atypical leukemic cell morphology in chronic lymphocytic leukemia The aim of this thesis is to evaluate the prognostic significance of atypical cell morphology and smudge cells in patients with untreated chronic lymphocytic leukemia. We performed differential leukocytes count and classified lymphocytes as typical and atypical in a cohort of 101 patients (median age, 66 years; males, 69%, Rai III/IV stages, 18%). For atypical CLL, we used the 15% threshold and 59% of patients were classified as atypical CLL (aCLL). For smudge cells, we chose the 30% threshold and 33% of patients were classified as smudge cells positive. Patients in early clinical Rai stage (0) had significantly higher number of smudge cells (p=0.04). We didn't find a significant association between aCLL / smudge cells with modern prognostic indicators. We didn't find a relationship between aCLL and the time to first-line therapy (p=0.394). However, patients with aCLL had a significantly shorter overall survival (p=0.0397). There was a trend toward shorter...
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