April 2022: Critical Role of Pathologists in Genomic Era: Correlating Genotype with Phenotype in Hematologic Malignancies

Speaker

Olga Weinberg, M.D.
Associate professor and director of fellowship education UT Southwestern dept pathology

Critical Role of Pathologists in Genomic Era: Correlating Genotype with Phenotype in Hematologic Malignancies.

Hematological malignancies are a heterogeneous group of diseases with diverse presentations and incidence. Major advances in molecular and cell biology have improved our understanding of the pathophysiology of myeloid neoplasms, expanded treatment options, and provided a deeper understanding of how and why individual patients may be at increased risk for development of hematologic malignancies. The recent accumulation of genetic data on the molecular underpinnings of myeloid neoplasms as well as numerous recently approved novel therapies have highlighted areas of controversy in how we currently define and classify myeloid malignancies. Pathologic examination of bone marrow is the definitive diagnostic procedure for hematopoietic disorders, both benign and malignant. For many patients, it is the final step in identifying previously elusive disorders. This talk will focus on presentation and areas of diagnostic confusion among myeloid malignancies.

Learning objectives

  • Provide overview of myeloid malignancies and clinical diagnosis
  • Cover recent genetic findings in myeloid neoplasms with phenotypic correlations
  • Discuss controversial areas in myeloid neoplasms diagnosis

Watch the Webinar


Answers to Questions from Live Webinar

Please check back for the Q&A.





Answers to Questions from Live Webinar

Below is a list of questions received from the live webinar attendees. Click on any question to reveal the speaker's response.

NEW QUESTION/ANSWER

It is common to see necrosis in cHL, hard to put a number on it offhand.

NEW QUESTION/ANSWER

Classic in the 2017 WHO

NEW QUESTION/ANSWER

It can be expressed in both CHL and ALCL so it may not be reliable.

NEW QUESTION/ANSWER

CD15, CD30, CD20, PAX5, OCT2, BOB1 and CD45 can be helpful.

NEW QUESTION/ANSWER

I have never seen this.

NEW QUESTION/ANSWER

No, there is no clinical role for this at present.

NEW QUESTION/ANSWER

This would be highly unusual

NEW QUESTION/ANSWER

I don’t have any experience with J chain but is usually negative in RS-cells. MUM1 is typically positive but not specific.

NEW QUESTION/ANSWER

No

NEW QUESTION/ANSWER

Yes. J-chain and MEF2B have been reported to be useful as well. PMID: 28851661

NEW QUESTION/ANSWER

I don’t think it is particularly helpful, some cases of cHL may have rearranged IGH

NEW QUESTION/ANSWER

No

NEW QUESTION/ANSWER

I don’t find it that helpful

NEW QUESTION/ANSWER

There has been some data to suggest it is prognostic.

NEW QUESTION/ANSWER

It does not appear to commonly result in loss of CD30 expression in follow-up biopsy but I don’t believe this has been extensively studied.

NEW QUESTION/ANSWER

Yes, for T-cell lymphomas including cutaneous T-cell lymphomas it is reasonable to report the % positive tumor cells because some trials that resulted in the approval of brentuximab used specific cutoffs.