Differential Diagnosis

The differential diagnosis for ALL includes acute myeloid leukemia, aplastic anemia, chronic myeloid leukemia in lymphoid blast crisis, a minimally differentiated and reactive bone marrow with increased hematogones, bilineal acute leukemia in which two distinct leukemic populations coexist, and bipheno-typic acute leukemia in which a single leukemic population coexpresses a sufficient amount of both myeloid and lymphoid markers. Although chronic lymphoid leukemia and other lymphoid malignancies with circulating lymphoma cells may initially be considered in the differential diagnosis of ALL based upon an initial complete blood count and differential, ALL is usually easily distinguished from these diseases by morphologic review and immunophenotyping.

Lymphoblastic lymphoma and Burkitt lymphoma are biologically the same disease as their leukemic counterparts. However, their differential diagnosis also includes other aggressive lymphomas, thymoma, and other solid tumors from the respective anatomic locations in which they are found. An adequate biopsy specimen from which appropriate morphologic, immunophenotypic (e.g., TdT), and molecular studies (e.g., BCR/ABL) can be performed usually allows the diagnosis to be definitively established.

0 0

Post a comment