12 - WBCs, lymph nodes, spleen, and thymus Flashcards
Most common cause of Agranulocytosis:
drug toxicity
Most common cancer in children:
ALL
More common type of ALL:
B cell ALL
Type of AML with the best prognosis:
Acute promyelocytic leukemia
Most common leukemia of adults in the western world:
Chronic Lymphocytic leukemia
Most common subtype of Hodgkin lymphoma:
nodular sclerosis
All subtypes of Hodgkin lymphoma are more common in males, except:
nodular sclerosis (F=M)
All patients with Hodgkin lymphoma in adults are usually adults, except in this subtype:
lymphocyte predominance (young males)
Most common indolent lymphoma of adults:
follicular lymphoma
Most common form of non-Hodgkin lymphoma:
Diffuse large B-cell lymphoma
Most common lymphoma of adults:
Diffuse large B-cell lymphoma
Fastest growing human tumor:
Burkitt lymphoma
Most important plasma cell neoplasm:
multiple myeloma
Decreased number of circulating leukocytes; most commonly neutrophils (neutropenia); deficiency of lymphocytes (lymphopenia) is less common, and is commonly seen in advanced HIV and other diseases.
Leukopenia
Clinically significant neutropenia (<500/mm3); highly susceptible to infections (Candida and Aspergillus); most common cause: drug toxicity
Agranulocytosis
An increase in the number of white cells in the blood in a variety of inflammatory states caused by microbial and nonmicrobial stimuli that may mimic leukemia.
Reactive leukocytosis, Leukemoid reaction (high leukocyte alkaline phosphatase, a product of normal WBCs; used to differentiate it from leukemias)
Enlargement of a lymph node as immune response to foreign antigens; histology usually nonspecific; depends on duration of disease and type of offending agent.
Reactive lymphadenitis
Most common type of cancer in children; highly aggressive tumors manifesting with signs and symptoms of bone marrow failure, marrow expansion, dissemination of leukemic cells, and CNS manifestations; lymphoblasts with irregular nuclear contours, condensed chromatin, small nucleoli and scant agranular cytoplasm on BMA; blasts compose >25% of marrow cellularity; TdT(+) in 95% of cases; most responsive to chemotherapy (Asparaginase).
Acute lymphoblastic leukemia (ALL)
Clinical differences between B- and T-cell ALL.
- B-cell ALL typically occurs in younger children presenting with BM failure
- T-cell ALL typically occurs in adolescent males presenting with thymic masses
Good prognostic factors in ALL.
Children 2-10 years old; t(12;21) and hyperdiploidy
Poor prognostic factors in ALL.
- Male gender;
- age younger than 2 or older than 10 years;
- a high leukocyte count at diagnosis;
- molecular evidence of persistent disease on day 28 of treatment, t(9;22) and MLL rearrangements
- Most common leukemia of adults in Western world; chronic leukemia associated with BCL2, an antiapoptotic molecule; patient presents with increased susceptibility to infections due to hypogammaglobulinemia; CBC showed >5000 lymphocytes/mm3; histologically, foci of mitotically active cells (proliferation centers) are present; also, smudge cells (due to fragility of circulating tumor cells) are also evident;
- Syndrome in which this type of leukemia transforms into DLBCL
- Chronic lymphocytic leukemia/Small lymphocytic lymphoma (CLL/SLL)
- Richter syndrome
SLL: <5000 lymphocytes/mm3
Most common indolent lymphoma of adults; frequent small “cleaved” cells mixed with large cells, growth pattern is nodular, centroblasts present; occurs in older adults, usually involves nodes, marrow, spleen; associated with t(14;18) that results in overexpression of cyclin D1.
Follicular lymphoma
Most common lymphoma of adults; most common form of NHL; tumor cells have large nuclei with open chromatin and prominent nucleoli; most important type of lymphoma in adults, accounting to ~50% of adult NHLs.
Diffuse Large B-cell lymphoma (DLBCL)
