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clinical pathology > 15 - lymphoid and myeloid neoplasms > Flashcards

15 - lymphoid and myeloid neoplasms Flashcards

1
Q

what are myeloid neoplasms

A

neoplasms of all non-lymphoid blood cells
—– arise from bone marrow

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2
Q

what are lymphoid neoplasms

A

neoplasms of lymphocyte origin, including plasma cells
— bone marrow (leukemia, multiple myeloma)
— lymph nodes, spleen, thymus
— tissue lymphoid populations, such as GI or skin

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3
Q

what does the term leukemia mean

A

the term leukemia refers to neoplastic cells in blood and/or marrow

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4
Q

where do true leukemias arise from

A

from the marrow

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5
Q

what is the difference between acute vs chronic leukemias

A
  • acute have many blast cells in marrow
  • chronic progresses more slowly
  • myeloid neoplasms much more difficult to treat
  • acute myeloid leukemia (AML) worst leukemia, chronic lymphocytic leukemia (CLL) best leukemia
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6
Q

what develops in the bone marrow but it not called leukemia

A

multiple myeloma

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7
Q

what method would you use to get a panel of antibodies (especially for lymphoid cells)

A

immunohistochemistry and flow cytometry

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8
Q

what are some cytochemical stains for myeloid cells

A

myeloperoxidase
nonspecific esterase

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9
Q

what is lymphoma

A

solid tumors that develop outside the marrow

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10
Q

what is lymphoid leukemia

A

refers to neoplasia in marrow and/or blood not associated with solid tumors
– acute lymphoblastic leukemia (ALL)
– chronic lymphocytic leukemia (CLL)

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11
Q

lymphoma with leukemia or lymphosarcoma cell leukemia

A

?

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12
Q

what can help differentiate lymphoma from leukemia

A

cluster of differentiation 34 (CD34) surface marker may help differentiate ALL (often positive) from lymphoma with leukemia (often negative)

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13
Q

what are 2 types of plasma cell tumors and where are they located

A
  • multiple myeloma develops within marrow

plasmacytoma develops outside the marrow

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14
Q

lymphoid markers

A
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15
Q

what is PCR for antigen receptor rearrangements (PARR)

A

It is an assay that assesses clonality in a population of lymphoid cells

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16
Q

what does PARR do and what it is used for

A

– amplifies DNA encoding the variable regions of B and T cell receptors
– differentiate inflammatory/reactive (PARR negative) vs. neoplastic (PARR positive) lymphocyte populations

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17
Q

when can you get false positives in PARR tests

A

false positive tests in small number of cases with ehrlichia canis, rickettsia rickettsia and borrelia burgdorferi in dogs

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18
Q

what are the reasons for marrow biopsy - ??

A

unexplained leukopenia and thrombocytopenia

rare abnormal “lymphocytes” in blood

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19
Q

what is present in bone marrow with acute lymphoblastic leukemia

A

neoplastic prolymphocytes or lymphoblasts present in bone marrow
—- differentiate from other blast cells using special stains and or CD surface markers

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20
Q

what are the types of ALL in cats

A

generally T-lymphocyte type (most FelV positive, some FIV positive)

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21
Q

what are the types of ALL in dogs

A

may be T-lymphocyte, B-lymphocyte, NK cell or null cell types

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22
Q

what is the difference between ALL lymphocytes and reactive lymphocytes in dogs blood

A

add photo

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23
Q

what is a PARR test used for

A

to differentiate reactive vs neoplastic lymphocytes

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24
Q

When is chronic lymphocytic leukemia primarily seen

A

in old animals

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25
Q

what is seen with the lymphocytes in chronic lymphocytic leukemia

A

lymphocytosis involving normal-appearing lymphocytes

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26
Q

in chronic lymphocytic leukemia what lymphocyte type is more common (also what subset predominated in dogs vs cats)

A

T-lymphocyte type is more common than B lymphocyte type in dogs and cats

  • dogs: cytotoxic T lymphocyte (CD8+) subset predominates with granular lymphocyte morphology
  • cats: Th lymphocyte (CD4+) subset predominates
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27
Q

what type for CLL develops outside the marrow (ex in the spleen) with secondary involvement of the marrow

A

T-lymphocyte type CLL

28
Q

B-type CLL in dogs have what accompanying it

A

monoclonal hyperglobulinemia

29
Q

what are some classifications of lymphomas

A

add photo

30
Q

in dogs with lymphoma when will you see neoplastic lymphocytes in the blood and in the marrow

A

neoplastic lymphocytes recognized in blood in 10%-20% of dogs with lymphoma

neoplastic lymphocytes may be recognized in bone marrow at times when not appreciated in blood

31
Q

what kind of lymphoma predominates canine cases

A

multicentric, intermediate to high grade lymphoma accounts for 80% of canine cases
- often present with painless peripheral lymphadenopathy

  • most commonly (60-70%) diffuse large B-cell lymphomas
  • high-grade peripheral T-cell lymphomas have more variably- sized calls with irregular nuclei
32
Q

what are some other forms of lymphoma

A

involving the thymus: CD3+, CD4-, CD8-
skin: usually T-cell
digestive system: usually T-cell
liver/spleen: T-cell
nervous system and other organs

33
Q

what is seen in 20-40% of T-cell lymphomas

A

hypercalcemia

34
Q

how does lymphoma generally present in felines

A

cats are generally ill with presented to the vet

  • superficial lymphadenopathy is uncommon
  • many tumor involve deep extranodal sites, especially in the gastrointestinal and upper resp tracks
  • tend to contain more heterogenous lymphoid populations than typically seen in dogs
35
Q

what lymphoma predominated prior to widespread FeLV testing and vaccination

A
  • mediastinal and multicentric forms
  • primarily in younger cats
  • most FeLV pos
36
Q

what lymphoma predominated after widespread FeLV testing and vaccination

A

Alimentary form predominated (both B and T cells)
- primarily in older cats
- most FeLV neg

37
Q

T/F FIV positive cats are 5x more likely to develop lymphoma than FIV and FeLV negative cats

A

true

38
Q

what enzootic form can cause bovine lymphoma

A
  • chronic bovine leukemia virus (BLV) infections
    —— in mature cattle (peak 5-8 yrs old)
    —— B cell type - multicentric form
39
Q

In addition to lymphoma what does BLV also cause

A

BLV also causes a persistent benign lymphocytosis

40
Q

what is associated with the sporadic form of bovine lymphoma

A

young cattle - multicentric calf, thymic and skin types

not BLV associated, may be B or T cell

41
Q

what is multiple myeloma or plasma cell myeloma

A

plasma cell tumor of bone marrow

42
Q

what are the characteristic of multiple myeloma (plasma cell myeloma)

A

monoclonal hyperglobulinemia (IgG or IgA is usually present
—- (rarely biclonal protein, only light chains or heavy chains, or no monoclonal protein)

  • Bence-jones proteins (light chains) in urine at times
  • focal lytic or diffuse osteoporotic bone lesions are often present
  • plasma cell infiltrates may be found in other tissues including spleen, liver, lymph nodes, and kidneys ( especially cats)
43
Q

what is seen with plasma cell tumors in cats

A

much more likely to exhibit metastasis, whether they begin within or outside the bone marrow
- consequently, the term “myeloma-related disorders” has been used in cats

-typically FeLV and FIV negative

  • atypical plasma cell morphology, a nonregenerative anemia and hypocholesterolemia are common
  • some cases also have light-chain proteinuria and thrombocytopenia
44
Q

what term is often used in dogs with extramedullary plasma cell tumors

A

plasmacytoma

45
Q

what is seen with plasmacytomas in dogs

A

generally benign solitary tumor(GI tract, oral cavity, skin, digits, and forelegs, ears)
- usually no monoclonal hyperglobulinemia measured in serum in dogs

46
Q

what is usually seen with cats and extramedullary plasma cell tumors

A

some skin tumors appear benign like dogs and other tumors are aggressive, producing paraprotein and quickly metastasizing

47
Q

what are myeloid neoplasms

A

neoplastic disorders characterized by the purposeless proliferation of nonlymphoid marrow cells

48
Q

myelodysplastic syndrome (MDS) appears to be…

A

clonal and may develop into acute myeloid leukemia

49
Q

where do neoplastic transformations generally occur in myeloid neoplasms

A

in pluripotent progenitor cells

50
Q

T/F abnormalities in more than one cell line are often present in myeloid neoplasms

A

true

51
Q

T/F some myeloid neoplasms evolve into one another

A

true

52
Q

what does the classification of acute vs chronic myeloid neoplasm depend on

A

depends on present blast cells in bone marrow

53
Q

cats are generally FIV and FeLV neg or pos with myeloid neoplasms

A

positive

54
Q

myeloid markers ?

A
55
Q

what are the types of myeloid neoplasms (myeloproliferative disorders)

A

-myelodysplastic syndromes (MDS)
- acute myeloid leukemias (AML)
- myeloproliferative neoplasms (MPNs) - formerly chronic myeloproliferative disorders

56
Q

what are some clinical signs of myeloid neoplasms

A
  • unexplained or frequent infections
  • pale mucous membranes
  • slow healing ulcerations of mucous membranes or skin
  • lethargy, weight loss, fever
  • splenomegaly and/or hepatomegaly
    ** excluded primary erythrocytosis and thrombocythemia
57
Q

what can be some blood findings with myeloid neoplasms

A
  • anemia (generally severe) with no reticulocytosis
  • nucleated erythrocytes are often present in blood
  • moderate to marker anisocytosis may be present
  • MCV is often increased in cats
  • leukocyte counts may be low, normal, or high
  • platelet counts are frequently decreased
  • abnormal morphology may be present one or more blood cell lines
58
Q

what can be found in the bone marrow with myeloid neoplasms

A
  • usually hypercellular with increased cellularity in one or two cell lines and decreased cellularity in others
  • increased immaturity of cells (including increased blast cells) in one or more cell lines
  • myelofibrosis may occur as a secondary even
  • stainable iron may be increased
59
Q

what are some characteristics of myelodysplastic syndromes

A
  • likely clonal neoplastic disorder
  • nonregenerative anemia
  • generally, leukopenia and/or thrombocytopenia
  • bone marrow is often hypercellular
  • dysplastic cells in more than one hematopoietic cell line
  • less than 20% blasts cells
60
Q

T/F MDS (<20% blasts) can transition to AML (>20% blasts)

A

true

61
Q

what does acute myeloid leukemia look like on blood work and marrow exam

A
  • non regenerative anemia
  • leukocyte counts may be low or normal, but more often are increased
  • platelet counts are usually decreased
  • abnormal blood cell morphology if generally present including blast cells
  • bone marrow is hypercellular with greater then 20% blasts
  • one, or sometimes two, cell types dominate the marrow cellularity
62
Q

what will you see in the bone marrow with AMLs

A

20% or greater blasts in bone marrow

63
Q

what will you see in the bone marrow with chronic myeloid neoplasms

A

much less than 20% blasts in marrow

64
Q

what species is CML seen primarily

A

dogs

65
Q

what can be seen on blood work with chronic myeloid neoplasms

A
  • leukocyte count exceeds 50x10^3/uL
  • marked neutrophilic left shift
  • few or no myeloblasts in blood
  • increased blood monocytes, eosinophils, and/or basophils may be present
  • less than 20% myeloblasts in bone marrow
66
Q

primary erythrocytosis

A
67
Q

essential thrombocythemia

A

clinical pathology (18 decks)

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