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Clinical Pathology > 2-Lymphoproliferative Disorders and Myeloid Neoplasms > Flashcards

2-Lymphoproliferative Disorders and Myeloid Neoplasms Flashcards

0
Q

What are 2 things that can help to diagnose leukemia?

A
  • Finding characteristic cells in blood, bone marrow or other organs
  • Associated hematologic abnormalities
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1
Q

The presence of neoplastic cells on peripheral blood and/or bone marrow or spleen is known as what?

A

Leukemia

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2
Q

What are 4 forms of traditional identification of cell types in leukemia?

A
  • Morphologic appearance
  • Cytochemical staining properties
  • Electron microscopic appearance
  • Monoclonal antibody binding to antigens
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3
Q

What are 3 forms of classification of leukemia based on the number of circulating neoplastic cells?

A
  • Leukemic leukemia
  • Subleukemic leukemia
  • Aleukemic leukemia
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4
Q

What are 2 more common classifications of leukemia?

A
  • Acute

- Chronic

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5
Q

What are 2 ways to differentiate between acute and chronic leukemia?

A
  • Degree of differentiation or maturity of cells

- Clinical course of disease

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6
Q

What are 2 characteristics of acute leukemias?

A
  • Neoplastic cells are immature (blasts)

- Survival time is usually short

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7
Q

What are 2 characteristics of chronic leukemias?

A
  • Mature well-differentiated cells predominate

- Patient survival times is usually long

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8
Q

Where are 5 possible location of neoplastic cells seen with leukemia?

A
  • Blood
  • Usually bone marrow
  • Maybe spleen
  • Liver
  • Lymph nodes
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9
Q

T/F: All lymphomas are malignant.

A

True

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10
Q

What are 2 types of proliferative disorders?

A
  • Lymphoproliferative disorders

- Myeloproliferative disorders

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11
Q

What are 2 examples of lymphoproliferative disorders?

A
  • Neoplasms of lymphocytes

- Neoplasms of plasma cells

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12
Q

What type of proliferative disorder involves neoplasms arising from bone marrow stem cells and involve neutrophils, monocytes, erythrocytes, and rarely eosinophils and basophils.

A

Myeloproliferative disorders

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13
Q

If lymphocyte concentration is greater than what value, can you be sure it is a leukemia?

A

> 35,000/ul

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14
Q

If a dog has what lymphocyte value and is Ehrlichia negative, this indicates leukemia?

A

> 15,000/ul

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15
Q

What does ALL stand for?

A

Acute Lymphoblastic Leukemia

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16
Q

What do you need to differentiate acute lymphoblastic leukemia (ALL) from?

A

Stage V lymphoma

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17
Q

65% of dogs presenting with multicentric lymphoma are what?

A

Leukemic

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18
Q

50% of dogs with ALL have what?

A

Lymphadenopathy

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19
Q

What are 4 CBC abnormalities that can be seen with ALL?

A
  • Anemia
  • Thrombocytopenia
  • Lymphocytosis (usually)
  • Lymphoblasts in blood
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20
Q

What is the prognosis with ALL?

A

Poor

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21
Q

Is the clinical course of ALL usually slow or rapid?

A

Rapid

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22
Q

How well does ALL respond to therapy?

A

Poorly responsive

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23
Q

What type of cats get ALL?

A

Younger and FeLV positive

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24
Q

What does CLL stand for?

A

Chronic lymphocytic leukemia

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25
Q

How do lymphocytes appear with CLL?

A

Small and appear well differentiated.

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26
Q

What species is CLL more common in?

A

Dogs

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27
Q

What must CLL be differentiated from?

A

Other causes of lymphocytosis.

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28
Q

If over how many lymphs is leukemia indicated?

A

> 35,000 lymphs

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29
Q

What is the maximum amount of lymphocytes seen with excitement lymphocytosis?

A

20,000/ul

30
Q

What can cause a strong lymphocytosis in cats?

A

Bartonellla henselae

31
Q

What is often seen with chronic ehrlichiosis?

A

Large granular lymphocytes

32
Q

Is excitement lymphocytosis common or rare in dogs?

A

Rare

33
Q

What are 6 possible clinical signs that can be seen with CLL?

A
  • Lethargy
  • Anorexia
  • Pale mucosal membranes
  • Lymphadenopathy
  • Splenomegaly
  • Hepatomegaly
34
Q

Lymphocytosis can range from what?

A

Slightly greater than reference interval to >300,000/ul

35
Q

Can anemia and thrombocytopenia be seen with CLL?

A

Yes

36
Q

What can you see an increased number of in bone marrow?

What percentage?

A
  • Small lymphs

- 25-100%

37
Q

Rarely, with CLL you will see what type of gammopathy?

A

Monoclonal

38
Q

Cats with CLL are usually FeLV positive or negative?

A

Negative

39
Q

Which is more common in dogs and cats, T-cell CLL or B-cell CLL?

A

T-cell CLL

40
Q

What are 4 classification of CLLs?

A
  • CD8+ T-cell
  • CD21+ B-cell
  • CD4-8-5+ T-cell (aberrant T-cell)
  • CD34+ (undifferentiated progenitor)
41
Q

What type of an outcome does the expression of CD34 predict?

A

Poor outcome

42
Q

If the CD8+ and lymphocyte concentration is under what value is a shorter survival time predicted?

A

<30,000/ul

43
Q

A similar outcome is seen with which 2 classifications of CLLs?

A
  • CD4-8-5+

- CD8+

44
Q

Which survive longer, CD21+ B-cell patients with small or large lymphocytes?

A

Small lymphocytes

45
Q

Which survive longer with B-cell leukemia, young or old dogs?

A

Old dogs

46
Q

T/F: Dogs with T-cell CLL and no anemia survive longer.

A

True

47
Q

What does PCR detect?

A

Antigen receptor rearrangements

48
Q

What can PCR be used to identify?

A

Clonal, neoplastic population of cells.

49
Q

What can PCR differentiate?

A

Non-neoplastic from neoplastic

50
Q

What can PCR differentiate lymphoproliferative disorders form?

A

Those that are neoplastic.

51
Q

Proliferation of plasma cells at various sites in the bone marrow and eventually other tissues is seen with what condition?

A

Multiple Myeloma

52
Q

Release in to the peripheral blood occurs occasionally, but usually in very small numbers is seen with which condition?

A

Multiple Myeloma

53
Q

Survival time with multiple myeloma is less if what other condition is present?

A

Leukemia

54
Q

With multiple myeloma, clinical signs are related to the presence of what?

A

Neoplastic plasma cells in the marrow and other tissues.

55
Q

Which immunoglobulin is more likely to result in hyperviscosity of the blood with multiple myeloma?

A

IgM

56
Q

With multiple myeloma, what percentage of plasma cells are seen in the bone marrow?
How are they usually arranged?

A
  • > 20%

- Usually in aggregates

57
Q

Multiple myeloma lab findings must be differentiated from what?

A

Chronic antigenic stimulation

58
Q

What type of gammopathy is seen with multiple myeloma?

A

Monoclonal or biclonal

59
Q

Which 3 immunoglobulins are referred to as “paraproteins”?

A
  • IgG
  • IgA
  • Occasionally IgM
60
Q

What can be seen in the urine with multiple myeloma?

A

Bence-Jones proteins

61
Q

What type of lesions are common to see in the bones with multiple myelomas?

A

Lytic lesions

62
Q

A platelet function abnormality can be seen with multiple myeloma due to the presence of what?

A

Protein

63
Q

Where is the best place to do a bone marrow aspirate with multiple myeloma?

A

Site of lytic lesion in bone

64
Q

What are 6 clinical sings seen with multiple myelomas?

Which one is most often the presenting complaint the owner brings the patient in for?

A
  • Lethargy
  • Anorexia
  • Lameness
  • Bleeding from the nares (presenting complaint)
  • Polyuria
  • Polydipsia
65
Q

What are 2 fundoscopic changes that can be seen with multiple myeloma?

A
  • Retinal hemorrhages

- Engorged retinal blood vessels

66
Q

Renal disease is sometimes seen with multiple myeloma due to what?

A

Proteins interfere with tubular and glomerular function.

67
Q

Renal disease with multiple myeloma may be secondary to what?

A

Hypercalcemia

68
Q

What causes the CNS signs that can be seen with multiple myeloma?

A

Hyperviscosity

69
Q

Bleeding disorders occur in what fraction of dogs with multiple myeloma?

A

1/3

70
Q

Platelet function defects seen with multiple myeloma due to what?

A

Immunoglobulins

71
Q

What are 4 things that can be seen with multiple myeloma in cats?

A
  • Atypical plasma cell morphology
  • Anemia
  • Bone lesions
  • Organ involvement (very common in cats)
72
Q

What are 4 indications of multiple myeloma?

A
  • Monoclonal gammopathy
  • Increased plasma cells in bone marrow
  • Lytic lesions in bones (+/-)
  • Bence-Jones proteins in urine

Clinical Pathology (12 decks)

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