23. Tumour Markers in Lymph Nodes, Spleen, Thymus, Bone Marrow Flashcards
How does immunohistochemistry help with diagnosis?
Evaluate architecture
Differentiate between B and T cell diseases
Classify Hodgkin’s lymphoma
Differentiate between benign and malignant
Detect monoclonality
Is flow cytometry or immunohistochemistry faster?
Flow cytometry
Is flow cytometry or immunohistory easier to read?
Flow cytometry
How many markers can be used on flow cytometry at once?
8-10
What are the advantages of immunohistochemistry?
Can see architecture
Can be sent to reference labs as sample doesn’t need to be alive
What translocation is associated with follicular lymphoma?
t(14;18)
Bcl-2
What translocation is associated with mantle cell lymphoma?
Cyclin D1
t(11;14)
What oncogene is associated with large B cell lymphoma?
ALK
What oncogene is associated with Burkitt’s lymphoma?
MYC
What is the white pulp of the spleen made up of?
Lymphoid follicles (where B and T cells are produced)
What is the red pulp of the spleen made up of?
Venous sinusoids
Cords
What cases cause atrophy of the spleen?
Age
Sickle cell anaemia
Coeliac disease
What are the functions of the spleen?
Haematopoiesis
Cell holding and destruction
Iron metabolism
Antibody formation
What are the causes of splenomegaly?
Congestive (too much blood) Infections Blood and bone marrow disease Lymphoma and leukaemia Collagen vascular disease Storage disorders Amyloidosis
What are causes of congestion of the spleen?
Liver cirrhosis
Portal vein thrombus
What storage disorders can cause splenomegaly?
Hyperlipidaemia
Gauccher’s disease
Lipid storage disorders
What are the results of hypersplenism?
Anaemia
Thrombocytopaenia
Leucopaenia
What are monoclonal antibodies?
Lab-made molecules which are designed to bind to antigens presented by a certain type of cell
What is the difference between hypersplenism and splenomegaly?
Hypersplenism is the overactive function of a spleen of any size
What are the causes of thymic enlargement?
Myasthenia gravis Thyomas Lymphomas Germ cell tumours Carcinoid tumours (neuroendocrine)
What are myeloproliferative cell neoplasms?
Clonal neoplastic proliferation of stem cells
Classify myeloproliferative cell neoplasms
Chronic myeloid leukaemia
Myelofibrosis
Polycythaemia rubra vera
Essential thrombocythaemia
What receptor is over expressed in myelofibrosis, PRV and essential thrombocythaemia?
JAK2
How do myeloproliferative neoplasms present?
Anaemia Infection Bleeding or thrombosis Hyperviscosity syndrome Hyperuricaemia Spleen infarction
What is secondary myelofibrosis caused by?
Metastasis, radio and chemotherapy
What investigations should be done for myeloproliferative disorders?
FBC LAP Bcr-abl and JAK2 genes Uric acid bone marrow trephine
What happens in myelofibrosis?
Enlarged spleen and liver
Loss of marrow cells
How is myelofibrosis treated?
Marrow stimulation
Splenectomy
What are the causes of secondary polycythaemia?
High altitudes
Congenital heart defects
Tumours that produce erythropoietin
What are the symptoms of polycythaemia?
Red face Thrombosis Haemorrhage Increased Hb Splenomegaly
