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Pathology > Bone Marrow > Flashcards

Bone Marrow Flashcards

1
Q

Hematopoiesis

A

Myeloid stem cell —> RBC, granulocytes, monocytes, platelets

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2
Q

Lymphopoiesis

A

Lymphoid stem cell —> T cell, B cell, plasma cell

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3
Q

Erythropoiesis

A

Erythropoietin (from kidney) regulates RBC production
Hypoxia (or ILs, CSFs, hormones) —> Epo release

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4
Q

Granulopoiesis

A

Myeloid series production (granulocytic + Monocytic cells)

Inflammatory mediators (ILs, TNFa) —> cytokine (G-CSF, GM-CSF) production —> stimulate granulopoiesis + monocytopoiesis

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5
Q

Megakaryopoiesis

A

Thrombopoietin (Tpo) by liver regulates thrombopoiesis (constitutively produced)

Megakaryocytes —> endomitosis to become polyploid —> extend into bone marrow venous sinusoids —> fragment to platelets

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6
Q

Cytology

A

Identification of cell types within tissue or fluid by evaluation of smears made from specimen

Faster than biopsy, more detail of internal cell structures

Sacrifices anatomic relationship

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7
Q

Core biopsy

A

Histologic assessment

Definitive determination of cellularity and fibrosis

Within the environment of tissue

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8
Q

Dynamic nature of bone marrow

A

Peripheral demands for WBC/RBC/platelets —> shift in bone marrow cytologies profiles due to hyperplastic responses

Disease of bone marrow —> impacts peripheral leukocyte, erythrocyte, platelet numbers

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9
Q

Reasons to evaluate bone marrow

A

Unexplained/persistent dec or inc in particular cell line
Abnormal or immature cells in circulation
Atypical cell reactions
FUO
Unexplained lab findings - hypercalcemia, hyperglobulinemia
Staging of neoplasia - lymphoma or mast cell tumors

NEED CONCURRENT CBC

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10
Q

Indications for core biopsy

A

Bone changes
Abnormal bone marrow cellularity (hypo/hyper cellular, aplasia)
Focal lesions
Unsuccessful aspiration

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11
Q

Parameters to evaluate in bone marrow

A

Cellularity + particles
Maturation sequences + morphology
Frequency of lymphocytes, macs, plasma cells, other cells
Adequacy of iron
Presence of abnormal cells

MYELOID:ERYTHROID ratio (M:E)!!

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12
Q

Erythroid series

A

Rubriblast —> prorubricyte —> rubricyte —> metarubricyte —> polychromatophil —> RBC

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13
Q

Myeloid series

A

Progranulocyte —> myelocyte —> metamyelocyte —> band cell —> neutrophil, eosinophils, basophil

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14
Q

Hyperplasia

A

Increase in response to peripheral demand for specific cell type

PREDICTIBLE

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15
Q

Causes of erythroid hyperplasia

A

Hemorrhage (trauma, coagulopathies, neoplasia)
Hemolysis (IMHA, toxin, infectious, oxidant injury, enzyme deficiencies, hypophosphatemia)

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16
Q

Trigger for erythropoiesis

A

Low Hb —> hypoxemia —> Epo by kidneys —> erythropoiesis in marrow

17
Q

Clinical indication of erythroid hyperplasia

A

M:E decreases, immature RBC in blood (polychromatophilic RBC - bluish cells, and reticulocytes in blood)

18
Q

Response to acute severe hemolysis or hemorrhage

A

Abrupt decrease in hemoglobin —> immediate tissue oxygen compromise —> tissue necrosis —> concurrent myeloid hyperplasia —> peripheral leukocytosis

M:E may be normal with increase in both myeloid + erythroid line

CONCURRENT CBC required for M:E evaluation

19
Q

Myeloid hyperplasia

A

Response to increased need for granulocytes and/or monocytes (i.e. infection)

M:E increases

Immature cells in blood increase with “left shift” in maturation

20
Q

Megakaryocytic hyperplasia

A

In response to destruction, loss consumption of platelets
(Immune mediated disease, DIC)

21
Q

Bone marrow hypoplasia

A

Hypoplasia of a cell line results in peripheral decrease in that cell type

Clinical signs reflect missing cell type

22
Q

Causes of bone marrow hypoplasia

A

Anemia of chronic disease / inflammation
Immune-mediated
Cytotoxic or drug-induced
Infection (viral)
Endocrine-induced
Iron deficiency
Renal failure
Malnutrition
Inherited disorders
Idiopathic

23
Q

Anemia of chronic disease or inflammation

A

Bone marrow hypoplasia
Most common cause of non regenerative anemia

Not as predictible as hyperplasia

24
Q

Types of bone marrow inflammation

A

Acute myelitis
Granulomatous or pyogranulomatous

25
Q

Myelodysplastic Syndrome

A

Group of Clonal myeloid proliferative disorders
Abnormal cell morphology
Marrow profile indicates hyperplasia of one or more cell line without improvement in peripheral cell count

Can be associated with FeLV, FIV

26
Q

Leukemia

A

Malignant hematopoietic neoplasm originating in bone marrow

OFten significant number of neoplastic cells in blood

Lymphocytic or myelogenous, acute or chronic

27
Q

Myelogenous leukemia

A

AML: peripheral blood smear with blast cells, lack of appropriate maturation of marrow cells, most common in FeLV cats; poor prognosis

CML: high peripheral cell count, normal morphology (process of elimination diagnosis); rare, chronic,

28
Q

Lymphoid leukemia

A

ALL: immature lymphocytes, may efface marrow, young to middle aged

CLL: well-differentiated lymphocytes, usually do not efface marrow, usually older animals

29
Q

Multiple myeloma

A

Plasma cell neoplasm in marrow, malignant

30
Q

Myelofibrosis

A

Generally secondary (scar formation, GF-induced fibroblast proliferation)
Difficult to aspirate
Histologic diagnosis

Pathology (21 decks)

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