Chapter 13 - Dz of WBCs, LNs, Spleen and Thymus Flashcards
lymphoid progenitor cells give rise to
- NK cells
- B cells
- T cells
myeloid progenitor cells give rise to
- myeloblasts > NPs
- monblast > monocyte
- eosinophilblast > eos
- basophiloblast > baso
- megakaryoblast > platelet
- erythroblast > RBC
increased ratio fat cells:hematopoetic elements
hypoplastic state (ex aplastic anemia)
decreased ratio fat cells:hematopoetic elements
direct involvement of marrow (ex hematopoetic tumors) and compensation hyperplasias (ex hemolytic anemia)
expanision of leuks
leukocytosis
def of leuks
leukopenia
lymphopenia MC ass’d with
- HIV
- DiGeorge syndrome
agranulocytosis increases susceptibility to
bacterial and fungal infections
significant reduction in NPs
agranulocytosis
MCC of agranulocytosis
drug toxicity
drugs that casue agranulocytosis
- aminopyrine
- cholaramphenicol
- sulfonamides
- chlorpromazine
- thiouracil
- phenylbutazone
necrotizing lesions of the gingiva, floor of mouth, buccal mucoas, pharynx or elsewhere in the oral cavity
common consequence if agranulocytosis
netropehic pts are at high risk of inf caused by
candida and aspergillus
leukocytosis from increased production in marrow
- chronic inf
- paraneoplastic
- myeloproliferative disorder
leukocytosis from increased release from marrow stores
- endotoxemia
- inf
- hypoxia
leukocytosis from decreased margination
- exercise
- catecholamines
leukocytosis from decreased extravasation into tissues
glucocorticoids
neurophils with coarse purple cytoplasmic granules
toxic granulation
sky-blue cytoplasmic patches of distended ER (“puddles”)
Dohle bodies
NPs with toxic granulations and Dohle bodies suggest
bacterial sepsis
causes of follicular hyperplasia
- RA
- toxo
- early stages of HIV
causes of paracortical hyperplasia
viral infections, T cell mediated (ex mono)
sinus histocytosis (reticular hyperplasia) may be prominent in
LNs draining cancers
common feature of all forms of hemophagocytic lymphohistiocytosis
systemic activation of MPs and CD8+ cytotoxic T cells
MC trigger for HLH
EBV infection
- HSM
- anemia
- thrombocytopenia
- high levels of plasma ferratin and IL-2 receptor
- elevated LFTs
- possible DIC
HLH
lymphotrophic viruses ass’d as causative agents of lymphomas
- HTLV-1
- EBV
- HHV-8/KSHV
smokers have a 1.3-2 fold increased risk of
AML
ALLs are compose of
immature B or T cells (lymphoblasts)
B-ALLs MC present as
childhood “leukemias”
T-ALLs MC present at
adolescent male thymic “lymphomas”
MC cancer of children
ALL
- myeloperoxidase negative
- periodic acid-Shiff-positive cytoplasmic material
lymphoblasts
TbT immunotyping
pre-B and pre-T lymphoblasts, + in more than 95% of B/T-ALLs
- CD10
- CD19
- PAX5
B-ALL
- CD1
- CD2
- CD5
- CD7
T-ALL
pathognmonic fo CLL/SLL
proliferation centers in LNs
- CD19
- CD20
- CD23
- CD5
CLL/SLL
5-10% of CLL/SLL pts can progress to
Richter synd - diffuse large B-cell lymphoma
translocations involving BCL2
follicular lymphoma
t(14;18)
follicular lymphoma
small cells with irregular or cleaved nuclear contours and scant cytoplasm
centrocytes
larger cells with open nuclear chromtin, severla nucleoli, and modest amounts of cytoplasm
centroblasts
centrocytes and centroblasts seen in
follicular lymphoma
MC form of NHL
diffuse large B-cell lymphoma (DLBCL)
breakpoint in BCL6 at chromasome 3q27
DLBCL
- DLBCL subtype
- KSS/HHV-8 infection
- clonal IgH gene rearrangements
primary effusion lymphoma
MYC gene translocation
Burkitt lymphoma
“starry sky”
Burkitt lmyphoma
- CD19+
- CD20+
- CD10+
- BCL6+
- BCL2-
Burkitt lymphoma
mass involving the iliocecum
sporadic burkitt
mass involving the mandible
endemic burkitt
dyscrasias
plasma cell neoplasms
Bence Jones proteins
free light chains in the urine - plasma cell tumors
tumorous masses scattered throughout the skeletal system
multiple myeloma
single mass in bone or soft tissue (plasma cell neoplasm)
solitary myelomas
lack of symptoms, high plasma M component
smoldering myeloma
- older adult
- high levels of IgM
- hyperviscosity of blood
- MC ass’d with lymphoplasmacytic lymphoma
Waldenstrom macoglobulinemia
ass’d with lymphoplasmacytic lymphoma and small bowel marginal zone lymphoma
heavy chain disease
- older pt
- lack of s/s
- moderately large M component in blood
monclonal gammopathy of undetermined significance (MGUS)