Chapter 13: Hematologic Disorders Flashcards
leukemia
is burkitt’s lymphoma an aggressive malignancy?
yes
the untreated patient will succomb to the disease in 6 months
platelet count less than ___/mm3 is considered severe thrombocytopenia and can result in massive bleeding and death
10,000
___ are dendritic mononuclear cells normally found in the epidermis, mucosa, lymph nodes, and bone marrow
langerhans cells
burkitt’s lymphoma has a predilection for the jaws. what specific locations are more common?
posterior jaws > anterior
maxilla > mandible
what are the neoplastic cells of hodgkin’s lymphoma?
reed-sternberg cells
typically binucleated (“owl eye” nuclei)
are males or females more commonly affected by hodgkin’s lymphoma?
males
mycosis fungoides
hodgkins lymphoma
reed-sternberg cells (owl-eye nuclei)
the decrease in platelets in thrombocytopenia may be due to what 3 things?
- reduced production
- increased destruction
- sequestration in the spleen
what are the two types of hodgkin’s lymphoma?
- nodular lymphocyte - predominant
- classical
what are the radiographic features of multiple myeloma?
- multiple, well-defined “punched out” radiolucencies
- may be ragged radiolucent lesions
- especially evident on skull film
what should you be able to see on a radiograph of a patient with langerhans cell histiocytosis?
- sharply demarcated (punched-out) readiolucencies
- occasionally may be ill-defined
- mandibular lesions appear scooped out because the superficial alveolar bone is destroyed
- extensive alveolar bone involvement resembles severe periodontitis clinically and radiographically the teeth look like they are floating in air
what is an example of a virus that can cause leukemia?
human T-cell leukemia/lymphoma virus type 1 (HTLV-1) transmitted by blood
multiple myeloma
plasmacytoma typically arises in what tissue?
bone
what is the treatment for burkitt’s lymphoma?
intensive chemotherapy
with acute infections, how does lymphoid hyperplasia present?
the lymphoid hyplerplasia (tonsillar) appears as enlarged, tender, soft, freely movable nodules
what is the prognosis of langerhans cell histiocytosis?
- good if it is limited to bone
- those with visceral and cutaneous involvement have a poor prognosis
what are the oral symptoms of agranulocytosis?
necrotizing, deep, punched out ulcerations of the buccal mucosa, tongue, and palate
at what platelet count is clinical evidence of thrombocytopenia seen? this condition is often initially detected due to what?
- below 100,000/mm3
- oral lesions
non-hodgkins lymphoma is also called a ___
lymphoma
___ lesions are the most common presentation of langerhans cell histiocytosis
bone
the abnormal cells of myltiple myeloma are ___, which likely arise from ___
- monoclonal
- a single precursor that undergoes uncontrolled mitotic division
what is the treatment for anemia?
depends on correcting the underlying condition
refer to physician
what is this, and what hematologic disorder is it associated with?
petechiae
thrombocytopenia
non-hodgkins lymphoma occurs primarily in what age patient?
adults
mycosis fungoides
50% of patients with plasmacytoma will have multiple myeloma within ___ years
2-3
lymphoid hyperplasia may affect what tissues?
- lymph nodes
- waldeyer’s ring
- aggregates of lymphoid tissues scattered throughout the oral cavity
some patients with multiple myeloma may have pathologic ___, complain of ___, or have ___
- fractures
- fatigue
- petechiae
radiographic features of burkitt’s lymphoma are consistent with ___
a malignant process
what is the prognosis for multiple myeloma? what is the median survival?
- prognosis is poor
- median survival of 3 years
NK/T cell lymphoma is also known as ___
angiocentric T-cell lymphoma
what is the prognosis for someone with burkitt’s lymphoma?
- stage I or II - 5-year survival is 90%
- stage III or IV - 5-year survival is 80%
- due to aggressive treatment
what is the prognosis of patients with chronic myeloid leukemia?
5-year surivival is 80%, but once blast transformation occurs, the patient will usually die within 6 months
what is the treatment of multiple myeloma? does it relapse?
- chemotherapy is typically used, 60% respond
- virtually all cases relapse
- bisphosphonates are given to reduce fractures
because african burkitt’s lymphoma is seen in other areas of the world, some prefer to call it ___
endemic burkitt’s lymphoma
___ and ___ contribute to the development of leukemia
environmental and genetic factors
reduced platelet count in thrombocytopenia may e the result of what?
various causes, such as infiltration of the bone marrow by malignant cells or the toxic effects of cancer chemotherapy
___ is a unifocal, monoclonal neoplastic proliferation of plasma cells
plasmacytoma
what is the treatment for NK/T cell lymphoma?
lesions typically respond to radiation therapy
if leukemia is suspected, what should happen?
referral to appropriate physician is mandatory
hodgkin’s lymphoma is a malignant ___ disorder
lymphoproliferative
what is normal platelet count?
200,000-400,000/mm3
growth of a burkitt’s lymphoma tumor mass may cause ___ and ___
facial swelling and proptosis (protrusion of the eye)
agranulocytosis is associated with bacterial infections because ___
neutrophils are the first line of host defense
the following is an oral symptom of what hematologic disorder?
anemia, as characterized by a bald tongue
what are the 5 histologic subtypes of the classical presentaiton of hodgkins lymphoma?
- lymphocyte rich
- nodular sclerosis - F>M; 70% of cases
- mixed cellularity
- lymphocyte depletion
- unclassifiable
what is the prognosis for patients with acute myeloid leukemia?
40% survival if they are younger than 60
10% if not
multiple myeloma is a malignancy of ___ origin
plasma cell
it has a multicentric origin within bone
plasmacytoma probably gives rise to ___
multiple myeloma
what is the average age patient with mycosis fungoides? male or female predilection?
average age is 60
M:F 2:1
in thrombocytopenia patients, the small capillaries leak blood which results in ___. if a larger quantity of blood is extravasated, a ___ will result. even larger amounts of extravasated blood results in a ___.
- petechiae (pinpoint hemorrhagic lesions)
- ecchymosis
- hematoma
what are 4 general symptoms related to the reduced oxygen-carrying capacity of the blood?
- tiredness
- headache
- fainting/feeling lightheaded
- pallor
___ is the enlargement of lymphoid tissue
lymphoid hyperplasia
what type of thrombocytopenia is a serious disorder of coagulation and is probably due to endothelial damage? you should refer to a physician for treatment; 70% survival
thrombotic thrombocytopenic purpura
which stage of mycosis fungoides is characterized by distinct papules and nodules, and has visceral involvement?
tumor
what is the treatment of lymphoid hyperplasia?
once the diagnosis is confirmed, no treatment is necessary
what is the bimodal pattern of age at diagnosis of hodgkin’s lymphoma?
- between 15-35
- after age 50
what are the histopathologic features of mycosis fungoides?
- atypical lymphocyte cells infiltrate the surface epithelium (epidermotropism is a propensity to invade the epidermis of the skin)
- these atypical lymphocytes are termed mycosis cells or sezary cells
- the atypical lymphocytes form small intraepithelial aggregates termed pautrier’s microabscesses
langerhans cell histiocytosis
renal failure may be a presenting sign in multiple myeloma because kidneys become overburdened with excess circulating proteins, termed ___ proteins
bence jones proteins
up to 50% of multiple myeloma patients will have these proteins in their urine
what are the most common accompanying symptoms of langerhans cell histiocytosis?
pain and tenderness
what radiographic changes are seen in non-hodgkins lymphoma?
ill-defined or ragged radioluscency
langerhans cell histiocytosis lesions are found most commonly in what 4 locations?
- skull
- ribs
- vertebrae
- mandible - jaws are affected in 15% of cases
if patients with non-hodgkins lymphoma wear a denture, what might they compain of?
they may complain that their denture has become too tight