Chapter 13 hematologic disorders Flashcards
What is a general term for a decrease in volume of RBCs or in the concentration of hemoglobin?
-Anemia
What does hematocrit =?
-Volume of RBCs
What are some underlying diseases that anemia might be associated with?
- Renal failure
- Liver disease
- Chronic inflammatory conditions
- Malignancies
- Vitamin or mineral deficiencies
What are the general symptoms of anemia?
- Tiredness
- Headache
- Fainting/feeling lightheaded
- Pallor
What are oral symptoms of anemia?
- Glossodynia (pain)
- Glossopyrosis (burning)
- Tongue atrophy (bald)
What is a hematologic disorder characterized by a markedly decreased number of circulating blood platelets?
-Thrombocytopenia
What is the result of thrombocytopenia?
-Abnormal bleeding
What are the decrease in platelets in thrombocytopenia due to?
- Reduced production
- Increased destruction
- Sequestration in the spleen
What is a normal platelet count?
200,000-400,000
Clinical evidence of thrombocytopenia is not seen until platelet count is below what?
100,000/mm3
In thrombocytopenia patients, the small capillaries leak blood which result in what?
-Petechiae (small breakage and leakage of capillaries)
What is the order of advancement of thrombocytopenia clinically?
- Petechiae
- purpura (fused petechiae)
- ecchymosis
What do special types of thrombocytopenia include?
- Thrombocytic thrombocytopenia (TTP)
- idiopathic thrombocytopenic purpura (ITP)
When does idopathic thrombocytopenic purpuara occur?
-In childhood after a viral infection
Thrombocytic thrombocytopenia is a serious disorder of coagulation and is probably due to what?
-Endothelail damage
What is enlargement of the lymphoid tissue?
-Lymphoid hyperplasia
Aggregates of lymphoid tissue are most commonly seen where?
- Oropharynx
- Soft palate
- Lateral tongue
- Floor of mouth
With acute infection, the lymphoid hyperplasia appear as what?
-Enlarged, tender, soft, freely movable nodules
With chronic infections, the lymphoid hyperplasia appear as what?
-Enlarged, nontender, firm, freely movable nodules
If you have tonsillar asymmetry what could is possibly be?
- Metastatic tumor
- Lymphoma
- Lymphoid hyperplasia
Agranulocytosis means what?
-Without granulocytes (usually neutrophils)
What does agranulocytosis lead to/have associated with it?
- Neutropenia
- Lymphopenia
What is agranulocytosis induced by?
-Drugs for anticancer treatments
What are the oral symptoms of agranulocytosis?
-Necrotizing, deep, punched-out ulcerations of the buccal mucosa, tongue and palate
What represents several types of malignancies of hematopoietic stem cell derivation?
-Leukemia
What is the philadelphia chromosome related to?
-Chronic myeloid leukemia has a translocation of the chormosomal material between the long arms of chromosomes 9 and 22
What are some environmental factors that might lead to leukemia?
- Exposure to pesticides and or benzene
- Ionizing radiation
What type of leukemia is a more common childhood malignancies?
-Acute lymphoblastic leukemia
What is the most common type of leukemia?
-Chronic lymphocytic leukemia (occurs in adulthood)
What virus can cause leukemia?
-Human T-cell leukemia virus type 1
The leukemic cells may infiltrate the oral soft tissues to produce a boggy (doughy), non-tender swelling that is termed what?
-Granulocytic sarcoma
What are langerhan cells?
-Dendritic mononuclear cells normally found in the epidermis, mucosa, lymph nodes, and bone marrow
T/F Langherhans cells are antigen presenting cells
True
What is eosinophilic granuloma of bone?
-One or multiple lesions with no visceral involvement
What are the subtypes of langerhan cell histiocyotsis?
- Eosinophilic granuloma of bone
- Acute disseminated histiocytosis
- Chronic disseminated histiocytosis
What is acute disseminated histiocytosis?
-Disease involves bone, skin, and viscera
What is acute disseminated histiocytosis aka?
-Letterer-Siwe disease
What is chronic disseminated histiocytosis?
-Disease involves bone, skin, and viscera
What is Chronic disseminated histiocytosis aka?
-Hand-Schuller-Christian disease
Where are langerhan cell histiocytosis most commonly found?
- Skull
- Ribs
- Vertebrae
- Mandible
In an X-ray what might make you think of langerhan cell histiocytosis?
- Sharply demarcated “punched-out” radiolucencies
- Occasionally may be ill-defined
- Mandibular lesions appear “scooped out” because the superficial alveolar bone is destroyed
- Extensive alveolar bone involvement that looks like a tooth floating in air
Langerhan cells contain rod shaped cytoplasmic structures known as what?
-Birbeck granules (found via electronmicroscopy)
Identification of what cell is necessary to confirm langerhan cell histiocytosis?
-Lesional Langerhan cell
More than half of patients with Langerhan cell histiocytosis are how old?
-Younger than 15
What is a malignant lymphoproliferative disorder?
-Hodgkin’s lymphoma
What are the neoplastic cells in Hodgkin’s lymphoma known as?
-Reed-Sternberg cells
What virus is associated with Hodgkin’s lymphoma?
-EBV (Epstein Barr Virus)
Where does Hodgkin’s lymphoma usually begin?
-Lymph nodes
What gender is Hodgkin’s lymphoma more common in?
-Males
Where are most of the lymph nodes involved in Hodgkin’s lymphoma at?
-Cervical and supraclavicular nodes
What do Reed-sternberg cells appear as?
-Owl’s eyes
What is non-Hodgkin’s lymphoma aka?
-Lymphoma
What type of cell are most non-Hodgkin’s lymphomas from?
-B-lymphocyte origin
Intraoral soft tissue lesions in non-Hodgkin’s lymphoma typically appear as nontender diffuse swelling affecting what locations?
- Posterior hard palate
- Gingiva
- Buccal vestibule
Swelling in non-hodgkins’ lymphoma are characteristically what when applying pressure?
-Boggy
What is the most common type of lymphoma of the oral cavity?
-Diffuse large B cell lymphoma
Mycosis fungoides is so named because it clinically resembles what?
-Fungal infection
What is the most common cutaneous lymphoma?
-Mycosis fungoides
What type of cell is mycosis fungoides?
-A T cell lymphoma
What is an aggressive expression of mycosis fungoides that represents dermatopathic T cell leukemia?
-Sezary syndrome
What is a propensity to invade the epidermis of the skin known as?
-Epidermotropism
What is Epidermotropism associated with?
-Mycosis Fungoides
The atypical lymphocytes in mycosis fungoides form small intraepithelial aggregates termed what?
-Pautrier’s microabscesses
What is a malignancy of B cell origin?
-Burkitt’s lymphoma
What virus is associated with Burkitt’s lymphoma?
EBV
What is the average age of someone who gets burkitt’s lymphoma?
-7
What is a “starry-sky” pattern in histology associated with?
-Burkitt’s lymphoma
What is the cell that creates the “starry-sky” pattern in Burkitt’s lymphoma?
-Macrophages
