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SP15 Pathology > Exam 2; WBC Disorders > Flashcards

Exam 2; WBC Disorders Flashcards

1
Q

This type of lymphoma arises in a single lymph node or spreads contiguously to involve a chain of nodes

A

Hodgkin Lymphoma

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2
Q

What cell type is distinctive in Hodgkin Lymphoma

A

Reed-Sternberg admixed with a variable inflammatory infiltrate

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3
Q

What is the bimodal age distribution of Hodgkin Lymphoma

A

20-30 years and then >50

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4
Q

What is the etiology of Hodgkin Lymphoma

A

it is unknown but EBV has been implicated in playing a role

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5
Q

What is necessary for a diagnosis of Hodgkin Lymphoma

A

a lymph node biopsy

identification of Reed-Sternberg cells in the appropriate background

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6
Q

These are large cells with mirror-image nuclei and prominent nucleoli; germinal center B cell origin; “owl eye”

A

Reed-Sternberg cells

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7
Q

Reed-Sternberg cells are the malignant cell of Hodgkin Lymphoma but only comprise what percentage of cells in the involved lymph node

A

2%

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8
Q

True or False

The spread of Hodgkin Lymphoma is unpredictable

A

False; it is predictable

lymph nodes - spleen - liver - marrow

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9
Q

This assess tumor extent and uses a combination of clinical findings and imaging (MRI)

A

staging

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10
Q

Staging is used to determine what regarding Hodgkin Lymphoma

A

treatment and prognosis

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11
Q

What is characteristic of low stage Hodgkin Lymphoma

A

localized involvement

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12
Q

What is characteristic of high stage Hodgkin Lymphoma

A

wide spread disease with distant or bone marrow involvement

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13
Q

This staging of Hodgkin Lymphoma is when the tumor is in one anatomic region or to contiguous anatomic regions on the same side of the diaphragm

A

I

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14
Q

This staging of Hodgkin Lymphoma is when the tumor is in more than two anatomic regions or two non-contiguous regions on the same side of the diaphragm

A

II

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15
Q

This staging of Hodgkin Lymphoma is when the tumor is on both sides of the diaphragm not extending beyond lymph nodes, spleen, or Waldeyer’s ring

A

III

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16
Q

This staging of Hodgkin Lymphoma is when the tumor is in the bone marrow, lung, etc. Any organ site outside the lymph nodes, seen or Wladeyer’s ring

A

IV

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17
Q

What are the “B” signs/symptoms of Hodgkin Lymphoma

A

fever
night sweats
significant unexplained weight loss

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18
Q

What is the treatment for low stage Hodgkin Lymphoma

A

chemotherapy and radiotherapy

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19
Q

What is the treatment for high stage Hodgkin Lymphoma

A

chemotherapy

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20
Q

There is a low risk of developing this when treating for Hodgkin Lymphoma

A

secondary treatment-related acute leukemia

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21
Q

What is the prognosis of Hodgkin Lymphoma dependent on

A

patients without “B” signs/symptoms have a better prognosis; so no systemic symptoms

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22
Q

Which stages of Hodgkin Lymphoma are more likely to have “B” symptoms

A

III and IV

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23
Q

What is the 5-year survival rate of stage I and IIA Hodgkin Lymphoma

A

almost 100%

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24
Q

What is the 5-years survival rate of stage IV Hodgkin Lymphoma

A

50%

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25
This lymphoma involves neoplastic lymphocytes originating in lymph nodes or extranodal lymphoid tissue
Non- Hodgkin Lymphoma
26
The majority of Non-Hodgkin Lymphomas are of this origin
``` B cell (85%) the remainder are T cell origin ```
27
In contrast to Hodgkin Lymphoma, Non-Hodgkin Lymphomas tend to have what
multiple node involvement more frequent extra nodal spread peripheral blood involvement
28
How does a lymphoma develop (Non-Hodgkin Lymphoma)
when there is a monoclonal expansion of lymphocytes that have been arrested at a particular stage in transformation, proliferating without normal regulatory mechanisms
29
True or False | All Non-Hodgkin Lymphoma is considered to arise from a single transformed cell
True
30
What are the clinical symptoms of Non-Hodgkin Lymphoma
painless lymph node enlargement frequent immune abnormalities splenomegaly
31
What percentage of Non-Hodgkin Lymphoma patients exhibit systemic symptoms
30% | may involve the GI, bones, CNS
32
What three things classify Non-Hodgkin Lymphoma
morphology cell of origin clinical features genotype
33
What are the two growth pattern classification options of Non-Hodgkin Lymphoma
nodular or difffuse
34
Which is better; nodular or diffuse Non-Hodgkin Lymphoma
nodular
35
Which is better; small cell or large cell Non-Hodgkin Lymphoma
small (better differentiated)
36
What is characteristic of low stage Non-Hodgkin Lymphoma
localized disease
37
What is characteristic of high stage Non-Hodgkin Lymphoma
numerous sites of involvement or bone marrow involvement
38
What is prognosis of Non-Hodgkin Lymphoma based upon
the sub-type of lymphoma rather than the stage; this is an exception to the general rule
39
This stage of Non-Hodgkin Lymphoma involves single lymph node region or extra lymphatic organ or site
I
40
This stage of Non-Hodgkin Lymphoma involves two or more lymph node regions on same side diaphragm alone or with involvement of contiguous extra lymphatic organ or tissue
II
41
This stage of Non-Hodgkin Lymphoma involves lymph node regions on both side of the diaphragm which may include the spleen
III
42
This stage of Non-Hodgkin Lymphoma involves multiple or disseminated foci of involvement of one or more extra lymphatic organs or tissues with or without lymphatic involvement
IV
43
What represents a "leukemic phase" of Non-Hodgkin Lymphoma
circulating lymphoma cells in the peripheral blood
44
What are three complications of Non-Hodgkin Lymphoma
infections anemia thrombocytopenia
45
What are three treatment options of Non-Hodgkin Lymphoma
chemotherapy possible radiation therapy bone marrow transplantation
46
What is the most important part of diagnosing Non-Hodgkin Lymphoma
which cell type it is
47
These are malignant neoplasms of hematopoietic tissue that arise in the bone marrow
leukemia
48
This type of leukemia is characterized by rapid onset with blasts in the blood
acute
49
This type of leukemia has indolent onset and tends to involve more mature ells
chronic
50
What cells are affected with leukemia
myeloid and lymphoid
51
What is the differences between the courses of acute and chronic leukemias
acute - rapid, usually fatal; survival is months | chronic - indolent, often long, survival is years
52
What would you find in the peripheral blood of acute and chronic leukemia
acute - mostly blasts (immature cells) | chronic - mostly mature cells
53
What would you find different in the WBC count of acute and chronic leukemia
acute - often increased (decreased in 30%) | chronic - often increased
54
What would you find different regarding the bone marrow of acute and chronic leukemia
``` acute - >20% class chronic - blasts not usually increased ```
55
What is the clonal proliferating cell of acute lymphoblastic leukemia
primitive lymphoid cell
56
acute lymphoblastic leukemia accounts for what percentage of acute leukemias
40% and is most frequent type in children <15 years old
57
True or False | acute lymphoblastic leukemia is the principal cause of cancer deaths in childhood with a peak incidence at age 4
True
58
True or False | Only T cells type of acute lymphoblastic leukemia exists
False, both B and T cell type exists
59
What are two clinical manifestations of acute lymphoblastic leukemia
lymphandenopathy | splenomegaly
60
What differs regarding the prognosis of acute lymphoblastic leukemia in children vs adults
children have a good prognosis | adults have a bad prognosis
61
What is the clonal proliferating cell in acute myelogenous leukemia
primitive myeloid cell
62
These cytoplasmic inclusions are found in acute myelogenous leukemia; a diagnostic marker
Auer rods
63
What are the clinical manifestations of acute myelogenous leukemia
increased WBC count often accompanied by anemia and thrombocytopenia
64
In which age group is acute myelogenous leukemia most common
in adults; median age of 50
65
acute myelogenous leukemia has this oral characteristic
lesional cells proliferate the soft tissues including the gingivae; granulocytic sarcoma
66
These are present in the cytoplasm of acute myelogenous leukemia
myeloperoxidase
67
This is the main treatment of acute myelogenous leukemia
chemotherapy; but many relapse (70% have remission)
68
Prognosis of acute myelogenous leukemia is influenced by what
cytogenetics
69
What is the clonal proliferating cell in chronic lymphocytic leukemia
mature lymphocyte; typically immunologically incompetent B cell
70
What is the most common Ig expression of the incompetent B cells of chronic lymphocytic leukemia
IgM kappa
71
chronic lymphocytic leukemia accounts for what percentage of chronic leukemias
2/3 most common in adults over 60 2:1 male to female
72
What are the clinical manifestations of chronic lymphocytic leukemia
increased WC count with lymphocytes splenomegaly lymphadenopathy anemia and thrombocytopenia
73
What is the basis of treatment for chronic lymphocytic leukemia and what is the medial survival
chemotherapy | 4-6 years
74
What is the clonal proliferating cell of chronic myelogenous leukemia
immature granulocytes; stem cells
75
There is a marked increase of this regarding chronic myelogenous leukemia
wbc count with eosinophils and/or basophilia
76
What are the clinical manifestations of chronic myelogenous leukemia
thrombocyotsis and anemia | splenomegaly
77
What is the specific chromosomal abnormality involving chronic myelogenous leukemia
Philadelphia chromosome [t9;22] resulting in the fusion of BCR-ABL genes which mimic the effects of growth factor activation driving the proliferation of CML
78
What is the treatment for chronic myelogenous leukemia
targeted chemotherapy blocks the BCR-ABL tyrosine kinase, inducing remissions BMT for relapsed or resistant disease
79
chronic myelogenous leukemia accounts for what percentage of chronic leukemia
1/3 | usually in adults 25-60 years old
80
The terminal phase of chronic myelogenous leukemia is marked by what
immature cells in peripheral blood and none marrow, decreased response to treatment the "blast crisis"
81
This is a clonal proliferation of monoclonal plasma cells
multiple myeloma
82
What are the percentages of Ig that is produced by the neoplastic cells in multiple myeloma; since this is a clonal disorder, only one occur
60% IgG | 20-25% IgA
83
When only light chains are produced in multiple myeloma what is the clinical symptom
excrete low molecular weight light chains in the urine; Bence Jones proteinuria
84
This symptom is characteristic of multiple myeloma
multifocal destructive bone lesions
85
What are the clinical manifestations of multiple myeloma
``` bone marrow infiltration by plasma cells increased serum monoclonal protein hypercalcemia renal failure infections ```
86
What are three characteristics regarding the blood and marrow features of multiple myeloma
circulating plasma cells in blood are uncommon RBC show rouleaux (stacks) formation marrow plasma cell infiltrates in single cells and sheets
87
What is typically the prognosis of multiple myeloma
variable but generally poor
88
What is the typical survival rate of multiple myeloma
4-6 years
89
What are some treatments for multiple myeloma
chemotherapy radiotherapy (for bone pain) bone marrow transplant NO CURE
90
How many new cases of multiple myeloma will there be in the US in 2015
24k cases | average patent age = 70
91
How many new cases of Hodgkin and Non-Hodgkin Lymphoma will there be in 2015 in the US
9k Hodgkin | 72k Non-Hodgkin

SP15 Pathology (17 decks)

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