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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
Q

This lymphoma involves neoplastic lymphocytes originating in lymph nodes or extranodal lymphoid tissue

A

Non- Hodgkin Lymphoma

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26
Q

The majority of Non-Hodgkin Lymphomas are of this origin

A 
B cell (85%)
the remainder are T cell origin
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27
Q

In contrast to Hodgkin Lymphoma, Non-Hodgkin Lymphomas tend to have what

A

multiple node involvement
more frequent extra nodal spread
peripheral blood involvement

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28
Q

How does a lymphoma develop (Non-Hodgkin Lymphoma)

A

when there is a monoclonal expansion of lymphocytes that have been arrested at a particular stage in transformation, proliferating without normal regulatory mechanisms

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29
Q

True or False

All Non-Hodgkin Lymphoma is considered to arise from a single transformed cell

A

True

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30
Q

What are the clinical symptoms of Non-Hodgkin Lymphoma

A

painless lymph node enlargement
frequent immune abnormalities
splenomegaly

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31
Q

What percentage of Non-Hodgkin Lymphoma patients exhibit systemic symptoms

A

30%

may involve the GI, bones, CNS

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32
Q

What three things classify Non-Hodgkin Lymphoma

A

morphology
cell of origin
clinical features
genotype

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33
Q

What are the two growth pattern classification options of Non-Hodgkin Lymphoma

A

nodular or difffuse

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34
Q

Which is better; nodular or diffuse Non-Hodgkin Lymphoma

A

nodular

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35
Q

Which is better; small cell or large cell Non-Hodgkin Lymphoma

A

small (better differentiated)

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36
Q

What is characteristic of low stage Non-Hodgkin Lymphoma

A

localized disease

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37
Q

What is characteristic of high stage Non-Hodgkin Lymphoma

A

numerous sites of involvement or bone marrow involvement

38
Q

What is prognosis of Non-Hodgkin Lymphoma based upon

A

the sub-type of lymphoma rather than the stage; this is an exception to the general rule

39
Q

This stage of Non-Hodgkin Lymphoma involves single lymph node region or extra lymphatic organ or site

A

I

40
Q

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

A

II

41
Q

This stage of Non-Hodgkin Lymphoma involves lymph node regions on both side of the diaphragm which may include the spleen

A

III

42
Q

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

A

IV

43
Q

What represents a “leukemic phase” of Non-Hodgkin Lymphoma

A

circulating lymphoma cells in the peripheral blood

44
Q

What are three complications of Non-Hodgkin Lymphoma

A

infections
anemia
thrombocytopenia

45
Q

What are three treatment options of Non-Hodgkin Lymphoma

A

chemotherapy
possible radiation therapy
bone marrow transplantation

46
Q

What is the most important part of diagnosing Non-Hodgkin Lymphoma

A

which cell type it is

47
Q

These are malignant neoplasms of hematopoietic tissue that arise in the bone marrow

A

leukemia

48
Q

This type of leukemia is characterized by rapid onset with blasts in the blood

A

acute

49
Q

This type of leukemia has indolent onset and tends to involve more mature ells

A

chronic

50
Q

What cells are affected with leukemia

A

myeloid and lymphoid

51
Q

What is the differences between the courses of acute and chronic leukemias

A

acute - rapid, usually fatal; survival is months

chronic - indolent, often long, survival is years

52
Q

What would you find in the peripheral blood of acute and chronic leukemia

A

acute - mostly blasts (immature cells)

chronic - mostly mature cells

53
Q

What would you find different in the WBC count of acute and chronic leukemia

A

acute - often increased (decreased in 30%)

chronic - often increased

54
Q

What would you find different regarding the bone marrow of acute and chronic leukemia

A 
acute - >20% class
chronic - blasts not usually increased
55
Q

What is the clonal proliferating cell of acute lymphoblastic leukemia

A

primitive lymphoid cell

56
Q

acute lymphoblastic leukemia accounts for what percentage of acute leukemias

A

40% and is most frequent type in children <15 years old

57
Q

True or False

acute lymphoblastic leukemia is the principal cause of cancer deaths in childhood with a peak incidence at age 4

A

True

58
Q

True or False

Only T cells type of acute lymphoblastic leukemia exists

A

False, both B and T cell type exists

59
Q

What are two clinical manifestations of acute lymphoblastic leukemia

A

lymphandenopathy

splenomegaly

60
Q

What differs regarding the prognosis of acute lymphoblastic leukemia in children vs adults

A

children have a good prognosis

adults have a bad prognosis

61
Q

What is the clonal proliferating cell in acute myelogenous leukemia

A

primitive myeloid cell

62
Q

These cytoplasmic inclusions are found in acute myelogenous leukemia; a diagnostic marker

A

Auer rods

63
Q

What are the clinical manifestations of acute myelogenous leukemia

A

increased WBC count often accompanied by anemia and thrombocytopenia

64
Q

In which age group is acute myelogenous leukemia most common

A

in adults; median age of 50

65
Q

acute myelogenous leukemia has this oral characteristic

A

lesional cells proliferate the soft tissues including the gingivae; granulocytic sarcoma

66
Q

These are present in the cytoplasm of acute myelogenous leukemia

A

myeloperoxidase

67
Q

This is the main treatment of acute myelogenous leukemia

A

chemotherapy; but many relapse (70% have remission)

68
Q

Prognosis of acute myelogenous leukemia is influenced by what

A

cytogenetics

69
Q

What is the clonal proliferating cell in chronic lymphocytic leukemia

A

mature lymphocyte; typically immunologically incompetent B cell

70
Q

What is the most common Ig expression of the incompetent B cells of chronic lymphocytic leukemia

A

IgM kappa

71
Q

chronic lymphocytic leukemia accounts for what percentage of chronic leukemias

A

2/3
most common in adults over 60
2:1 male to female

72
Q

What are the clinical manifestations of chronic lymphocytic leukemia

A

increased WC count with lymphocytes
splenomegaly
lymphadenopathy
anemia and thrombocytopenia

73
Q

What is the basis of treatment for chronic lymphocytic leukemia and what is the medial survival

A

chemotherapy

4-6 years

74
Q

What is the clonal proliferating cell of chronic myelogenous leukemia

A

immature granulocytes; stem cells

75
Q

There is a marked increase of this regarding chronic myelogenous leukemia

A

wbc count with eosinophils and/or basophilia

76
Q

What are the clinical manifestations of chronic myelogenous leukemia

A

thrombocyotsis and anemia

splenomegaly

77
Q

What is the specific chromosomal abnormality involving chronic myelogenous leukemia

A

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
Q

What is the treatment for chronic myelogenous leukemia

A

targeted chemotherapy blocks the BCR-ABL tyrosine kinase, inducing remissions
BMT for relapsed or resistant disease

79
Q

chronic myelogenous leukemia accounts for what percentage of chronic leukemia

A

1/3

usually in adults 25-60 years old

80
Q

The terminal phase of chronic myelogenous leukemia is marked by what

A

immature cells in peripheral blood and none marrow, decreased response to treatment the “blast crisis”

81
Q

This is a clonal proliferation of monoclonal plasma cells

A

multiple myeloma

82
Q

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

A

60% IgG

20-25% IgA

83
Q

When only light chains are produced in multiple myeloma what is the clinical symptom

A

excrete low molecular weight light chains in the urine; Bence Jones proteinuria

84
Q

This symptom is characteristic of multiple myeloma

A

multifocal destructive bone lesions

85
Q

What are the clinical manifestations of multiple myeloma

A 
bone marrow infiltration by plasma cells
increased serum monoclonal protein
hypercalcemia
renal failure
infections
86
Q

What are three characteristics regarding the blood and marrow features of multiple myeloma

A

circulating plasma cells in blood are uncommon
RBC show rouleaux (stacks) formation
marrow plasma cell infiltrates in single cells and sheets

87
Q

What is typically the prognosis of multiple myeloma

A

variable but generally poor

88
Q

What is the typical survival rate of multiple myeloma

A

4-6 years

89
Q

What are some treatments for multiple myeloma

A

chemotherapy
radiotherapy (for bone pain)
bone marrow transplant
NO CURE

90
Q

How many new cases of multiple myeloma will there be in the US in 2015

A

24k cases

average patent age = 70

91
Q

How many new cases of Hodgkin and Non-Hodgkin Lymphoma will there be in 2015 in the US

A

9k Hodgkin

72k Non-Hodgkin

SP15 Pathology (17 decks)

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