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Systems PATH > Haematopoietic system > Flashcards

Haematopoietic system Flashcards

1
Q

Primary Haematopoietic neoplasia:

Solid vs circulating tumours

A

solid = discrete mass - lymphoma

Circulating = leukaemia

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2
Q

Define lymphoid leukaemia

A

Neoplastic lymphocytes in bone marrow/ blood.

ie circulating

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3
Q

Define lymphoma

A

Neoplastic lymphocytes in tissues/ organs

ie Solid

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4
Q

Name and describe the four classifications of lymphoma.

A
  1. Anatomical - ie location
  2. Cellular morphology - cell size, nuclear features, mitotic rate
  3. Immuno-phenotype - B/T cell or Null
  4. Biologic behaviour - Low - high grade
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5
Q

True or false.

Low grade tumours are less responsive to chemotherapy than high grade.

Why?

A

True.

Low grade (indolent) tumours are slower growing and therefore less responsive to therapies

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6
Q

Which immuno-phenotype shows a better response to therapy?

A

B cell

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7
Q

Multicentric

A

Generalised, found in multiple lymphocytes.

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8
Q

What are the common featuers of primary bone neoplasia?

A
  1. Hypercellular marrow: uncontrolled proliferation of the neoplastic haematopoietic cells
  2. Anemia: non-regenerative anemia - ineffective erythropoiesis. Bone marrow is occupied by neoplastic haematopoietic cells = competition for nutrients &/or space (myelophthisis). Neoplastic cells secrete inhib factors
  3. Thrombocytopenia +/- Neutropenia: not always present
  4. Leukemic cells in peripheral blood: immature stages of haematopoietic cells in peripheral blood commonly seen in haematopoietic neoplasia.
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9
Q

What is the difference between lymphoproliferative and myeloproliferative diseases?

A

Neoplastic transformation of lymphoid cell lines = lymphoproliferative.

Neoplastic proliferation of one or more bone marrow cell lines = myeloproliferative (granulocytes, erythrocytes, monocytes etc)

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10
Q

Describe clinical signs associated with lymphoma.

A
  1. Non-specific - wt loss and anorexia
  2. Lymphandenopathy - painless swelling
  3. Depending on anatomical location
    1. Exophthalmos - retrobulbar LN
    2. Dyspnoea, tracheal/ oesophageal obstruction - thymic
    3. Diarrhea, obstruction, melena - Alimentary
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11
Q

Describe the gross appearance of a lymphoma lesion.

A
  • Lymphnodes - enlarged
    • Soft to firm, bulge on cut surface
    • Pale tan - white
    • Homogenous appearance
    • Focal necrosis/ haemorrhage
    • Fibrosed to surrounding tissue
  • Organomegaly
  • Multiple tan-white-pink organ nodules
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12
Q

Name the most common canine hematopoietic neoplasia.

A

Canine lymphoma

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13
Q

What percentage of canine lymphoma show multicentric lymphoma?

A

85%

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14
Q

How does canine lymphoma result in hypercalcemia?

A

The tumours produce pth-like factor which does not respond to normal negative feedback.

(also occurs in anal-sac carcinomas)

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15
Q

Name the most common malignant neoplasm of cats.

A

Feline Lymphoma

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16
Q

Which virus is feline lymphoma associated with?

A

FeLV

  • 10-20% of cats with lymphoma are FeLV positive
  • Occurs in young cats
  • Mediastinal and multicentric forms possible
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17
Q

Which form of feline lymphoma are most common?

Order these as most common onwards..

Misc, multicentric, alimentary, thymic

A

Alimentary > multicentric > thymic > misc

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18
Q

Which form of lymphoma is characteristic of Enzootic Bovine Lymphoma?

Which virus is associated with the disease?

A

Multicentric lymphoma of b cells.

Bovine Leukosis virus, retrovirus

Remember: 30% don’t initially present with lymphoma - persistent lymphocytosis

3% of cattle develop lymphoma

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19
Q

How is BLV transmitted?

A

Through transmission of viral infected lymphocytes:

  1. Direct contact
  2. Natural breeding
  3. Contaminated needles
  4. Dehorning/ ear-tagging equipment
  5. Arthropods - horizontal spread
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20
Q

Which sites are commonly affected by Enzootic Bovine lymphoma?

(x6)

A
  1. LNs
  2. Right atrium
  3. Abomasum
  4. Spinal canal
  5. Uterus
  6. Kidney
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21
Q

How is sporadic bovine lymphoma characterised between these different age groups:

  • Calves <6m?
  • Juvenile - yearlings?
  • 2-3 years?
A
  1. Multicentric lymphoma, symmetrical lymphadenophathy/ leukemia, bone marrow/ organinfiltration
  2. Mediastinal lymphoma - large cranial thoracic/ lower cervical masses - resp distress and wt loss
  3. Plaque-like to nodular raised skin lesions, lesions may come and go, can survive up to 18 months, eventually leads to systemic involvement
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22
Q

Which groups are most at risk of developing porcine lymphoma?

Where are lesions commonly found?

A
  1. Females
  2. Large white - autosomal recessive
  3. <1 yo
  • Multicentric - visceral LN, spleen, liver, stomach, intestine, kidney, bone marrow
  • Mediastinal
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23
Q

Name and describe three types of plasma cell tumours (benign and malignant)

A
  1. Plasmacytoma
    1. Cutaneous - common in dogs, surgery is curative - benign
    2. Extramedullary - don’t arise from bone marrow, may affect GI tract, may mets to LNs
  2. Plasma cell myeloma - aggressive and malignant tumours arising from bone marrow
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24
Q

Describe this lesion.

A

The pinna of this dog has a 1cmx1cm nodular red mass which protrudes from the surface of the ear. The mass is firm to touch and shows well demarcation.

Pinnal cutaneous plasmacytoma

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25
Q

Describe the histological finding associated with plasmacytomas.

(x6)

A
  1. Sheets of rounds cells
  2. Show anisocytosis - uneven size
  3. Show anisokaryosis - variation in nuclear size
  4. Clock face pattern of dense chromatin seen
  5. Halo of Golgi
  6. Multinucleated giant cells may be seen
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26
Q

Describe the gross findings associated with multiple myeloma.

A
  • Affected bone exhibit multiple dark-red soft / gelatinous tissue nodules filling areas of bone resorption / lysis.
  • 2/3 of dog cases show osteolytic lesions
  • Lesions can be found in any haematopoietically active bone, but are most common in the vertebrae.
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27
Q

True or false.

Histological signs of multiple myeloma are similar to that of plasmacytoma.

Describe the histo changes.

A

True

Masses composed of sheets of neoplastic plasma cells in the bone marrow

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28
Q

What clinical signs are commonly associated with plasma cell myeloma?

A
  • Pain in affected bones - lameness
  • Spinal cord compression leads to paraplegia - pathological ventrebral fracture
  • Hypercalcemia - osteolysis
  • Bence-jones proteinuria
  • Monoclonal gammopathy
  • Hyperviscosity syndrome - increased blood viscosity
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29
Q

Bence-Jones protein

A

Monoclonal globulin protein/ immunoglobulin light chain found in urine

30
Q

Decribe this serum electrophoresis.

A

Monoclonal gammopathy

31
Q

Histiocyte

A

A mononuclear phagocyte

32
Q
  1. What are the two types of reactive histiocytosis?
  2. True or False - It is not considered a true neoplastic disorder.
  3. What is the cell of origin?
  4. Describe the clinical signs.
A
  1. Cutaneous - limited to the skin, systemic - affects skin and other organs
  2. True - it is an immunoregulatory disorder - controlled by immunosuppressive therapy
  3. Activated dermal dendritic cell (APC)
  4. Multifocal skin masses which come and go and are progressive
33
Q

Decribe the histo features of canine reactive histiocytosis.

A

Exophytic

Lymphocytes and inflammatory cels at the base of the tumour

Regression due to apoptosis of histiocytes

34
Q

A malignant neoplasia of macrophages or dendritic cells.

Which breed of dog are associated with the disease?

A

Histiocytic sarcoma

Rottweiler, bernese mountain dog, flat coats

35
Q

Describe the differences between solitary and multiple lesions which occur in histiocytic sarcomas.

A

Multiple - disseminated (malignant) - occurs in spleen, lung, LNs, bone marrow, skin, subcutis

Solitary - surround joints, subcutis, liver, lungs or splee, brain

36
Q

What histological features characterise disseminated histiocytic sarcomas?

A

Masses/ diffuse infiltrates composed of atypical histiocytes.

May retain the ability to phagocytose - haemophagocytosis = non-regnerative anaemia

37
Q

Why are eosinophils often associated with mast cell tumours?

Which type of stain is used to identify mast cells definitively?

A

Mast cells secrete granules which secrete eosinophilic chemotactic factor which cause eosinophils to move into the site.

Toluidine blue

38
Q

Describe the structure and function of the lymphnodes.

Outline the circulation of lymph through the lymphatics.

A

Structure - Outer cortex contains follicles (mainly b cells), inner cortex (mainly t cells), medulla (mainly b cells and macrophages)

Function - immune response and lymph filtration

Afferent lymphatics – subscapular sinuses – trabecular sinuses – medullary sinuses – efferent lymphatics – thoracic duct

39
Q

What disease situations may lead to enargement of the lymphnodes?

A
  1. Lymphadenitis
  2. Lymphoid hyperplasia
  3. Hyperplasia of monocyte/ macrophage system
  4. Primary or secondary neoplasia
40
Q

Lymphodenopathy

A

Enlargement of the lymphnodes due to an unknown cause.

41
Q

Lymphandenitis

A

An inflammatory response to an infectious agent within the node

42
Q

What gross changes are associated with chronic lymphandenitis?

A

LNs are:

  1. Large
  2. Irregular
  3. Firm - fibrosis
  4. Supprative/ granulomatous inflammation
43
Q

Describe the gross appearance of chronic suppurative lymphandenitis.

Name two bacteria which can lead to these findings.

A

Swollen LNs with a puss filled centre (LN abscesses), may fistulate (burst) to the skin surface,

They are a response to pyogenic bacteria such as:

  1. Strep equi var equi (zooepi is also pyogenic)
  2. Strep porcinus - porcine jowl abscesses
44
Q

Describe the pathogenesis of bastard strangles.

Which LNs are often affected by strangles?

A

Inward bursting of LN abscesses leads to swallowing of pus - intestinal spread of bacteria.

Parotid, retropharyngeal, mandibular LNs

45
Q

Outline the pathogenesis of Porcine Jowl Abscess.

A

Ingested bacteria colonise oral cavity/ tonsils and spread to mandibular LNs

46
Q

The bacteria causes caseous lymphadenitis of the mediastinal LNs.

A

Corynebacterium pseudotuberculosis

47
Q
  1. Outline the pathogenesis of Corynebacterium pseudotuberculosis.
  2. How do clinical lesions differ between the main domestic species?
A
  1. Enters via contamination of shear wounds (rarely inhalation), drains to regional lymphnodes (superficial more affected than deep)
    1. Prescapular/ prefemoral
  2. Species
    1. Sheep/ goat - chronic suppurative lymphandenitis
    2. Horse/ cattle - Ulcerative lymphangitis
    3. Horse - Pectoral abscess
48
Q

Describe this lesion

A

This lymphnode is diffusely enlarged. The normal architecture is completely disrupted by a lamellar formation of white pus and firm fibrous tissue.

Chronic diffuse severe suppurative fibrosing lymphandeitis

Corynebacterium pseudotuberculosis

49
Q
A

Focal shearing wound abscessation of the scapular LN.

Corynebacterium pseudotuberculosis

50
Q

Describe this lesion

A

Focal swelling of the mandible of a piglet - could be LN salivary gland or neoplastic?

Skin of the mass shows multifocal to coelescing irregular areas of haemorrhage.

The mass is approximately 20x20 cm

Chronic focal severe suppurative lymphandenitis - Porcine jowl abscess

Streptococcus porcinus

51
Q

Describe this lesion

A

This lymphnode shows multifocal to coelescing areas of disruption of architecture by a white to yellow mass. There is a focal area that is severely affected (2x1cm). The mass is firm to oozing on the cut surface.

Chronic multifocal-coelecing mod-severe granulomatous lymphandenitis

Mycobacterium bovis

(MAP, Actinobacillus lignieresii, parasitic)

52
Q

Diffuse granulomatous lymphadenitis caun be caused by what?

How do LNs appear grossly?

A

Enlarged, firm, pale, loss of architecture

PCV2

Histoplasma capsulatum

Blastomyces dermatitidis

Cryptococcus neoformans

53
Q

Describe this lesion

A

Area of central necrosis surrounded by epitheloid macrophages and fibroblasts (capsule)

Granulomatous lymphandenitis

Mycobacterium bovis

54
Q
A

Acid fast Mycobacterium bacteria stained with Ziel Nielson

55
Q

PMWS

A

Postweaning multisystemic wasting syndrome

PCV2

56
Q
A

Diffuse enlargement of the mesenteric lymphnodes - PMWS (PCV2)

57
Q

Botryoid intracytoplasmic viral inclusions are found in what condition?

A

PMWS - PCV2

58
Q

What?

Cause?

A

Reactive lymphoid hyperplasia

  • Proliferation of lymphoid follicles
  • Increased T cells in paracortex
  • May have increased plasma cells in medullary cords

Caused by: Ag response, Interleukin circulating

59
Q

What types of tumours commonly metastasise to the lymphnodes?

A

Carcinomas

Melanomas

Mast cell tumours

60
Q

Describe the three stages used to assess tumour malignancy.

A

Assessment of regional lymphnodes.

Stage 0 - LN normal

Stage 1 - LN enlarged but freely moveable

Stage 2 - LN enlarged and fixed

61
Q

What is the function of the thymus?

A

Proliferation and maturation of T cells

62
Q

Which two types of neoplasm are possible of the thymus?

A

Thymic lymphoma - T cell

Thymoma - epithelial

63
Q

Describe this lesion

A

Diffuse enlargement (rounded edges) of the spleen. The tissue appears to be friable with a beige to orange discolouration.

Chronic diffuse moderate lymphoplasmasitic amyloidosis of the spleen

Idiopathic

64
Q

Splenic torsion may be a sequelae to what GIT disorder in the dog?

A

Splenic torsion

65
Q

Describe this lesion

A

Multifocal to coelescing white round white lesions throughout the splenic tissue. (miliary)

Chronic disseminated severe suppurative hepatitis

Francisella tularensis (Yersinia pseudotuberculosis)

66
Q

What aetiological agents can cause septicaemic splenitis?

A

Anthrax

Erysipelas

African Swine fever

67
Q

What aetiological agent causes granulomatous splenitis in the chicken?

A

Mycobacterium avium

68
Q

What aetiological agent can cause diffuse granulmatous splenitis in the dog?

A

Histoplasmosis

69
Q

Differentials for splenic masses

A

Benign nodular hyperplasia

Neoplasia - haemangiosarcoma

70
Q

Lymphoid hyperplasia of the spleen

A

White pulp

71
Q

Benign endothelial tumour of the spleen

A

Haemangioma

72
Q

Describe this lesion

A

Multifocal 5x5x5cm nodular masses protruding from the splenic surface, poor demarcation on histology. Firm to touch and beige in colour.

Splenic haemangiosarcoma

Sequelae: splenic rupture, haemoabdomen, peritoneal seeding and metastasis

Systems PATH (13 decks)

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