Hematopoietic Neoplasia Flashcards

1
Q

Hematopoietic Neoplasias

A
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2
Q

Myeloid Neoplasia

A
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3
Q

Lymphoid Neoplasia

A
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4
Q

Preleukemia

A

Neoplastic cells proliferating in the bone marrow w/out being released into peripheral blood

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5
Q

“Leukemic Phase”

A

primary hemopoietic neoplasm is a solid, extramedullary tumor but releases neoplastic cells into the circultion.

i.e. lymphoma, plasma cell, mast cell tumors that arise outside the marrow.

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6
Q

Lymphocytic Leukemia

A
  1. Acute lymphocytic / lymphoblastic
    • High numbers of immmature lymphocytes in bone marrow and peripheral blood.
  2. Chronic
    • Increased numbers of small lymphocytes in marrow and peripheral blood.
    • These lymphs are small and appear morphologically normal. They are presumed to be mature.
    • PARR may help differentiate a polyclonal (normal, reactive) proliferation of lymphocytes from a monoclonal (neoplastic) proliferation of lymphocytes
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7
Q

Bone marrow involvement in the lymphoid neoplasias

A

Only ALL, CLL, plasma cell leukemia have BM as the primary site.

Lymphosarcoma, Large granular lymphosarcoma, Plasmacytoma may have abnormal cells showing up in the marrow, but the BM is not the primary site.

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8
Q

LSA in juvenile cattle

A

Not virally assoc., not transmissible.

  1. Multicentric
  2. Thymic
  3. Cutaneous
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9
Q

BLV

A
  • LSA in adult cattle.
  • 4-8 yrs of age; typically dairy cattle
  • Horizontal spread
  • Most infected cattle do not develop neoplastic disease.
  • Solid tumors >>> leukemia. Leukemia and BM involvement can occur late in the disease.
  • 30% have a persistent lymphocytosis.
  • 5-10% develop lymphoid neoplasia including solid tissue tumors, lymphocytic leukemia, or both.
  • If only bone marrow affected, need clonality to differentiate lymphocytic leukemia from a persistent lymphocytosis.
  • AGID for gp 51
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10
Q

FeLV

A
  • high rate of LSA and myeloid neoplasms
  • Older cats may not be viremic at time of detection of the neoplasm and therefore are ELISA negative for group specific antigen p27
  • Viral antigen will be detected w/in tumor tissue using immunohistochemistry, PCR, or both.
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11
Q

Large granular lymphocytic leukemia

A
  • rare
  • large, irregular, magenta colored cytoplasmic granules
  • probably cytotoxic T cells, or NK cells
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12
Q

Plasma cell neoplasms

A
  1. Plasmacytoma
    1. Cutaneous
      1. typically benign despite frequent pleomorphism, heterogeneity, anisocytosis, ansokaryosis, multinucleation
      2. “plasmacytoma” appropriate
    2. Soft tissue / Internal
      1. Malignant
      2. intestine, spleen, kidneys, nervous system
      3. “systemic malignant plasma cell tumor” or “plasma cell sarcoma”
  2. Plasma Cell Sarcoma/ Multiple Myeloma / Plasma cell myeloma
  3. Plasma Cell Leukemia
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13
Q

Plasma cell sarcoma - criteria for Dx

A

aka “plasma cell myeloma” and “multiple myeloma”

Need 2 of the 4

  1. Osteolysis
  2. Plasma cells comprise > 20% of the bone marrow cells (??? 10% in cats)
  3. Monoclonal gammopathy (usually IgG, IgA, uncommonly IgM)
  4. Bence Jones proteinuria (light chains from the globulins)
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14
Q

Hyperglobulinemia sequelae

A
  • hyperviscosity
  • incrased rouleaux
  • impaired platelet function
  • bleeding
  • CNS signs
  • renal failure
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15
Q

Myeloid neoplasms

A

Clonal proliferations in the lineage of

  • erythrocytes
  • granulocytes
  • monocytes
  • magakaryocytes
  • mast cells
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16
Q

MN

MPN

MDS

A

Myeloid Neoplasms

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

17
Q

Acute Myeloid Neoplasms

A

Acute Myeloid Neoplasms

Neoplasm

FAB

Bone Marrow Features

Undifferentiated

AUL

Blasts of unknown lineage

Granulocytic

M1

Granulocytic myeloblasts > 90%

M2

Granulocytic myeloblasts > 30% to < 90%

Granulomonocytic

M4

Granulocytic myeloblasts & monoblasts > 30%

Monocytic

M5a

Monoblasts and promonocytes >80%

M5b

Monoblasts and promonocytes >30% to < 80%

Erythrogranulocytic

M6

Rubriblasts and granulocytic myeloblasts >30%

Erythrocytic

M6Er

Rubriblasts >30%

Megakaryocytic

M7

Megakaryoblasts > 30%

18
Q

Mastocytemia

A

The presence of mast cells in the peripheral blood. Same term used for neoplastic or non-neoplastic.

19
Q

Mastocytemia DDx

A
  1. Reactive (Non-neoplastic)
    1. parvoviral enteritis
    2. cutaneous hypersensitivities
    3. parasitic infections
    4. IMHA
    5. bacterial peritonitis
    6. pancreatic necrosis
    7. pleuritis
  2. Neoplastic
    1. progression of systemic mast cell neoplasia (either visceral or cutaneous)
    2. 1’ BM mast cell leukemia
20
Q

Chronic Myeloid Neoplasma

aka

Myeloproliferative Neoplasms

A

Chronic Myeloid Neoplasms

Neoplasm

Bone Marrow Features

Granulocytic (neutrophilic)

Neutrophilic myeloblasts < 30%

Granulocytic (eosinophilic)

Eosinophilic myeloblasts < 30%

Granulocytic (basophilic)

Basophilic myeloblasts < 30%

Granulomonocytic

Myeloblasts and monoblastss < 30%

Monocytic

Monoblasts < 30%

Thrombocytic (essential thrombocythemia)

All platelet precursors increased with orderly maturation.

Erythrocytic (primary erythrocytosis)

All erythroid precursors increased with orderly maturation.

21
Q

MDS

A

Myelodysplastic Syndrome

Clonal proliferative disorder characterized by abnormal development and maturation of hemopoietic cells. May result in ineffective hemopoiesis and peripheral cytopenias (anemia, thrombocytopenia, neutropenia).

BM usually hypercellular, but dyshemopoiesis results in impaired maturation and abnormal morphologic findings in the affected cell lines. (nuclear fragmentation, abnormal megakaryocyte lobulation, asynchronous nuclear maturation, increased apoptosis, hypersegmentation of granulocyte nuclei.)