Lecture 2: Malignant haematopological disease

Question 1

What is a myeloblast and why is it worrying if you see one in the periphery?

Answer 1

A very early neuttrophils precursor- in the periphery it is indicative of a leukaemia

Question 2

What do eosinophils and basophils look like?

Answer 2

Eosinophils stain pink and basophils are dark blue, both with lots of cytoplasmic granules

Question 3

Why does blood pressure drop during an allergic reaction?

Answer 3

Histamines are released which are vasodilators so plasma leaks out into the tissue

Question 4

What are monocytes?

Answer 4

Also known as macrophages, can be specific to a specific tissue type eg Kupffer cells

Question 5

What can cause neutrophilia?

Answer 5

Infection, inflammation, pregnancy, malignancy

Question 6

What causes monocytosis?

Answer 6

Acute or chronic infection, connective tissue disease

Question 7

What causes eosinophilia?

Answer 7

Allergy, parasites, drugs

Question 8

What is neutropenia and what are the consequences of this?

Answer 8

Too few neutrophils- results in more infections

Question 9

How can you tell if RBCs are a normal size?

Answer 9

They should be the size of a B cell nucleus

Question 10

What are some causes of immunodeficiency?

Answer 10

Inherited e.g. SCIDs, HIV, drug- induced lymphopenia

Question 11

What is the difference between a lymphoma and a leukaemia?

Answer 11

Lymphoma is a disease of a solid organ e.g. lymph nodes or spleen where as leukaemia is a disease of the blood cells/bone marrow (but they do overlap)

Question 12

Is an acute or chronic infection more serious?

Answer 12

Acute because this tends to arise from over-proliferation of immature cells

Question 13

What are the two categories that haematological malignancies can be split into?

Answer 13

Myeloid (innate cells) or lymphoid (B and T cells)

Question 14

What techniques are used to classify a malignancy?

Answer 14

Morphology in blood smears, immunophenotyping, cytogenetics and molecular studies- specific molecules and surface markers are on specific cell types

Question 15

What are blast cells?

Answer 15

Very early precursors which are seen in leukaemia

Question 16

What technique can be used for immunophenotyping?

Answer 16

flow cytometry

Question 17

Give an example of how genetics can help identify a cancer.

Answer 17

Using karyotyping, we can see if there is any translocations e.g. in chronic myeloid leukaemia part of chromosome 9 has translocated to chromosome 22- Philadelphia chromosome

Question 18

What is acute leukaemia?

Answer 18

An over-proliferation of blast cells, can be myeloid or lymphoblastic and involves very low or high blood count (either a lot of blast cells in periphery or blast cells prevent other cells leaving bone marrow), anaemia, low platelet count

Question 19

What is chronic myeloid leukaemia?

Answer 19

A clonal disorder of bone marrow stem cells caused by enhanced tyrosine kinase activity, can be treated with TK inhibitors. Very large spleen and higher than expected mature cells in periphery

Question 20

How is chronic lymphoblastic leukaemia recognised?

Answer 20

By smear cells in blood film which are destroyed B cells, as they are more fragile and break when the slide is being made

Question 21

How can a lymphoma be identified?

Answer 21

A large number of lymphocytes, swollen lymph nodes