Lymphoreticular system - leukemias, spleen and thymus

Question 1

leukemia

- definition

Answer 1

Malignancies of the haematopietic system which are primarily disorders of the bone marrow** (lymphoma is outside the bone marrow)

• widespread involvement of the bone marrow
• large numbers of tumour cells circulating in peripheral blood

Question 2

leukemia progress

Answer 2

1. (leukemic cells) originate in the bone marrow
2. spill from the bone marrow into the blood
3. infiltrate lymph nodes, liver, spleen and other tissues

cells get larger as it progresses

Question 3

ways to classify leukemia (2)

Answer 3

• acute vs chronic
• lymphoid vs myeloid

so there are like 4 categories:
AML (acute myeloid)
ALL (acute lymphoid)
CML (chronic myeloid)
CLL (chronic lymphoid)

Question 4

acute leukemia symptoms

Answer 4

symptoms associated with suppression of normal bone marrow fn

• fever (reflecting infection)
• bleeding (caused by thrombocytopenia)

fatal if untreated!!

Question 5

chronic leukemia symptoms

Answer 5

non-specific symptoms

• fatigue,
• weight loss,
• anemia,
• abnormal sensation in the abdomen (caused by splenomegaly)

better prognosis than acute leukemia

Question 6

acute leukemia histo appearance

Answer 6

immature blast cells

Question 7

chronic leukemia histo appearance

Answer 7

mature, well differentiated

Question 8

lymphoid leukemia vs myeloid leukemia

Answer 8

lymphoid: originating from a precursor of a B/T lymphocyte
myeloid: originating from a precursor of granulocytes, monocytes, erythrocytes, or megakaryocytes

Question 9

AML (acute myeloid)

Answer 9

fatal w/o treatment

Question 10

ALL (acute lymphoid)

Answer 10

affects children

rare

Question 11

CML (chronic myeloid)

- who it affects

Answer 11

middle age/ children

- indolent chronic phase

Question 12

CLL (chronic lymphoid)

- who it affects

Answer 12

elderly (~ 65yrs)

Question 13

spleen

histo features

Answer 13

red and white pulp

red pulp: macrophages
white pulp: T/B cells

Question 14

spleen functions (4)

Answer 14

• Filtration of unwanted elements of the blood
• Major secondary organ in the immune system
• Source of lymphoreticular / hematopoietic cells
• Reserve pool and storage space

Question 15

causes of splenomegaly** (5)

Answer 15

• Infections
• Congestion (portal HTN)
• Lympho-hematogenous disorders
• Immunologic/ inflammatory conditions
• Storage diseases

Question 16

infection of the spleen

Answer 16

blood borne infections

- IVDA/ tattoo

Question 17

types of ympho-hematogenous disorders of spleen (3)

Answer 17

• lymphomas
• leukemia
• anemia: spleen compensating the blood loss

Question 18

Immune reactions/ inflammation causing pathology of the spleen

Answer 18

infective endocarditis -> valvular disease -> atheromatous disease causing thromboembolism -> infarct (wedge shaped)

Question 19

diseases of the thymus (4)

Answer 19

• Developmental Disorders
• Thymic Hyperplasias
• Myasthenia gravis
• Thymic (mediastinal) Neoplasms (thymomas/ lymphomas/ NHL/ HL)