Lymphoreticular system pathology Flashcards
Leukopenia is defined as a __ in WBCs. 2 reasons for leukopenia are __ and __
Leukopenia is defined as a reduction in WBCs. 2 reasons for leukopenia are low production and early death of WBCs
Leukopenia can result from ___, immune suppressing drugs, nutritional deficiencies (__ and __ deficits), genetic conditions like __ and leukemia
Leukopenia can result from aplastic anemia, immune suppressing drugs, nutritional deficiencies (B12 and Folate deficits), genetic conditions like SCID and leukemia
Examples of conditions in which WBCs are killed off too early include infections like in __, autoimmunity (e.g. ___), drugs and sequestration in the ___
Examples of conditions in which WBCs are killed off too early include infections like in HIV, autoimmunity (e.g. Lupus), drugs and sequestration in the spleen
What is the most common complication/consequence of leukopenia (neutropenia)?
Recurrent fungal and bacterial infection (esp Candida and Aspergillus)
What are some causes of leukocytosis?
Increased marrow stores (due to infection, hypoxia, endotoxemia)
Decreased Margination: Cells adherent to vessels(e.g. during exercise, epinephrine)
Decreased extravasation into tissues (e.g. w/ Glucocorticoid use)
Increased marrow precursors (due to tumor, infection, myeloproliferative disorders)
What are the components of the lymphoreticular system?
Group of cells that ingest and sequester particles and dyes
Cells of the lymphoreticular system can be found in the brain, ___, tissue, liver, ___, kidney, and ___
Cells of the lymphoreticular system can be found in the brain (microglia), tissue (macrophages/histiocytes), liver (Kupffer cells), kidney (glomerular mesangial cells), and bone (marrow, osteoclasts)
The major lymphoreticular sites are the ___, lymph nodes, ___ (B cells mature here) and ___ (where T cells mature)
The major lymphoreticular sites are the spleen, lymph nodes, bone marrow (B cells mature here) and thymus (where T cells mature)
How does the spleen prevent damaged RBCs from going into the circulation?
The sinusoids that traverse the spleen are lined by macrophages that eat up damaged RBCs
The white pulp of the spleen contains T and B cells. Where in the white pulp are these cells?
T cells - PALS (periarteriolar lymphoid sheaths)
B cells - follicles
What are some disroders of the spleen?
Systemic disorders
Neoplasms
Congenital anomalies (Asplenia, Hypoplasia, Accessory spleen)
Rupture
What is an example of a condition ass’d with splenomegaly that can result in splenic rupture?
Epstein-Barr Virus infection (mononucleiosis)
Disorders that can lead to splenomegaly include infections, ___ hypertension, ___ (hint: cancer in the lymph nodes), inflammatory conditions (e.g. __ and __), storage diseases (___ and ___), and amyloidosis
Disorders that can lead to splenomegaly include infections, portal hypertension, lymphoma (hint: cancer in the lymph nodes), inflammatory conditions (e.g. RA and SLE), storage diseases (gaucher and niemann pick), and amyloidosis
How can a patient present with anemia-like symptoms and not be anemic? (in context of the spleen)
Splenomegaly >> seuqestration of platelets + RBCs >> hematologic abnormalities (so patient presents like they have anemia but they don’t actually)
Where in the body would you find the structure below and why does it look this way?
Hassal corpuscle in the Thymus
Hassal corpuscle looks like the keratin pearls (from squamous cell carcinoma) because T cells are being trained to recognize normal squamous cell epithelium
Examples of developmental thymic disorders include ___ and ___
hypoplasia/anaplasia (DiGeorge syndrome)
thymic cysts
Myasthenia gravis and SLE are both disorders in which what can happen to the thymus?
Thymic hyperplasia
Draw and describe the growth sequence of lymphocytes/granulocytes/phagocytic cells/RBCs
Name the mature cells in this slide
Band neutrophil
Platelet
Monocyte
Lymphocyte
Segmented neutrophil
Eosinophil
RBC
Basophil
The predominant cells in the bone marrow are___
Neutrophils + precursors
Megakaryocytes
RBCs
(there’s also adipose tissue in there)
Draw and describe the sequence of RBC maturation (include cell names and characteristics)
(until I’m red, I’m normo)
Pronormoblast (the pro-athlete); huge nucleus and dark cytoplasm
Basophilic normoblast (pro not doing so well so he looks really blue)
Polychromatophilic normoblast (now he has to work poly jobs); smaller than basophilic, nucleus has 2 shades of color
Orthochromic normoblast (he got hurt now he needs an orthopedic surgeon); concentric dark nucleus, smaller cell
Reticulocyte (bluer cytoplasm, no nucleus, chromatin almost gone)
Mature RBC (he gives up and skips town; nucleus is gone and rbc is a lot smaller)
Draw and describe the sequence of neutrophil maturation
How can you tell a blast from a lymphocyte?
(see image below)
1 = blast
2 = promyelocyte
3 = myelocyte
4 = metamyelocyte
5 = band
6 = segmented
Label the cells in this slide
1 = blast
2 = promyelocyte
3 = myelocyte
4 = metamyelocyte
5 = band
6 = segmented
10= lymphocyte
11= monocyte (young)
In the lymph node diagram below, where are T cells, B cells and activated B cells housed?
T cells - paracortical area
B cells - primary follicle
activated B cells - germinal center
The lymph node germical center is where which 3 important B cell processes take place?
If there are any errors, the B cell undergoes ___
Clonal expansion
Somatic hypermutation
Class switching
Apoptosis
Lymphadenitis refers to ___
An enlarged lymph node is called __
An enlarged lymphnode that’s likely lymphadenitis will likely be ___
A diffuse enlarged lymph node with what other features suggests malignancy?
Inflammation, likely due to infectious process
Lymphadenopathy
painful
No pain, fixed/immobile, no resolution within a few weeks
Lymphoma is a __ lesion that usually arises in lymphoid tissue and is __ derived, whereas leukemia can be either lymphoid or myeloid derived and can arise in __ and __
Multiple myeloma is __ derived
Lymphoma is a mass lesion that usually arises in lymphoid tissue and is lymphoid derived, whereas leukemia can be either lymphoid or myeloid derived and can arise in blood and bone marrow
Multiple myeloma is plasma cell derived
Etiology of WBC malignancies include chromosomal translocations and oncogenes, inherited genetic factors: (Down’s, NF-type I), viruses (HTLV-1, **EBV, HHV8), environmental agents, and iatrogenic factors
The two types of leukemia are ___ and ___. What is the difference between the 2?
Acute and Chronic
Acute - malignancy involving arrest in differentiation/maturation (so there are a lot of precursor/progenitor cells)
Chronic - malignancy involving mature cells
Leukemia involving myeloid lineage cells is called __, whereas leukemia involing lymphoid lineage cells is called ___
Leukemia involving myeloid lineage cells is called myelogenous leukemia, whereas leukemia involing lymphoid lineage cells is called lymphocytic leukemia
