Monday - Dr. Nelson - Hypersensitivity Reactions and molecular basis of cancer Flashcards
Reactive follicular hyperplasia
Just means that the follicles of a lymph node (where the B cells are) are enlarged because they are reacting to a pathogen
How can you tell the difference between a B lymphocyte reactive proliferation and a monoclonal (neoplastic proliferation)
“B lymphocyte immunoglogulin gene rearrangement analysis”
Also can look at the kappa lambda ratio
…also can look at the protein serum electrophoresis
Ratio of light chains usually seen when you do a flow cytometry of a lymph node
What does an abnormal ratio imply?
1.5 kappa/1 lambda
abnormal ratios imply there is some sort of monoclonal neoplasm
Ratio of lypmocytes in the peripheral blood
~85% T cells
~15% B cells
What type of response would you see looking at an electrophoresis of plasma from a cirrhotic alcoholic
polyclonal immunological response (gamma fraction increases in general)
albumin might also be low
Atopy
refers to the predisposition to develop immediate hypersensitivity reactions
immediate part of a hypersensitivity reaction
late-phase reaction
immediate: vasodilation, congestion, edema
Late-phase: inflammatory infiltrate rich in eosinophils, neutrophils, T cells.
when do you see fibrinoid necrosis
in immune complex formation and deposition into tissues of vessels (type III hypersensitivity)
neutrophils digest this deposition, causing the tissue to become necrotic and full of fibrin.
What are you thinking if you see low C3 levels of comlement?
low levels indicate disease. The complement is being used up to fight a pathogen (can be low in type III hypersensitivity)
Foreign body granulomas
see foreign material within histiocytes/giant cells, sometimes called “foreign body giant cell reaction”
histiocyte
just a macrophage that has transformed into an “epithelial-like” cell because of a pathogen
Caseating granulomas
Granulomas that induce cell mediated immune response with central necrosis; these are usually associated with infection (e.g. mycobacterial, fungal infection)
infection that is difficult to erradicate
non-caseating granulomas
Granulomas that induce cell mediated immune response without central necrosis (e.g. sarcoidosis, crohn’s disease)
four types of genes typically mutated in cancer
Growth-promoting proto-oncogenes
Growth-inhibiting tumor suppressor genes
genes that regulate programmed cell death
genes involved in DNA repair
RAS
mutation in ras causes uncontrolled DNA creation
HER2/neu
epidermal growth factor receptor that is over expressed in 25% of breast cancer
warburg effect
Even in the presence of ample oxygen, cancer cells participate in fermentation.
used in diagnostics, (pet scan, give radioactive glucose)
BCL2
increases in BCL2 cause the cell to be able to bypass apoptosis.
can make cancer resistant to chemo
breast cancer metastasis
liver and bone mostly
What chromosome is immunoglobulin expressed on that usually has a translocation in lymphomas
14
can you get cancer from one mutation?
no, you need more than one complementary drive mutation in order to get cancer, Even though some mutations are diagnostic for some cancers.