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pathology of hematopoiteic system Flashcards

1
Q

hematopoiesis

A

-process of how blood cells are made
-made in:
embryo: yolk sac
fetus: liver, spleen, bone marrow, lymph nodes
neonates: bone marrow of long/ flat bones, red marrow.
adults: bone marrow in all regions of flat/long bones. see yellow marrow.
-extra-medullary hematopoieses EMH due to need.

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2
Q

basic concepts of hematopoiesis

A
  • Bone marrow is located in multiple sites but responds as a single tissue
  • Samples can be taken from any bone with red marrow:
  • Proximal femur, iliac crest, proximal humerus of dogs and cats
  • Sternum of horses
  • Proximal rib of cattle
  • Aspirates and core biopsies
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3
Q

pathology of bone marrow and blood cell

A

-end result depends on which type of cell damaged.
* Multipotent stem cells = multiple cell lines affected
* Committed stem cells = one or more lines affected
* Differentiated cells = one cell type affected.
-alterations are reflected in peripheral blood. decreased cell lines=cytopenias, anemias
increases in cell lines= cytoses and philias.
-in the bone marrow, changes are reflected as increased or
decreased cellularity the changes in red hematopoetic tissue (red marrow) to adipose tissue (yellow marrow)

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4
Q

bone marrow and blood cells degeneration and necrosis

A

-hematopoietic tissues are highly active and susceptible to insults.
-radiation/ toxins and drugs. viral agents. immune mediated or idiopathic causes.

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5
Q

bone marrow inflammation

A

-osteomyelitis: * Inflammation of the bone (osteitis)
and the medullary cavity (myelitis).

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6
Q

bone marrow hypoplasia/ aplasia

A

-decreased proliferative activity
-more yellow, white marrow than red
causes: bone marrow suppression (estrogen, chronic renal disease)
-lack of nutrients (iron, B12, folate)
-endocrine disorders (hypothyroidism)

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7
Q

bone marrow hyperplasia

A

-proliferative response more red replaces yellow
-response to increased peripheral demand or hypodunction of blood cells.
–Erythroid hyperplasia ➝ response to anemia
–Megakaryocytic hyperplasia ➝ response to ↓ platelets
-myloid hyperplasia (neutrophilia, esoniphilia, monocytosis) from bacterial infections, parasites, chronic infections.

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8
Q

bone marrow atrophy

A

-serous atrophy of fat
* Gelatinous transformation of fat within the marrow. Due to cachexia. (severe stage of emaciation) due to cancer ect.

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9
Q

hematopoietic neoplasia

A
  • Affect primarily:
  • Bone marrow
  • The circulating blood (leukemia)
  • Lymphoid tissue (lymph nodes, spleen, thymus, etc)
    -divided into lymphoproliferative and myeloproliferative diseases:
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10
Q

lymphoproliferative diseases

A

-neoplastic disorders of lymphocytes (t, b NK cells)
-lymphoma (in bone marrow/blood)
-lymphoid leukemia (neoplastic lymphocytes in tissues/organs)
-plasma cell tumors

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11
Q

Myeloproliferative
Disease

A

-histocytic neoplasia
-myloid leukemia
-mast cell tumors

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12
Q

canine lymphoma

A

-most common canine hematopoitic neoplasia
-older or middle ages animals
-85% habe multicentric lymphoma
-enlarged lymph nodes with firbosis
-organomegly
-thickening of tubular organs
-hypercalcemia of malignancy sometimes seen.

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13
Q

types of lymphomas

A
  • Alimentary (tubed organs, intestines)
    > multicentric
    > thymic (lung)
    -cutaneous (skin)
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14
Q

feline lymphomas

A

-most common malignant neoplasia of cats
-Alimentary > multicentric
> thymic > miscellaneous
forms
* Leukemia and bone
marrow involvement are
common
-path: feline leukemia virus FeLV. 10-20% cats.
* FeLV is associated with mediastinal and multicentric T cell lymphoma
* Young cats!

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15
Q

bovine lymphoma forms

A

-ezonitc bovine lymphoma
* Sporadic Bovine Lymphoma
* Calf form
* Juvenile form / Thymic form
* Cutaneous form

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16
Q

Enzootic bovine lymphoma

A

-adult cattle
* Bovine leukemia virus (retrovirus)
* 30% of infected cattle → persistent lymphocytosis
* < 5% of infected cattle → lymphoma
* Multicentric lymphoma of B cell origin.
-more common in dairy
-transmission by arthropods, breeding, tagging.
-lesions in heart, abomasum, uterus and spinal canal.

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17
Q

Sporadic bovine lymphoma

A

-Not associated with a viral infection!
-Affects young animals, 3 forms:
1 calf form: young, symmetrical lymphadenopathy. leukemia. kidney, liver, spleen. (multicenteric)
2: juveiline form= thymic form: mediastinal mass.
3 cutaneous form: 2-3 yr old. plagues or nodular raised skin lesions which leads to systemic. survive 12-18 months.

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18
Q

porcine lymphoma

A

-most common neoplasm of pigs
-multicenteric
-often less than 1 yr, more in females
-heriditory form (large white pigs)

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19
Q

reaction of bone to injury and disease

A
  1. Two processes usually occur together
    * removal of damaged bone
    * resorption or lysis
    * production of new bone.
  2. Injury to the periosteum (and
    endosteum) will usually be
    followed by new bone production.
    -bone density will change is response to use wolffs law.
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20
Q

fractures and path (on exam)

A
  • physical discontinuity in a bone
    resulting in instability and pain
  • A normal bone fractures due to excessive
    force → traumatic fracture
  • An abnormal bone fractures under normal
    force → pathologic fracture
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21
Q

fracture repair 5 phases

A

1 - inflammation and injury. tearing of perio and endostium, rupture of BV. growth factors
2- organization of the hematoma
3- callus formation external and internal callus
4- callus remodeling
5- callus modeling

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22
Q

fracture repair phase 1

A

Phase 1 – Injury and inflammation
* tearing of the periosteum & endosteum
* rupture of blood vessels of the bone
* surrounding soft tissue injury
 hematoma
 ischemia
inflammation-> growth factors

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23
Q

fracture repair phase 2

A

Organization of the hematoma
* activation of undifferentiated
mesenchymal (stem) cells
* neovascularization

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24
Q

fracture repair phase 3

A

-Callus formation: external and internal callus
-distant to the fracture gap
* ‘favorable’ environment BS is still intact, lots of O2 so osteoblasts → woven bone
-near the fracture gap
* ‘poor’ environment
* fibroblasts & chondroblasts
* cartilage is later replaced via endochondral ossification
-begins 24 hr
-36 hours for bone production
-can see callus on xray at 2 weeks
-time varies with age, health, nutrition ect.

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25
fracture phase 4
-callus remodeling * woven bone replaced by lamellar bone * compact bone formed in cortex * cancellous bone in metaphysis / diaphysis -during callus remodeling bone marrow may be filled with bone
26
fracture phase 5
Callus modeling * Restoration of bone to its original form & function * Months to years
27
nonunion/ delayed union/ malunion
-nonunion: failure a fractured bone to heal -delayed: longer/slower than normal healing time of a bone. lack of progress after 3 months and healing after 6 months. -malunion: healing which results in deformity
28
Complications of Fracture Repair
* inadequate blood supply * instability * infection * fragments of necrotic bone or soft tissue * other underlying disease * pathologic fracture
29
Disorders Associated with the Physis
1. Physeal / growth plate fractures * Salter-Harris fractures 2. Growth retardation lattices 3. Growth arrest lines 4. Premature closure 5. Osteochondrosis / osteochondritis
30
Physeal or growth plate fractures
* Physis is composed of cartilage * Weak compared to bone * More easily injured / fractured * Physis is site of growth * injury can affect growth capital femoral physeal fracture in cats-common in young under 2 yr overweight neutered males.
31
Salter-Harris classification scheme for physeal fractures
S – straight across (separated or slipped) A – above (or away from joint) L – lower (into joint) T -through everything all together E -through everything all together R – rammed (ruined / crushed)
32
Growth retardation lattices
* Thin lines to wide bands of osteosclerosis in the metaphysis, parallel to the physis * GRL are due to impaired osteoclastic activity and retention of 1° spongiosa * Typically detected in aborted, stillborn, or neonatal animals * Look for the underlying cause
33
Premature closure
* Partial (or focal) * alters shape * Complete (or diffuse) * short bones * Many causes * trauma, vitamin A toxicity, Mn deficiency, radiation, other  congenital spinal stenosis
34
Osteochondrosis
“The focal or multifocal failure (or delay) of endochondral ossification resulting in localized thickening of hyaline cartilage.” Physis or articular surface * articular-epiphyseal (AE) complex * Not as stable a bone * Subject to injury
35
plasma cell tumors
1. Cutaneous Plasmacytoma * Common skin masses in dogs * Surgical excision is usually curative 2. Extramedullary Plasmacytoma * Arising at sites other than BM / skin * Often affect the GI tract * More aggressive, may metastasize to the lymph nodes
36
Multiple Myeloma
-plasma cell tumor -dogs> cats * Malignant tumour of plasma cell origin arising in the bone marrow * Neoplastic (clonal) plasma cells secrete immunoglobulin leading to hypergammaglobulinemia
36
Multiple myeloma clinical signs
Clinical diagnosis of multiple myeloma is based on finding 2 - 3 + of the following features: * Increased plasma cells in bone marrow * Punched out lesions on radiographs * Monoclonal gammopathy * Hypercalcemia * Light chain (Bence-Jones) proteinuria
37
Lymph node metastasis
* Common with carcinomas, melanomas, mast cell tumors... * May see lymph node enlargement * Variable effacement of normal architecture.
38
Thymus – Structure and function
* Structure – Composed of epithelial tissue and lymphoid tissue – Lobulated and split into cortical and medullary areas * Function – Proliferation & maturation of T cells
39
thymus diseases
-thymic aplasia/hypoplasia from congenital immunodeficeincy -lymphocytolysis, thymic atrophy: can lead to acquired immunodeficiency from malnutrition, drugs, infections. -thymic hemmorage/ hematoma
40
thymic hemorrhage
* In dogs, sudden death is occasionally seen due to hypovolemic shock resulting from massive thymic/mediastinal hemorrhage * Several implicated causes: trauma, ruptured aorta, anticoagulant rodenticide
41
thymus primary neoplasm feautures
* Space occupying mass in cranial mediastinum * Dyspnea * 2 main differentials (thymic lymphona, or thymoma)
42
thymic lymphona
Neoplastic proliferation of T-lymphocytes -Often younger animals (cats, calves, and dogs) Malignant behavior
43
Thymoma
-Neoplastic proliferation of Epithelial cells -Dogs, sheep, goats -Slow growing, encapsulated
44
spleen structure and function
-red pulp: sinusoids, spenic cords= filter blood. RBC storage and hematopoieses -white pulp: T cells, B cells= immune response.
45
siderofibrosis = gamna-gandy bodies
-spleen is granular white, yellow deposites in splenic capsule. -incidental finding maybe due to hemorrhage. -fibrous tissue, mineral deposits, hematoidin.
46
splenic contraction
* Contraction of the smooth muscle in the capsule/trabeculae * Occurs with catecholamine release, shock, acute splenic rupture * Gross: Small dry spleen with wrinkling of the capsule -can have areas of black looking like infarctions.
47
splenic rupture
* Fairly common * Primary - trauma * Secondary to splenomegaly, splenic neoplasia. * Potential sequelae include hemoabdomen and splenosis
48
Splenic rupture → splenosis
splenosis: seeding of splenic explants on peritoneal surfaces forming accessory spleens. -small red nodules within the omentum.
49
spleen circulatory disturbances
-Active hyperemia (acute systemic infection) -Passive congestion (vascular pooling shock, barbituate administration, hemolytic anemia -splenic infarction -splenic hematoma -grossly: dark blue or black, oozes blood when cut.
50
Splenic Infarcts
-Ischemic necrosis of the spleen -causes: 1. Vascular damage 2. Hypercoagulable states 3. Splenomegaly (of any cause) 4. Septic emboli
51
splenic hematoma
* Common in dogs * Trauma * Often associated with nodular hyperplasia or vascular tumours -gross: red nodular mass, very large, soft and dark red. -use histo to rule out neoplasia
52
acute spenitis ( Multifocal necrotic or suppurative splenitis)
-caused by tularemia, or yersenosis (Yersinia pseudotuberculosis). -gross: miliary white foci in the spleen, may also be in lymph node and liver.
53
Acute splenitis – Septicemic splenitis
-causes: African swine fever * Erysipelas * Anthrax* -gross: splenomegaly, dark discoloration, engorged viscous blood.
54
anthrax pathogenesis for septic splenitis events
-caused by bacillus anthracis -ingested spoores or contact -lymphagitis and lymphadentis -massive bacteriemia (sepsis) and toxemia -increased vascular permeability and impaired coagulation -sudden death -take blood smear from ear
55
chronic spenitis - granulomatous splenitis
- can be nodular or diffuse. -causes: myobacterium avium in chickens. -hispoplasmosis in dogs.
56
spleen growth disturbances
-Aplasia -Atrophy -Benign nodular hyperplasia -Lymphoid hyperplasia -Hyperplasia of the monocyte- macrophage system -Extramedullary hematopoiesis
57
Lymphoid hyperplasia of spleen
-hyperplasia of white pulp -response to blood-borne chronic antigenic stimulation -Malignant Catarrhal Fever, Bovine
58
primary splenic neoplasias
-Lymphoproliferative diseases: Lymphoma/Leukemia* -Myeloproliferative diseases: -Histiocytic sarcoma* -Mastocytosis* -Hemangioma -Hemangiosarcoma Others: Fibrosarcoma, Fibrohistiocytic nodules, etc
59
Splenic hemangioma
-benign tumor of endothelial origin -gross: single, soft, dark red nodular mass -histology is needed.
60
Splenic hemangiosarcoma
-primary neoplasm -most common malignant tumor of canine spleen -gross: single to multiple masses, dark red -leads to splenic rupture, hemaabdomen, peritoneal seeding. common masses in liver.
61
histocytic proliferative disorders
-cutaneous histiocytoma: common begin skin mass -reactive histocytosis -histocytic sarcoma
62
Histiocytic Sarcoma
* Malignant neoplasia of macrophages or dendritic cells * Breed predispositions * Bernese Mountain dog, Rottweiler, Flat-coated Retriever * Can be solitary of multiple: * Solitary lesions * Subsynovium (joints), subcutis * Lymph nodes, spleen or liver * Multiple lesions * Disseminated histiocytic sarcoma = Malignant histiocytosis
63
mast cell neoplasia
-mast cells are in connective tissue but originate in bone marrow. -common cutaneous mast cell tumors in dogs. -systemic mastocytosis are visceral mast cell tumors to the hematopoietic system and other organs
64
secondary bone marrow neoplasia
* Results of metastasis of a tumour from a distant site to the bone marrow * Can be a carcinoma or a sarcoma
65
Myelophthisis
-Replacement of hematopoietic tissue within the bone marrow by abnormal tissue. -fibrosis-> myelofibrosis -neoplastic cells-> leukemia -can result in pancytopenia due to competition for space and nutrients.
66
lymph nodes structure and function
-filtration of lymph and immune response. -outer cortex (B cells) -inner cortex (T cells) and medulla
67
enlarged lymph node differentials
-lymphadentitis -lymhoid hyperplasia -hyperplasia of monocyte system -primary or secondary neoplasia
67
Lymphadenopathy
-enlargement of the lymph nodes from unknown causes
68
Lymphadenitis
* An inflammatory response to an infectious agent within the node not reactive hyperplasia which is antigen driven response. -acute: the result of a regional lymph node draining a site of infection/inflammation and becoming infected
69
Chronic lymphadenitis
* With chronicity the lymph nodes become large, irregular, and firm due to fibrosis -can then be suppurative or granulatamous. -path: could be rhodococcus equi.
70
Equine Strangles
* Streptococcus equi subsp equi * Inflammation of the URT → abscesses in the mandibular, retropharyngeal and parotid LN * May fistulate to the surface
71
Caseous lymphadenitis
* Chronic suppurative lymphadenitis in sheep & goats -caused by Corynebacterium pseudotuberculosis -enters via shear wounds, drains in regional LN. -* Chronic suppurative inflammation, caseous necrosis & fibrosis * As lesion progresses → characteristic concentric laminations
72
Nodular granulomatous lymphadenitis bovine
-bovine tuburculosis caused by myobacterium bovis. -enlargement of lymph nodes with yellow nodules.
73
Diffuse granulomatous lymphadenitis pigs
-Postweaning multisystemic wasting syndrome (PMWS): Porcine Circovirus type 2 -gross enlargement of mesenteric lymph nodes
74
Benign Reactive Hyperplasia of lymph nodes
* Immunological reaction = response to antigen presentation or circulating interleukin levels * Causes lymph node enlargement * Can be localized or generalized * Lymph nodes draining site of local infection or vaccination
75
Secondary lymph node neoplasia
* Lymph node metastasis: * Common with carcinomas, melanomas, mast cell tumors... * May see lymph node enlargement One basis of staging tumor malignancy * Stage 0: regional node normal * Stage 1: regional node enlarged but still freely moveable * Stage 2: regional node enlarged and fixed Lymph node: Neoplasia Secondary lymph node neoplasia

veterinary systemic pathology (13 decks)

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