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Small Animal Final Year > Pathology of Lymphoid System > Flashcards

Pathology of Lymphoid System Flashcards

1
Q

What is this?

A

Spleen

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2
Q

Discuss the differences between the 2 types of pulp in the spleen

A

Red pulp: meshwork of sinusoids with blood and macrophages

•Removal and destruction of erythrocytes:

  • non-specific (effete, damaged, abnormal)
  • specific (antibody-coated)
  • Retrieval of iron from erythrocyte breakdown
  • Storage of blood

White pulp: mainly T- and B lymphocyte system (Ag processing)

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3
Q

What is this?

A

Senile nodular hyperplasia

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4
Q

What does this show?

A

Congestion - Barbiturate euthanasia

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5
Q

What is this?

A

Siderofibrosis/calcinosis

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6
Q

What does this show?

A

Surface indentations

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7
Q

Name 5 responses of the spleen to injury (6)

A
  • Acute inflammation – hyperaemia, microabscesses, abscesses
  • Hyperplasia of monocyte/macrophage system – granulomatous dx
  • Hyperplasia of lymphoid system – production of plasma cells and antibody, cell-mediated immunity (white pulp – lymphoid aggregates which produce T and B in immune response). Common in viral infection
  • Lymphoid atrophy
  • Storage of blood or contraction to expel reserve blood
  • Neoplasia
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8
Q

Name 3 thigs causing diffuse splenomegaly (4)

A

•Infection/reactive hyperplasia

•Congestion (Barbiturate euthanasia, Anthrax!
Torsion/Gastric dilatation-volvulus (artery will continue to pump blood in), circulatory failure)

  • Neoplasia- Leukaemia, systemic tumours (mast cells, HS, myeloma, lymphoma)
  • Haemolytic anaemia
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9
Q

Name 3 causes of focal to mulifocal splenomegaly (4)

A
  • Nodular hyperplasia
  • Haematoma
  • Haemangioma/sarcoma, leiomyoma/sarcoma, fibrosarcoma, HS
  • Abscess
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10
Q

What is this?

A

Diffuse (uniform) splenomegaly

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11
Q

What is this?

A

FOCAL to MULTIFOCAL (nodular) splenomegaly

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12
Q

What is this?

A

Spleen - follicular hyperplasia

Reactive hyperplasia of white pulp lymphoid tissue

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13
Q

What is going on in this sheep?

A

T Pyogenes abscess

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14
Q

What is going on in this cat?

A

Feline infectious peritonitis

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15
Q

What is Senile nodular hyperplasia?

A

A common incidental change in older animals, particularly dogs.
Histologically a mixture of red and white pulp tissue.
Possibly coincidental haemorrhage

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16
Q

What is this?

A

Haematoma

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17
Q

What has happened here?

A

Splenic reuptue and accessory splenic tissue

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18
Q

What is this?

A

Haemangioma

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19
Q

What is this?

A

Haemangiosarcoma

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20
Q

What can be seen?

A

Lymphoma

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21
Q

What is this?

A

Metastatic adenocarcinoma

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22
Q

What is this?

A

Dog spleen haemangiosarcoma

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23
Q

What is going on here?

A

Haemangiosarcoma
All the spaces – poor quality vascular channels which are prone to rupture
RBC can get damaged

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24
Q

Name 3 ways the thymus responds to injury (4)

A
  • Lymphoid atrophy
  • Inflammation – very rare
  • Haemorrhages and haematomas into the thymus

–Questionable quality of vessels

–Seizuring dog – see haemorrhage in thymus and the pancreas

•Neoplasia

25
Q

Name 3 things a thymus may present with (5) Name causes.

A

•Cysts

–Some remnants after aging involution

–Not a problem unless compressing lung tissue

•Hypoplasia (immunodeficiency)

–E.g. some mice and then they cannot train their T cell

•Atrophy – stress, age (involution)

–Stop sending growth factors and proliferative growth factors

•Depletion - viral infections

(EHV1; FPV; CPV; CDV; FIV)

•Neoplasia:

–Thymic lymphoma (cats and cattle)

–Thymoma (epithelial plus lymphoid) (adult; dogs, sheep and

26
Q

Discuss the epidemiology of Severe Combined Immunodeficiency (SCID) and the causes

A
  • SCID is not a specific condition, but a constellation of entities, which vary in severity and molecular basis, but which all result in failed production of functional lymphocytes (splenic and thymic hypoplasia).
  • Classically affects horses, humans, mice, and dogs

–Young animals

–Common in foals

•Autosomal recessive in Arabian horse and their crosses

– All foals die by 5 months of age as a result of infection by a variety of pathogens, with equine adenovirus, Pneumocystis carinii , Cryptosporidium parvum, and Rhodococcus equi being most important.

  • More commonly, defects affect just T, or both B and T lymphocytes, resulting in impairment of both cell types (and thus both CMI and humoral immunity)
  • Two major molecular mechanisms of importance in animals:

–Autosomal recessive defect causing inhibition of DNA-dependent protein kinase (Arabian foals, Jack Russell terriers, C.B-17 lab mice)

–X-linked defect in type I cytokine receptors (Basset hound, Cardigan Welsh Corgi)

  • Characteristic lesion in foals: Bilateral cranioventral bronchopneumonia with small spleen, lymph nodes and thymus (can be difficult to locate thymus)
  • Common – small lymphoid organs and need to PCR to identify genetics
27
Q

What is wrong with the thymus in this dog?

A

Thymis haemorrhage

28
Q

What is wrong with the thmus in this cat?

A

Thymic lymphoma

29
Q

What is wrong with this cow thymus?

A

Thymoma

30
Q

What does the histology of this cat heart show?

A

Cardiac failure

31
Q

What is the most common haematopoietic malignancy in animals?

A

Lymphoma

32
Q

Lymphoma:

A) What are similarily affected?

B) What is infiltrated?

C) What can it be associated with?

A

A) Lymph nodes

B) Liver and spleen

C) Viral infection

(e.g. FeLV or BLV in cattle, bovine enzootic lymphoma)

33
Q

What are the three types of lymphoma?

A

Multicentric (most common), alimentary, mediastinal or other (cutaneous)

34
Q

What do we assess with a lymphoma? (4)

A

•Immunophenotype:

–B versus T-cell versus

non-B /non-T lymphocyte

•Cellular morphology

–Size, nuclei, mitotic rate

•Histologic pattern

−Diffuse vs follicular

•Biologic behaviour

−Low grade (indolent) to high-grade (aggressive)

35
Q

What is the difference between these two?

A

Top = high grade lymphoma: Neoplastic lymphocytes are large and have large nuclei with dispersed chromatin and prominent nucleoli; a mitotic figure is evident at the top right.

Bottom = low grade lymphoma: In this sample, neoplastic lymphocytes are of small to intermediate size and have partially condensed chromatin

36
Q

Define leukaemia

A

Umbrella term referring to malignant haematopoietic neoplasms originating in bone marrow and typically have significant numbers of neoplastic cells in the blood.

37
Q

What are the basic classifications of leukaemia?

A

Lymphoid

Myeloid

Chronic

CLL

CML

Acute

ALL

AML

38
Q

What is seen with acute leukaemia?

A
  • Poorly differentiated
  • Presence of ›30% blast cells (immature, large cells) (human medicine ›20%)
  • Often rapid, aggressive course
  • Often accompanied by other cytopenias, why?

–High lymphocytes

–Low neutrophils/platelets

–Increase haemorrhage

–BM tumour – more and more lymphoblast so take over the space to make neutrophils. Tumour takes over the BM

  • High proliferation
  • Respond to radiation
39
Q

What is this?

A

Acute leukaemias

40
Q

How can you classify chronic leukaemia?

A
  • Well differentiated
  • Usually indolent

–Low grade

  • Slowly progressive
  • High cell number in circulation
  • Uncommon in veterinary species
  • ‘Blast crisis’

–Can switch from chronic to acute

41
Q

How does a Cutaneous plasmacytomas usually present?

A
  • Solid masses which may be single or multiple
  • Usually benign
42
Q

How does an Extramedullary plasmacytoma usually present?

A
  • Solid tissue tumour
  • Malignant
  • Arises most frequently in GI tract

–Can obsruct

  • But also trachea, spleen, kidney, uterus, CNS, and elsewhere
  • Produce monoclonal immunoglobulins
  • Amyloidosis
43
Q

What is this?

A

Multiple myeloma

44
Q

What is a multiple myeloma and how may it present?

A

–Malignant tumour of plasma cells that arises in bone marrow

–Usually secretes large amounts of Ig (hyperglobulinaemia, ‘monoclonal gammopathy’)

–Rare in animals

–Osteolysis => hypercalcaemia

–Light chain proteinuria

(Bence Jones paraproteins)

–Possible anaemia

45
Q

How does a cutaneous histiocytoma usually present?

A

–Young dogs, benign

–Often spontaneously regress

•Lymphocytes tell them too

–Circular raised, alopecic nodule

46
Q

How does a histiocytic sarcoma present and who is at risk?

A

–Uncommon, malignant

–Dendritic cells or macrophages

–Rottweiler and Bernese mountain dogs at increased risk?

–Disseminated form is rapid and aggressive

–Sometimes haemophagocytic syndrome (anaemia!)

47
Q

What is this?

A

Histiocytic sarcoma

48
Q

Discuss mast cell proliferations.

A
  • Mostly cutaneous or subcutaneous
  • Can occasionally develop in the spleen, liver, intestine, or elsewhere
  • Mutations in the c-kit protooncogene that codes for KIT protein (stem cell factor receptor) may be responsible for development or progression of mast cell tumours.
  • KIT expression is inversely related to the degree of differentiation of canine mast cell tumours (increased KIT = less differentiated tumour).
  • Solitary to multicentric, dermal to subcutaneous, nodular to pedunculated masses
  • May be erythematous and oedematous
  • High variability of biological behaviour
49
Q

What were the standards to grade mast cell tumours (2)

A
  • Bostock 1973
  • Patnaik 1984
50
Q

What is the maor problem with canine cutaenous mast cell tumours?

A

Biological behaviour varies - benign to fatal malignancy

51
Q

What is Histologic criteria, Patnaik et al., 1984?

A

•Cellular morphology (nuclei, size, granularity)

–How mature?

  • Mitotic index (mitoses/10 high power fields)
  • Cellularity
  • Invasiveness
  • Stromal reaction

Grade 1 MCTs have no mitotic figures and minimal stromal reaction or necrosis.

Grade 2 MCTs are moderately to highly cellular and composed of moderately pleomorphic mast cells with round to indented nuclei and mostly finely granular cytoplasm that extend to the lower dermis, subcutis, and occasionally into deeper tissues. Grade 2 MCTs have 0 to 2 mitotic figures per high-power field (hpf), and some contain areas of oedema, necrosis, and hyalinised collagen.

Grade 3 MCTs are highly cellular and composed of pleomorphic mast cells, with indented to round vesicular nuclei and 1 to multiple prominent nucleoli, arranged in sheets that replace the subcutis and underlying tissues. Grade 3 MCTs have 3 to 6 mitotic figures per hpf and contain areas of haemorrhage, oedema, necrosis, and hyalinised collagen.

52
Q

Dicuss the 3 grades of Patnaik and what the problem of this is

A
  • Grade 1: 93% of the dogs survive longer than 1 500 days
  • Grade 2: Have a low to moderate metastatic potential and an approximately 47% survive 1 500 days
  • Grade 3: Have a high metastatic rate and an approximately 6% survival rate of 1 500 days
  • Problem is you cant tell the owner whether they are 1 or 2 – as they are alive
53
Q

What is the new histological grading system?

A

2 tier

54
Q

How do you diagnose a high grade tumour with the 2 tier system?

A

–At least 7 mitotic figures in 10HPFs

–At least 3 multinucleated (3 or more) in 10HPFs

–At least 3 bizarre nuclei in 10 HPFs

–Karyomegaly

55
Q

What is the prognosis of a high grade tumour?

A
  • less than 4 month survival time
  • shorter time to metastases
56
Q

What is the prognosis of a low grade tumour?

A
  • more favourable prognosis
  • Over 2 years survival
57
Q

What do you grade this with:

A) The old scale?

B) The new scale?

A

A) 2

B) Low grade

58
Q

Which of these is low grade tumour?

A

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Small Animal Final Year (317 decks)

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