Pathology of the Hematopoietic System - Part 1 Flashcards
All of these organs are composed of hematopoietic cells
H cells like lymphocytes and ly –> originate from stem cells (original source = yolk sac).
T cell = replicate in thymus
B cell = replicate in bursa.
Primary = organs that regulate development of lymphocytes
Secondary = where lymphocytes respond to antigens
The composition of the marrow changes with ____.
age
Hematopoiesis occurs throughout ___ and ____ bones.
flat, long
Hematopoietic tissue ( ____ marrow) ______ and is _______ with ________ tissue, mainly ___ (_____ marrow)
red, regresses, replaced, nonhematopoietic, fat, yellow
In adults, hematopoiesis occurs primarily in the?
pelvis, sternum, ribs, vertebrae, and proximal humerus and femur.
This is why when we biopsy, we go to these body parts.
Calf, neonate, normal active
bone marrow
When animal is just born, bone marrow is very active.
Color = age
Normal bone marrow,
2-month-old calf.
With time, bone marrow is less active.
Stem cells differentiate into either lymphocytes or other cells such as myeloid cells, granulocytes, etc. erythrocytes, etc.
Tissue = cells that migrate into tissue and initiate immune response.
Erythropoietin (Epo) regulates production of ____.
RBCs
Produced in the kidney and liver, especially in the peritubular epithelial ? cells.
Release of Epo stimulated by ______.
hypoxia
Other stimulators of Erythropoiesis: ?
ILs, Colony stimulating factors (CSFs), hormones
Label accordingly
Nuclei lost at Metano
If see metano or poly in blood smear –> some type of pathology occurring
________ and ______ cells are referred to collectively as myeloid cells.
Granulocytic, monocytic
Main purpose of mylopoeisis is to develop B cells so that –> tissue –> attack microbes (main function = host defense).
The functions of Granulopoiesis and monocytopoiesis are:
1. Neutrophils and monocyte-derived macrophages: _______ and _______ activity
2. _______ and _______: parasiticidal activity, allergic
reactions
3. ______: antigen processing and presentation, and cytokine production
phagocytosis, microbicidal, Eosinophils, basophils, Macrophages
MQs are also responsible for microbials such as fungi, protozol –> granulomatous inflammation.
List the stimulators of granulopoiesis and monocytopoiesis:
- Interleukins (ILs)
- Granulocyte colony-stimulating factor (G-CSF) and GM
(granulocyte-macrophage)-CSF
Thrombopoietin (Tpo), synthesized primarily in the ______, regulates _______.
liver, thrombopoiesis
Mega = multilobulated nuclei and the cytoplasm will eventually break down and then eventually become platelets.
Other cells in bone marrow include?
- Lymphocytes (1-10%)
- Plasma cells (<1%)
- Stromal cells: reticular cells, adventitial cells, adipocytes
- Osteoblasts, osteoclasts
What samples would you collect from your patient?
Bone marrow
aspirates and core biopsies
Always want to do them together because they have different functions and show you different things.
When do you do bone marrow aspirate or core biopsies?
* Any abnormal hematology finding such as:
* Unexplained cytopenias (any non-regenerative anemia)
* Maturation defects or morphologic abnormalities in blood cells
* Potential myeloproliferative (myeloid proliferation)/ lymphoproliferative
(leukemia) disease (suspect neoplasias)
* Potential malignancies metastatic to the bone marrow
Always submit a concurrent CBC to interpret findings in bone marrow (periphery versus site of origin).
You collect bone marrow aspirates and core biopsies from any bone with ____ marrow:
* (3) in dogs and cats
* ______ of horses
* Proximal rib of ____
red, Proximal femur, iliac crest, proximal humerus, Sternum, cattle
Bone marrow is located in _____ sites but responds as a ____ tissue
multiple, single
Diagnostics – bone marrow
aspirates and core biopsies
locate site
sterilize
needle for bone marrow
take out piece of marrow
put on glass slide
can also smear
put into formalin fixative agent
Bone marrow aspirate/smears are
interpreted by clinical pathologists and are important for:
1. Cellular _____ and ______
2. _____ to _____ ratio (M:E ratio) in both cytology and biopsy.
3. _____ or ______ neoplasia
morphology, maturation, Erythroid, myeloid, Primary, metastatic
Bone marrow core biopsies are interpreted by anatomic pathologists and are important for examining the:
1. Ratio of ___ to _______ cells
2. _____ to _____ ratio (M:E ratio)
3. Adequacy of ____ (difference of storage of iron differs between species)
4. _____ elements (e.g. for myelofibrosis = scarring of bone marrow; loss fo cells –> scarring)
5. _____ or _____ neoplasia
fat, hematopoietic, Erythroid, myeloid, iron, Stromal, Primary, metastatic
Smear ?
Core biopsy
Short, cylinderal biopsy
Bone on bottom
purple dots?
Evaluate amount of fat and hematopoietic cells
Bone marrow aspirate on cytology
RB - erythroid origin; eosinophillic cytoplasm
PG - granulated cytoplasm; count these to get ratio.
Bone marrow core biopsy
Young cat, bone marrow, H&E - Normal
Myeloid/ Erythroid ratio (~3:1)
Megakaryocyte in top right. not counted in ME ratio.
Clear = fat lobules
List the typical bone marrow patterns:
- Hyperplasia
- Hypoplasia
- Myelitis/Necrosis
- Dysplasia/Neoplasia
- Myelofibrosis
In bone marrow patterns, one or multiple cell lines may be _______
depending on the stimulus.
hyperplastic
Erythroid hyperplasia ➝ ?
response to anemia
BM pushes RBC out as fast as possible; takes time; see erythroid cells in anemia?
Megakaryocytic hyperplasia ➝ ?
response to ↓
platelets
Myeloid hyperplasia (monocytic/granulocytic cell
lines)
* Neutrophilia ➝ ?
* Eosinophilia ➝ ?
* Monocytosis ➝ ?
bacterial infections, tissue necrosis
parasites, hypersensitivities
chronic infections, specific agents
The pathogenesis of bone marrow patterns is described as a ____ in cell ______ in blood caused by ______
peripheral demand; or adequate numbers of ______ cells in peripheral blood -> lead to
___ cell production in the marrow in response to _____ and ______.
↓, numbers, increased, hypofunctional, ↑, poietins, interleukins
Bone marrow hyperplasia
Gross finding: Red marrow replacing yellow marrow
(fat) at metaphysis and endosteal surface of diaphysis.
Adult horse – bone marrow hyperplasia secondary to EIA (Equine infectious anemia; retrovirus; initially when infected peripheral demand due to anemia so BM is working hard to push RBC out –> hyperplasia).
Bone marrow hypoplasia/atrophy is defined as ________ proliferative activity and is characterized by an ______ in yellow marrow
decreased, increase
Bone marrow hypoplasia/atrophy often accompanies
marrow degeneration