Pathology Overview-Parsa Flashcards
What are some causes of vessel wall abnormalities (aka nonthrombocytopenic purpuras)?
- Many infections
- Drug runs
- Henoch-Schonlein purpura (immune)
- Scurvy & Ehlers-Danlos Syndrome
- Hereditary hemorrhagic telangiectasia
- Perivascular amyloidosis
What are some causes of Thrombocytopenia?
- Decreased platelet production (anemia, leukemia)
- Decreased platelet survival (immunological, DIC, TTP)
- Sequestration (splenomegaly)
- Dilutional (following blood transfusion)
ITP
Auto-immune thrombocytopenia
What do you see in the smear of DIC?
Schistocytes
What are some causes of bleeding disorders related to defective platelet functions?
- Defects of adhesion (Von Willebrand Disease & Bernard-Soulier Syndrome)
- Defects of aggregation (Glanzmann Thrombasthenia)
- Disorders of platelet secretion (TxA2 synthesis)
- Urea (decreased TxA2 leads to increased platelets)
What are some causes of abnormalities of clotting factors?
- Acquired deficiencies (Vit K def, DIC)
2. Common hereditary deficiencies (Hem A, B & vWD)
What is leukopenia?
Decreased WBC count either from decreased production or increased destruction
What is leukocytosis?
A reactive increase in WBC count either from normal physiologic stress (exercise) or infection
What is leukemia?
A neoplastic increase in WBC count
What is seen on the smear of infectious leukocytosis?
Dohle bodies
Which disorders are myeloproliferative?
- AML
- Chronic myeloproliferative disorders/neoplasia
- MDS
Which disorders are lymphoproliferative?
- ALL
- CLL
- Lymphoma
What are the two forms of the blast phase of CML?
- AML (2/3 of cases)
2. ALL (pre-B lymphoid; 1/3 of cases)
What do you expect to see in a blood smear and bone marrow biopsy in a pt w/primary myelofibrosis?
Teardrop cells in blood smear and extensive fibrosis in bone marrow biopsy
Describe the blood smear, bone marrow biopsy and mutation present in a pt w/primary thrombocythemia.
Atypical platelets in smear
Increased atypical neoplastic megakaryocytic in biopsy
50% have JAK2 mutation
What is LAP and in what diseases is it usually decreased?
Leukocyte alkaline phosphatase; decreased in leukemias
What is AML?
Aggressive tumors comprised of immature myeloid lineage blasts, which replace the marrow and suppress normal hematopoiesis
Associated with diverse acquired mutations that lead to expression of abnormal transcription factors, which interfere with myeloid differentiation
What causes petechiae?
Thrombocytopenia
Which subsets of AML have Auer rods?
M2 & M3
What is a chloroma?
Aka granulocytic sarcoma or leukemia cutis; rare destructive neoplastic granulocytic masses
What would you see in pts w/AML M5
Blood smear with mono blasts and promonocytes and lesions in skin and gingiva
What are the important points about MDS?
- Pts are elderly
- Presence of cytopenias
- Prsence of oval macrocytes, pseudo-pelger-huet, increased eosinophils & basophils
How are MDS different from MPS?
Don’t have specific mutations (like BCR-ABL & Jak2 in MPS)
Loss of which chromosome is a good prognostic marker for MDS?
5
Loss of which chromosome is a poor prognostic marker for MDS?
7
From what type of cells do CLL/SLL arise from?
Naive B-cells
What Sxs and smear components are indicative of CLL/SLL?
> 50 years old, male, fatigue, LYMPHADENOPATHY, smear shows smudge cells
What is the Tx for CLL?
Nothing; let old people die
T-cell ALL pattern
More likely to present in adolescents as a mediastinal mass
B-cell ALL pattern
More likely to present in children as leukemia; CD10+ CD19+ CD22+
What mutation and biopsy pattern are characteristic of Burkitt’s Lymphoma?
c-myc t8:14 mutation; start sky pattern in biopsy (cells with fragmented apoptotic bodies scattered around)
Marginal zone lymphoma
Almost treatable; see marginal zone in inter follicular zone
Hodgkin classification
Classical (see classical Reed-Sternberg cells) and Lymphocyte Predominance (see Reed-Sternberg variant lacunar cells)
What is the most important difference b/n Hodgkin and Non-Hodgkin lymphoma?
Hodgkin is localized; Non are more generalized
What is the testing done for multiple myeloma?
Immunofixation
