Test 4: 5: lymphoid Flashcards
— regulated the production of RBC
erythropoietin (Epo)
released during hypoxia by kidneys promotes RBC proliferation and inhibits apoptosis
erythropoiesis is the formation of ___
red blood cells
regulated by Epo- which is made by kidneys
Granulopoiesis is the formation of —
myeloid series
Inflammatory mediators (ILs and TNF-α) stimulate fibroblasts, macrophages, and endothelial cells to produce cytokines (G-CSF and GM-CSF) that increase granulopoiesis and monocytopoiesis.
Granulocytic and monocytic cells are referred to collectively as —
myeloid cells
In the context of hematology, “myeloid” is also
sometimes used to mean a hematopoietic cell of nonlymphoid origin; in neuroanatomy, the prefixes “myelo-” or “myel-” can refer to the spinal cord or myelin.)
Thrombopoietin (Tpo), synthesized primarily in the —, regulates thrombopoiesis.
liver
always/ constitutively produced
makes megakaryocytes → platelets
Megakaryocytes arise from a progenitor cell → endomitosis to become — →extend cytoplasmic processes bone marrow venous sinusoids →shed cytoplasmic fragments (—) into circulation.
polyploid
platelets
neutrophil
eosinophil
basophil
monocyte
lymphocyte
— tissue (red marrow) regresses and is replaced with nonhematopoietic tissue, mainly fat (yellow marrow).
Hematopoietic
what is a cytology how is it different from biopsy
Aspirates = Cytologic preparations are collections of cells expressed or “smeared” on a slide, stained and examined microscopically. Most aspects of a ‘marrow evaluation’ can be done cytologically
Core biopsies = Histologic preparations are sections of tissue that have been fixed with formalin, embedded in paraffin or plastic, sectioned, stained, and coverslipped.
why do you submit a CBC with a bone marrow sample
need to compare to each other, they change rapidly in response to each other
M:E ratio is for —
THIS ONLY INCLUDES ERYTHROID AND MYELOID - NOT MEGAKARYOCYTES!
Normal M:E in healthy animals: Companion animals M:E=1:1 – 2:1, Livestock
& horses M:E = 0.5:1.
when to do core biopsy
if bone changes
FNA showed abnormal cellularity
focal lesion
FNA unsuccessful- dry tap
what cells for the M:E ration
myeloid : neutrophil, eosinophil, basophil
erythroid: red blood cell
deep blue ?
purple?
deep blue: erythroid
purple: myeloid
what is a band cell
immature neutrophil
— is an Increase in response to peripheral demand for a specific cell type
hyperplasia
predictable
2 causes of erythroid hyperplasia?
Hemorrhage
– Trauma
– Coagulopathies
– Neoplasia
Hemolysis
– IMHA
– Toxin
– Infectious
– Oxidant injury
– Enzyme deficiencies
– Hypophosphatemia
this causes — in the bone marrow
liver failure- ↓ red blood cells
low hemoglobin = hypoxemia= Epo production by kidneys which triggers bone marrow to make more red blood cells
Erythroid hyperplasia
what happens to M:E if there is erthroid hyperplasia
decreases because E increases
there will be immature RBC in the blood (polychromatophilic RBC (bluish)and Reticulocytes(stained with methylene blue))
leads to regenerative anemia
With persistence of blood loss (e.g., refractory immune-mediated thrombocytopenia, or
chronic urinary or GI losses), there is depletion of —. This blunts the regenerative response and
eventually results in a — anemia, secondary to iron depletion. Erythroid hyperplasia may not be evident.
iron
non-regenerative
how can prolonged blood loss cause increase in myeloid cells
sudden loss of blood = loss of hemoglobin/oxygen= cell death which recruits myeloid cells. This recruitment causes ↑ production of myeloid cells in the bone marrow
M:E will be equal but both increased
which is false in respect to erythroid hyperplasia
increased M:E
it will cause a decrease because E gets bigger
what happens to M:E with myeloid hyperplasia
increase
caused by need for more granulocytes or monocytes
infection
what is a left shift in maturation?
there is such a need for cells that
myeloid cells are moved into blood before fully mature
will see band cells
three causes of megakaryocytic hyperplasia
- Destruction
- Loss
- Consumption
platelets
three causes of megakaryocytic hyperplasia
Peripheral destruction (immune-mediated thrombocytopenia, ITP)
Loss (hemorrhage)
Consumption (disseminated intravascular coagulation, DIC)
- The marrow will respond by increasing megakaryocytes.
platelets
what is the marrow response in a dog with immune mediated thrombocytopenia
megakaryocytic hyperplasia
(produce platelets)
2 manifestations of bone marrow hypoplasia
- Measurable hypoplasia (change in M:E);
decrease/absence of a particular cell line - Failure to respond with appropriate hyperplasia despite peripheral cytopenia (thus, marrow may appear normal)→ body tells marrow it needs something but marrow says nope
high or low thyroid will cause bone marrow hypolasia
low
causes mild to moderate erythroid hypoplasia
high or low estrogen will cause bone marrow hypoplasia
high
can be severe generalized marrow hypoplasia/aplastic anemia
how does anemia cause bone marrow hypoplasia
non-regenerative anemia
Hepcidin:
-Acute phase protein synthesized in the liver; expression increases with inflammation, infection, or iron overload and decreases with anemia or hypoxia -Limits iron availability, causing functional iron deficiency: Binds to and causes the degradation of the cell surface iron efflux molecule, ferroportin, thus inhibiting both absorption of dietary iron from the GI and export of iron from macrophages and hepatocytes into the plasma.
Inflammatory cytokines (e.g. TNF & IL-1):
-Inhibit erythropoiesis by oxidative damage and trigger apoptosis of developing erythroid cells
-Decrease expression of Epo, Epo receptors, and stem-cell factor
how does anemia of chronic disease cause bone marrow hypoplasia
non-regenerative anemia
Hepcidin:
-Acute phase protein synthesized in the liver; expression increases with inflammation, infection, or iron overload and decreases with anemia or hypoxia -Limits iron availability, causing functional iron deficiency: Binds to and causes the degradation of the cell surface iron efflux molecule, ferroportin, thus inhibiting both absorption of dietary iron from the GI and export of iron from macrophages and hepatocytes into the plasma.
Inflammatory cytokines (e.g. TNF & IL-1):
-Inhibit erythropoiesis by oxidative damage and trigger apoptosis of developing erythroid cells
-Decrease expression of Epo, Epo receptors, and stem-cell factor
— is the most common cause of nonregenerative anemia and causes a lack of compensatory —. This process is controlled by — which limits iron availability.
Anemia of chronic disease
erythropoiesis
hepcidin
leads to bone marrow hypoplasia
IMHA
Immune-Mediated Hemolytic Anemia
body attacks red blood cells
how to tell acute bone marrow inflammation
fibrinous / neutrophils in higher amounts
can be hard to measure cause cells are supposed to be there or inflammation can be focal
if you see necrosis good way to know that something is going wrong
how to tell chronic bone marrow inflammation
granulomatous inflammation
necrosis
Myelodysplastic Syndrome
group of clonal myeloid proliferative disorders characterized by ineffective hematopoiesis, resulting in a peripheral cytopenia of the affected cell population(s).
can lead to acute myeloid leukemia
marrow profile indicates hyperplasia of one or more cell lines with no improvement in the peripheral cell count and abnormal cell morphology
Rare in veterinary medicine, occurring most frequently in cats infected with FeLV.
when can you see MYELODYSPLASTIC SYNDROME (MDS)
Rare in veterinary medicine, occurring most frequently in cats infected with FeLV.
Refers to a group of clonal myeloid proliferative disorders characterized by ineffective hematopoiesis, resulting in a peripheral cytopenia of the affected cell population(s).
AML vs CML
acute myloid leukemia: blood smear show blast cells, >20% of cells will be of myloid origin, seen in FELV + cats, poor prognosis
chronic myelogenous leukemia: high cell counts, very rare, marrow hyperplasia of the affected cell line; normal morphology and therefore diagnosis is made by process of elimination
compare ALL or CLL
acute lymphoid leukemia immature lymphocytes, may efface the marrow, young animals
chronic lymphoid leukemia well differentiated lymphocytes, does NOT efface the marrow, older animals
what are bence-jones proteins
light chains that break off antibodies and secreted in the urine
seen in multiple myeloma (plasma cell neoplasm)
— are plasma cell neoplasm in the medullary marrow
multiple myeloma
how to detect multiple myeloma
- Plasma cell neoplasm in the
marrow (medullary)
Specific diagnostic criteria
* Marrow plasma cells greater
than 30%
* Monoclonal protein (M-spike)- single type of immunoglobulin(antibody)
* Bence-Jones protein in the
urine (light chain that fell off antibody)
* Lytic bone lesions- oval shaped lesion on bone
myelofibrosis
when bone marrow scars in reaction to injury,neoplasia, and inflammation
Fibrosis impedes marrow collection by aspiration and therefore best diagnosed histologically
