Thymus Flashcards

1
Q

what antigen is expressed in acute leukemia?

A

CD34

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2
Q

what tumor often presents with bence-jones proteinuria?

A

multiple myeloma- tumor of plasma cells arising from the bone marrow

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3
Q

Horse presents icteric with rapid breathing and increased heart rate
* On PE the horse was depressed with a fever and petechiation of the mucous membranes
* On necropsy: * Icterus
* Splenomegaly
differential?

A

equine infectious anemia
transmitted by biting flies
diagnosed by coggins!

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4
Q

what does the thymus look like in ruminants and pigs?

A

has cervical and thoracic lobes

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5
Q

what other species variably have small cervical lobes?

A

cats and horses

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6
Q

T/F: dogs rarely have cervical lobes on the thymus

A

false, they do NOT have cervical lobes

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7
Q

T/F: all animals have thoracic lobes of the thymus

A

true
ventral in horse, pig, dog and dorsal in ruminants

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8
Q

what is the thymus important for?

A

development of T cells

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9
Q

what does the thymus stroma contain?

A

epithelial cells, reticular cell specialized fibroblasts), macrophages and dendritic cells
these are the supportive components of the thymus

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9
Q

what does the cortex of the thymus contain?

A

cortical and medullary epithelial cells- essential for T cell development
these are antigen presenting cells

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10
Q

what are hassell’s corpuscles?

A

degenerating epithelial cells, but still important for T reg production: dendritic cells mediated T reg production

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11
Q

what is the cell of origin of a thymoma?

A

thymic epithelial cell

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12
Q

what are the 3 zones of the thymus?

A
  1. subcapsular zone: T progenitor cells enter from bone marrow
  2. cortex: DP T cell recognizes antigen/MHCII or antigen/MHC1, then go to positive selection. T cells that recognize MHCI/self antigen go to NEGATIVE SELECTION
  3. medulla: 5% of remaining mature T cells leave thymus and are distributed to spleen and lymph nodes
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13
Q

what do T cells recognize that leads them to undergo negative selection?

A

MHCI/self antigen

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14
Q

how do T cells enter the thymus? how do they leave?

A

progenitors go from BM to thymus, enter subcapsular zone as DN T cells, then go into cortex as DP T cells, then in medulla as SP T cells, then leave and go to the peripheral and lymphoid tissue

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15
Q

a DP T cell recognizes MHCI/self antigen. does it undergo positive or negative selection?

A

negative selection

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16
Q

what do DN cells express?

A

nothing; CD4 and CD8 negative

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17
Q

DN cells become DP cells. what do these DP cells express?

A

CD4 and CD8 positive

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18
Q

what do single positive cells express?

A

leave thymus either as single positive cells- express either CD4 or CD8
shouldn’t leave thymus as anything other than a SP cell!

19
Q

what can cause the thymus to decrease in size?

A
  1. involution: normal process, decreases in size after a couple years
  2. hypoplasia: in animals with fetal disease
  3. atrophy
  4. necrosis
20
Q

why does thymus involution occur?

A

it occurs following sexual maturity
lymphoid and epithelial components are replaced by adipose and connective tissue
T cells continue to circulate thru splenic and lymph node T zones
antigen-specific T cell expansion occurs with antigen presentation

T cells stick around and have memory: do don’t need to use thymus throughout life

21
Q

why does thymic hypoplasia occur in neonatal animals?

A

immunodeficient: small and wimpy thymus

22
Q

why would the thymus atropy or necrose?

A

lymphocytolysis or inadequate supply from bone marrow
- heavy metals, radiation, anti-cancer therapy, fungal toxins
- viral disease

23
Q

what viruses can affect the thymus?

A
  1. parvovirus: dogs/cats: injures lymph tissue/necrosis
  2. canine distemper: injures lymphoid tissue
  3. feline immunodeficiency virus: injures lymphoid tissue
  4. equine herpesvirus 1: injures lymphoid tissue
  5. bovine diarrheal virus: injures lymphoid tissue
  6. porcine circovirus-2L injury or inflammation of the thymus
24
what infectious diseases also already affect the bone marrow?
parvo distemper FELV FIV EIA
24
What viral disease can cause inflammation in the thymus? A) BVDV B) Parvo virus C) Porcine circovirus-2 D) Equine infectious anemia
C: porcine circovirus-2
25
why does thymic enlargement happen in adults?
- hemorrhage - inflammation - neoplasia - cysts - hyperplasia (ex autoimmune disease)
26
what are causes for thymic hemorrhaging?
anticoagulants, trauma, idiopathic/spontaneous
27
A 10 week old pig presents with severe wasting and unthriftiness * Upon exam: * The animal is dyspneic * There are enlarged lymph nodes * The animal is euthanized and sent for post mortem exam * On necropsy the thymus is enlarged * Bronchial and mediastinal lymph nodes are enlarged * Inguinal lymph nodes are enlarged * The lungs are firm with cranioventral consolidation histopathology of the thymus shows granulomatous inflammation with globular viral inclusions in macrophages (arrows) what is your top differential?
porcine circovirus-2
28
what causes postweaning multisystemic wasting syndrome?
porcine circovirus 2
29
porcine circovirus-2
* Enlarged lymph nodes, interstitial pneumonia and poor body condition * Lymphoid depletion of follicles and paracortex > replacement by granulomatous inflammation * Thymus – (atrophy) to granulomatous inflammation with multinucleated cells with cytoplasmic viral inclusions
30
A 12 year old male neutered Portuguese Water Dog presents with regurgitation and coughing On physical exam you have difficulty auscultating the thorax radiographs revealed a cranial mediastinal mass. ultrasound revealed a heterogenous mass with irregular cystic regions and numerous cavitations. a moderate lymphocytosis : 13,000 (normal is 5,000) is present on CBC. what test could we do to better characterize this lymphocytosis?
flow cytometry! decide whether heterogenous or homogenous population
31
there was a moderate lymphocytosis characterized by heterogenous T cell expansion by flow cytometry. why would there be that many lymphocytes present?
neoplastic epithelial cells drag the lymphocytes along with them. they are not neoplastic!
32
you do flow cytometry of a mediastinal mass. you see a large population of DP CD4 and CD8 cells. are these neoplastic?
no, but they are part of thymic development. in an adult dog, shouldn't have a large population of DP cells because that's done- the thymus has gone away in an adult. in a normal animal, can't even aspirate the thymus
33
you just diagnosed a dog with a thymoma. what paraneoplastic syndromes are you concerned about?
1. myasthenia gravis and megaesophagus: very common (40%) 2. thymoma associated lymphocytosis 3. exfoliative dermatitis: ulceration, scaling, individual epithelial cell necrosis
34
what are your differentials for a mediastinal mass?
1. lymphoma of thymus 2. thymoma 3. hemangiosarcoma 4. chemodectoma (neuroendocrine tumor)
35
thymic lymphoma in cattle
less than 2 years of age, not associated with BLV!
36
thymic lymphoma in cats
typically 1-3 years old can be associated with FeLV/FIV
37
thymic lymphoma in dogs
mean age 8 years hypercalcemia common
38
thymic lymphoma in goats
3 years mediastinal involvement frequent
39
thymic lymphoma in pigs
less than 2 years of age spontaneous
40
A 10 year old dog presents with increased respiratory effort and a mediastinal mass is evident on radiographs. Cytology is performed on an aspirate of the mass and there are abundant small, heterogeneous T cells and occasional concerning epithelial cells. Based on your concern what is a paraneoplastic condition you would be worried about? * A) Hyperglobulinemia * B) Hypercalcemia * C) Myasthenia gravis * D) Superficial necrolytic dermatitis
C see A with multiple myeloma, see B with AGASACA, lymphoma, see D with liver tumors or pancreatic tumors
41
why is it difficult to aspirate the thymus in an adult dog?
the thymus gets replaced by adipose. T cells expand into periphery with antigen stimulation
42
in thymic neoplasia, what cells are stimulating reactive T cells?
neoplastic epithelial cells
43
thymoma
neoplastic thymic EPITHELIAL CELL reactive (nonneoplastic) T cells are stimulated by neoplastic epithelial cells- majority are DP T CELLS within the mass reactive lymphocytosis is also associated: SP and DN T cells are in peripheral blood neoplastic epithelial cells are important in T cell dvlpt and lead to auto-immune disease: myasthenia gravis and exfoliative dermatitis myasthenia gravis: auto-immunity to neuromuscular junction exfoliative dermatitis: auto-immunity to epidermis
44
A 2 year old cat presents with increased respiratory effort and on radiographs a cranial mediastinal mass is identified. On aspirate of the mass there are large lymphocytes with atypia consistent with lymphoid neoplasia. What do you want to test for in this patient?
feline leukemia virus!