WBC 1 Flashcards
Severe chronic congenital neutropenia is also known as
Kostmann Syndrome
Deficiency of this vitamin can cause ineffective granulopoesis
B12 (cobalamin)
Lack of response to an infection due to an overwhelming infection (consumption of WBC)
In a state of anergy WBCs are consumed in the peripheral blood to the point they are decreased.
Toxic granules seen in neutrophils as seen during a shift in bone marrow activity
Dohle bodies are formed by the activation of enzymes in the ER
Dohle bodies are usually seen in:
severe infections (sepsis), or severe inflammatory reactions (Kawasaki’s)
Agranular, enlarged lymphocytes as a result of antigen stimulation (normal N/C ratio)
Reactive lymphocytes
Or Atypical lymphocytes
The presence of what cells may indicate neoplastic proliferation?
blasts
Defined by the presence of large oblong germinal centers surrounded by a collar of small resting naive B cells
Follicular hyperplasia
Hyperplasia of cells lining the lymphatic sinusoids where HISTIOCYTE (tissue macrophage) number is greatly increased
Sinus histiocytosis.
(Active B cells in center
Inactive B cells in periphery)
Pattern of chronic lymphadenitis usually caused by drugs, IM, vaccines
Parafollicular hyperplasia
Follicular hyperplasia is the stimulation of which compartment?
B-cell (compartment of lymph nodes)
Dark zone of germinal region contain these proliferating B cells
Centroblasts
Abnormal expansion of the interfollicular zones but is confined within the lymph node capsule
Parafollicular hyperplasia
Marginal layer gets thinner; germinal center gets larger.
Follicular hyperplasia
Lymph node hyperplasia prominent in breast carcinoma
Sinus hyperplasia
Foreign bodies are attacked by killer T cells here
parafollicular
Folluclar hyperplasia is a chronic reaction that can be seen in these infections: (examples)
HIV, toxoplasmosis
Light zone of germinal centers contain these B cells with irregular or cleaved nuclear contours
Centrocytes
Some will be come memory cells
Macrophages that eat up failed B cells that have undergone apoptosis are called:
tingible bodies
Lymphoid neoplastic proliferation arising as discrete tissue masses in LYMPH NODES
lymphoma
Type of myeloid neoplasm: immature progenitor cells accumulate in the BM
Acute myeloid leukemia
Increased WBC count with left shift (80% bands)
increased leukocyte alkaline phosphatase
Leukemoid reaction
Reed-Sternberg cells (RS cells) are required for diagnosis of:
Hodgkin’s lymphoma
Neoplasms that present with widespread involvement of the bone marrow and peripheral blood; arise in BONE MARROW
Lymphocytic leukemia
Type of myeloid neoplasm: associated with ineffective hematopoiesis and resultant peripheral blood cytopenias
Myelodysplastic syndrome
WHO class of lymphoma which includes:
adult T cell lymphoma (ATL)
Anaplastic large cell lymphoma (ALCL)
Sezary’s and Mycosis fungoides
Peripheral T cell lymphoma (MATURE T cell)
Clover leaf or flower cells in PBS
Adult T-cell lymphoma
Type of myeloid neoplasm: increased production of one or more terminally differentiated myeloid elements which usually leads to elevated peripheral blood counts
Chronic myeloproliferative disorder
Distinct tumor giant cell. Binucleate, mirror imaged. Owl eyes.
Reed-Sternberg cells induce the accumulation of other inflammatory cells
WHO class of lymphoma which includes B lymphoblastic leukemia (ALL) / lymphoma
Precursor B cell (Neoplasm of IMMATURE B cell)
Sezary’s and Mycosis fungoides manifest what lesions?
Skin lesions (T cells tend to go to skin)
WHO class of lymphoma which includes hairy cell leukemia, Burkitt’s and Follicular Lymphoma.
Peripheral B cell CLL, SLL (Neoplasm of MATURE B cell)
Leukocyte common antigen
CD45
T cell antigen
CD5
CD4 / CD8
CD3
B cell antigen
CD10
CD19
CD20 (pre B, mature B)
IgM
Monocyte antigen
CD14
CD64
Stem cell antigen
CD34
Hodgkin antigen
CD15, CD30
Peripheral T cell antigen
CD3
Pan-B marker
CD19
Ratio of kappa light chain B cells to lambda light chain B cells (benign)
2:1
2/3 are kappa
1/3 are lambda
(When one light chain is significantly more common than the other, it suggests derivation from a monoclonal population indicating MALIGNANCY)
Small, painful, solitary lymphatic enlargements indicate:
Benign
lymphoma presents as multiple and painless
A nodular white lymph node specimen when cut probably indicates:
lymphoma
Bcl-6 (30%)
t(14:18) (10%)
DLBCL
also bcl-2
Starry-sky appearance on PBS
Burkitt’s lymphoma
Neoplasm that presents in children <15 years
Acute Lymphoblastic Lymphoma/Leukemia
Caused by HTLV-1
Adult T cell lymphoma
Marker of pre-T and pre-B cells
TdT+
Terminal Dioxynucleotidil Transferase
(+) TdT, (+) CD5
T-ALL
pre-T cell lymphoma
Peaks at 4 years old
pre-B ALL
At 4 years old B cells are maximal in bone marrow
(+) CD15 could indicate
Hodgkin’s lymphoma
(+) CD5, (+) CD23
vs
(+) CD5, (-) CD23
SLL
vs
Mantle cell lymphoma
Pre-T ALL usually has this clinical manifestation
mediastinal mass
Rapidly fatal if left untreated. Good remission with treatment.
Follicular lymphoma progression to DLBCL because of this gene rearrangement or mutation
c-MYC
c-myc activation
Burkitt’s
(+) TdT, (+) CD19
Pre-B cell lymphoma
Jaw lesion of Burkitt’s lymphoma is:
endemic form
bcl-2 expression seen in which lymphoma?
Follicular lymphoma
can be seen in DLBCL
Difference between SLL and CLL
CLL has increased peripheral blood WBC
CLL is a stage of SLL
t(11;14)
Translocation of 11 and 14
cyclin D1 upregulation –> promotion of G1 to S
Mantle Cell Lymphoma
t(8;14)
translocation
c-myc activation (inactivates p53)
Affects male:female::2:1, >60 y/o, and often asymptomatic.
SLL/CLL
Cyclin D-IgH function?
Associated with what type of lymphoma?
Promotes G1 to S
Mantle Cell Lymphoma
ALK positivity is typical but not required in
Anaplastic large cell lymphoma
EBV
Burkitt’s Lymphoma
EBV stimulatesNF-kappa B
t(9;22)
Translocation of 9 and 22
CML (Philadelphia chromosome)
In the indolent course, this lymphoma is incurable
Follicular lymphoma
NHL with BIPHASIC prevalence: elderly and pediatric
DLBCL
Sporadic form of this neoplasm affects the pelvis or abdomen
Burkitt’s lymphoma
t(14;18)
Translocation Follicular Lymphoma (bcl-2 activation inhibits apoptosis)
Progression (complication) where lymphoma transforms into DLBCL
Richter Syndrome
from HCL, CLL/SLL
Trisomy 12
CLL/SLL
Clinical manifestation of Extranodal NK/T cell Lymphoma
nasal: nasopharanx, oropharynx, nose, oral cavity
Cutaneous like Sezary and Mycosis fungoides
Lymphoma associated with warm IHA/AIHA
CLL/SLL
This has 3 Clinical stages: inflammatory, plaque, tumor
Mycosis fungoides
Skin lesions + hypercalcemia
Adult T-cell lymphoma
CNS + testicular involvement is a manifestation of:
ALL
Hallmark cell is horseshoe-shaped nuclei
Anaplastic large cell lymphoma
Smudge cells in PBS
CLL/SLL
WHO class of lymphoma which includes T lymphoblastic Leukemia/Lymphoma
Precursor T cell (neoplasm of IMMATURE T cell)
Clinical feature of this HL: mediastinal or cervical mass
Nodular sclerosis HL
Non-classical Hodgkin’s Lymphoma subtype
Lymphocyte predominant HL has (-) CD15 and (-) CD30
Hodgkin lymphoma subtype with presence of frequent mononuclear variants and RS cells with CLASSICAL IMMUNOPHENOTYPIC profile
Lymphocyte rich HL
in Lymphocyte predominant HL, classical RS cells are difficult to find
Hodgkin’s lymphoma associated with HIV+
Lymphocyte depletion HL
Most common HL
Nodular sclerosing HL
Histological feature of this HL: Frequent RS cells surrounded by reactive cells (eosinophils, lymphocytes, histiocytes)
Mixed-cellularity HL
Histology of this HL reveals collagen banding and lacunar cells
Nodular sclerosing HL
Popcorn cell =
Lymphocyte predominant HL
multilobed nucleus
These two subtypes of Hodgkin’s lymphoma are usually not associated with EBV
Nodular sclerosing
and
Lymphocyte predominant
Classic HL that is commonly (-) for EBV
Nodular sclerosing HL
HL with poorest prognosis
Lymphocyte depletion HL