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gen path 2 > WBC disorders > Flashcards

WBC disorders Flashcards

1
Q

what are lymphomas?

A

malignant proliferations of cells native to lymphoid tissue- lymphocytes and their precursors and derivatives

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2
Q

two main types of lymphomas?

A

hodgkins and non hodgkins

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3
Q

what is Leukemia

A

malignant proliferations of cells native to the bone marrow, which often spillover into the blood.

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4
Q

hodgkins lymphoma morphological features

A
  1. Reed-Sternberg cells admixed with a

2. variable inflammatory infiltrate

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5
Q

distinguishing features of hodgkins lymphoma compared to non hodgkins lymphoma

A

Hodgkin lymphoma (HL) is often accompanied by

  1. fever,
  2. arises in a single lymph node or chain of nodes,
  3. more common in young adults (average age 30 years),
  4. characterized by contiguous spread within lymph node groups ,
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6
Q

cause of hodgkins lymphoma

A

unknown

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7
Q

the neoplastic cell associated with hodgkins lymphoma

A

Reed-Sternberg cells

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8
Q

A diagnosis of Hodgkin lymphoma requires the presence of ______ in the appropriate histologic background:

A

RS cells

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9
Q

small or large numbers of RS cells are present in the involved node

A

small

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10
Q

RS cells characteristics

A
  1. large cell
  2. mirror image nuclei
  3. prominent nucleoli
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11
Q

Choice of therapy (chemotherapy, radiotherapy, or both) and prognosis are based on _____

A

stage

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12
Q

localized lymph node involvement, without systemic signs (fever, weight loss), and has a better prognosis denotes ____ stage

A

low stage disease

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13
Q

______-stage disease indicates widespread disease, often with bone marrow involvement, and has a worse prognosis.

A

high

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14
Q

All stages are further divided on the basis of absence (A) or presence (B) of _______

A

systemic symptoms,

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15
Q

Most patients have enlarged, painless, superficial ___________ as the initial manifestation of disease.

A

lymph node involvement

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16
Q

as disease progresses what happens

A
  1. involvement of other lymph nodes in chest and abdomen
  2. involve spleen and liver (seen with MRI)
  3. Complications with infections (decreased cell-mediated immunity), anemia, and thrombocytopenia can occur in advanced disease.
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17
Q

There is a low, but definite risk for developing ________ after treatment with chemotherapy and radiotherapy because of the bone marrow toxicities of the chemotherapeutic drugs used.

A

acute leukemia

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18
Q

choice of therapy

A

chemo, and to an lesser extent radiotherapy

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19
Q

There is more ______ diversity in NHL than in HD

A

morphologic

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20
Q

Non-Hodgkin lymphomas (NHL) arise in

A

lymphoid tissue– either in lymph nodes or lymphoid tissue of solid organ

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21
Q

NHL differences compared to Hodgkins lymphoma

A

NHLs tend to have

  1. multiple node involvement,
  2. more frequent extranodal spread and peripheral blood involvement
  3. affect all ages
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22
Q

what is required for diagnosis of NHL

A

histologic examination of involved tissue

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23
Q

The majority (85%) of NHL are clonal neoplasms of

A

B lymphocytes. remianing 15% is T cell involvment

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24
Q

B cells are involved with what

A

antibody production

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25
Q

A _______ develops when there is a monoclonal expansion of lymphocytes that have been “arrested” (or have acquired a genetic rearrangement that alters growth regulation) at a particular stage in transformation.

A

lymphoma

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26
Q

T/F all lymphoid neoplasms are considered to arise from a single transformed cell.

A

TRUE

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27
Q

NHLs are classified on the basis of……

A
  1. their morphology (microscopic appearance),
  2. cell of origin (immunophenotype),
  3. clinical features
  4. genotype.
28
Q

T/F There is MORE correlation between stage and prognosis in NHL than in HD

A

FALSE, theres less

29
Q

Stage 1 NHL

A

Involves single lymph node region or extralymphatic organ or site

30
Q

Stage 2 NHL

A

Involves two or more lymph node regions on same side of diaphragm alone or with involvement of contiguous extralymphatic organ or tissue

31
Q

Stage 3 NHL

A

Involves lymph node regions on both sides of diaphragm which may include spleen.

32
Q

Stage 4 NHL

A

Multiple or disseminated foci of involvement of one or more extra lymphatic organs or tissues with or without lymphatic involvement

33
Q

in distinction to the group of diseases classified as leukemias, NHL’s can…..

A

spread to involve

  1. solid organs
  2. GI tract
  3. bones
  4. nervous system
34
Q

clinical presentation of NHL

A
  1. painless enlarged lymph nodes
  2. evidence of extranodal spread- enlarged liver or spleen
  3. bone marrow involvement
35
Q

what is the ‘leukemic phase’ of the disease

A

when you see Circulating lymphoma cells in the peripheral blood

36
Q

T/F complications with infection and treatment options are similar to hodgkins lymphoma

A

TRUE

37
Q

Leukemias are malignant neoplasms of….

A

hematopoietic tissue that arise in the bone marrow.

38
Q

The malignant cells __________ in the _______, commonly producing a pattern of diffuse infiltration

A

proliferate in the bone marrow,

39
Q

what happens to these proliferating cells in the bone marrow

A

There is often “spill over” of the proliferating cells into the blood and other organs.

40
Q

This group of diseases can be roughly conceptualized both in terms of _____ and of ______ involved

A

onset

cell type

41
Q

disease onset can be ____ or _____

A

acute or chronic

42
Q

leukemia cell types involved

A

myelogenous (myeloid and monocytic) and lymphoid.

43
Q

examples of leukemias basic classification

A

acute lymphoblastic leukemia (ALL),
chronic lymphocytic leukemia (CLL),
acute myelogenous leukemia (AML),
chronic myelogenous leukemia (CML).

44
Q

acute leukemias characteristics

A
  1. rapid
  2. usually fatal, survival months
  3. BLAST (immature cells) in blood and bone marrow (>20%)
  4. increase white blood cell count
45
Q

chronic leukemia characteristics

A
  1. slow (indolent)
  2. long survival, years
  3. mature cells, NO BLAST
  4. increase white blood cell count
46
Q

Acute lymphocytic leukemia

A
  1. 40% of acute leukemias
  2. proliferating cell is a primitive lymphoid
  3. principal cause of cancer deaths in childhood (<15 years old)
  4. Five subtypes recognized immunologically (early B precursor, pre-B, mature B, and T cell)
47
Q

T/F Cytogenetic analysis has prognostic significance

A

TRUE

48
Q

what is more common in ALL than AML.

A

Enlargement of lymph nodes, liver and spleen, and nervous system involvement.

49
Q

what group has the best prognosis?

A

children 2-10 with pre-B cell types

50
Q

ALL associated with _____

A

children cancer

51
Q

Acute myelogenous leukemia (AML)

A
  1. proliferating cell is a primitive myeloid cell
  2. Cytoplasmic inclusions called Auer rods
  3. older adult population, with a median age of 50 years.
52
Q

Cytoplasmic evidence of myeloid differentiation includes

A

includes the presence of several types of granules (myeloperoxidase) found in more mature myeloid cells.

53
Q

T/F Auer rods are not used in diagnostic

A

FALSE, when present, they are

54
Q

what is most predictive of prognosis of AML

A

karyotype

55
Q

Sometimes the lesional cells will proliferate in ______, producing what is termed ________.

A 
soft tissue (including the gingivae)
granulocytic sarcoma
56
Q

T/F Although many patients can obtain remission of disease after chemotherapy, the duration of remission is often transient.

A

TRUE

57
Q

Infiltration of the gingivae is a feature commonly associated with _______

A

acute myelo-monocytic leukemias.

58
Q

Clinical features result from

A

(1) impairment of marrow function as abnormal cells suppress growth of normal cells,
(2) infiltration of body organs due to proliferation of the abnormal cells.

59
Q

other clinical features

A
  1. Anemia –> fatigue, pallor, weakness
  2. Thrombocytopenia (decreased platelets) –> bleeding and bruises.
  3. infection –> fever
  4. organ enlargement (lymph nodes, spleen, liver) occurs as the abnormal cells proliferate in these sites –> abdominal pain, blocked vasculature or lymphatics
60
Q

Plasma cell disorders result from clonal expansion of _____

A

immunoglobulin-secreting cells.

61
Q

increase secretion of immunoglobulin results in what

A

increased serum monoclonal protein (M component)

62
Q

monoclonal protein (M component) may have adverse effects on

A

renal and neurologic function.

63
Q

what makes the diagnosis of Multiple Myeloma ?

A

Documenting

  1. monoclonal protein
  2. skeletal lesions
64
Q

Multiple Myeloma proliferating cell is a

A

plasma cell that produces immunoglobulin

65
Q

what characterizes myeloma

A

Multifocal destructive bone lesions characterize myeloma

66
Q

how does bone lesion occur in myeloma?

A

secretion of osteoclast activating factors by the myeloma cells induces bone resorption

67
Q

Patients often present with _____, _____, and ______

A

bone pain, hypercalcemia, and renal disease.

gen path 2 (8 decks)

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