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Pathology EX 2 > WBC disorders > Flashcards

WBC disorders Flashcards

1
Q

Lymphomas are ______ proliferations of cells native to lymphoid tissue - Lymphocytes and their precursors and derivatives.

A

Malignant

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2
Q

Lymphomas arise in ____ and can spread to ________

A

Lymphoid tissue

solid tissue, marrow, and blood

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3
Q

2 Types of Lymphomas are:

A
  1. Hodgkin

2. Non-Hodgkin

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4
Q

Leukemias are malignant proliferations of cells native to the ______, which often spillover into the blood

A

Bone marrow (myeloid and lymphoid)

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5
Q

Leukemia may spread to _______

A

Solid tissues (Typically liver and spleen)

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6
Q

Leukemia can be _____ and ______

A

Acute, Chronic

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7
Q

Hodgkin lymphoma has a _____

A

Distinctive cell type (Reed-sternberg cell)

Contiguous (근접) spread within lymph node group

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8
Q

Hodgkin lymphoma is often accompanied by ______

A

Fever, and arises in a SINGLE lymph node or chain of nodes

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9
Q

Hodgkin lymphoma is more common in ______

A

young adults (20-30 yrs) and over 50 yrs old

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10
Q

Hodgkin lymphoma is highly curable in most cases with _______ and ______

A

Chemotherapy

Radiotherapy

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11
Q

The cause of HL is unkown, but ______ has been implicated in playing a role

A

EBV (Epstein-Barr Virus), is seen 70% of the cases

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12
Q

Reed-Sternberg (RS) cell is a large cell with ______ and _______

A

Large cell with mirror-image nuclei and prominent nucleoli

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13
Q

RS cell is the malignant cell of HL, but comprises only ___% of cells in the involved lymph node.

A

2%

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14
Q

Origin of RS cell

A

Germinal center B lymphocyte but remains uncertain

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15
Q

Staging refers to….

A

the assessment of the amount of tumor burden and its distribution in the body

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16
Q

HL staging is..

A

Predictable (lymph nodes, spleen, liver, and bone marrow)

Staging used to determine treatment and prognosis

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17
Q

Low Stage of HL denotes….

A

localized lymph node involvement, with No systemic signs (fever, weight loss) and has a better prognosis

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18
Q

High stage of HL indicates….

A

Widespread disease, often with bone marrow involvement, and has a worse prognosis

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19
Q

Choice of therapy and prognosis are based on ________

A

STAGE

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20
Q

Treatment consists of a combination of _______ and _______

A

Chemotherapy (used more than radio)

Radiotherapy

@ Low stage both are used

@ High stage CHEMOTHERAPY!!

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21
Q

HL Stage 1

A

Tumor in one region or 2 contiguous anatomic regions on the SAME side of the diaphragm

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22
Q

HL stage 2

A

Tumor in more than 2 anatomic regions or 2 Non-contiguous regions on the same side of the diaphragm

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23
Q

HL stage 3

A

Tumor on both sides of the diaphragm not extending beyond lymph nodes, spleen or Waldeyer’s ring (so still within the lymph node)

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24
Q

HL stage 4

A

Tumor in bone marrow, lung, etc. Any organ site OUTSIDE of the lymph nodes, spleen or Waldeyer’s ring

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25
Q

“B” signs/symptoms of HL include:

A

Fever, night sweats, and significant weight loss

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26
Q

Patients without B sings/symptoms have better

_______

A

prognosis

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27
Q

Stage 3 and 4 disease more likely to have ______

A

B symptoms

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28
Q

5 yr survival almost 100% at ___ and ___

A

Stage 1 and Stage 2A

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29
Q

5 yr survival rate in stage 4 is ____

A

50%

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30
Q

Non-Hodgkin Lymphomas (NHL) aries in lymphoid tissue - either in ____ or _____

A

Lymph nodes or lymphoid tissue of solid organs

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31
Q

NHLs have to capcity to spread into ______, _____, _____, and ______

A

Other nodes, solid organs, bone marrow, and blood.

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32
Q

Over ____ types are currently recognized but only ______ of these subtypes comprise over 90% of the NHLs in the US.

A

Two dozens, 8 subtypes

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33
Q

Most _____ are of _____ origin and most remainder are _____

A

85%, B cell

T cell

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34
Q

NHL incidence rises steadily after age of ____ and roughly ______ in 2015

A

40 yrs old, 71,000 cases

But it does affect all ages

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35
Q

Unlike HL, NHLs tend to have ________ involvement, more frequent extranodal spread and peripheral blood involvement

A

Multiple node

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36
Q

A lymphoma develops when there is a _____ expansion of lymphocytes that have been arrested (or have acquired a genetic rearrangement that alters growth regulation)

A

Monoclonal

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37
Q

In NHLs, ________ occur frequently.

A

Immune abnormalities

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38
Q

NHLs may involve ______

A

GI tract, bones, CNS

39
Q

NHLs are classified on the basis of their _____, _______, ________, and _______

A

Morphology
Cell of origin
Clinical features
Genotype

40
Q

_____ disease is better than diffuse

_____ cell disease better than large

A

Nodular

Small

41
Q

Low stage of NHL

A

localized disease

42
Q

High stage of NHL include ______

A

Numerous sites of involvement or bone marrow involvement

43
Q

Stage 1 of NHL

A

single lymph node region or extralymphatic organ or site

44
Q

Stage 2 of NHL

A

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

45
Q

Stage 3 of NHL

A

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

46
Q

Stage 4 of NHL

A

Multiple or disseminated (퍼진) foci of involvement of one or more extralymphatic organs or tissues with or without lymphatic involvement

47
Q

Clinical Features and course of NHLs

A

Usually painless enlarged lymph nodes, or evidence of extranodal spread (enlarged liver or spleen)

More common bone marrow involvement than HL

Lymphoma cells may circulate in peripheral blood = Leukemic phase

48
Q

NHLs have complications with….

A

Infections, anemia, and thrombocytopenia

49
Q

Leukemias are malignant neoplasms of hematopoietic tissue that arise in the ______

A

bone marrow

50
Q

The malignant cells proliferate in the bone marrow, commonly producing a pattern of ________. Often ______ of the proliferating cells into the blood and other organs

A

diffuse infiltration

Spill over

51
Q

Acute leukemia:

A

Rapid onset with blasts in the blood

Myeloid lymphoid cells affected

52
Q

Chronic leukemia:

A

Indolent onset and tends to involve more mature cells

Myeloid lymphoid cells affected

53
Q

Acute Lymphoblastic Leukemia (ALL) has the proliferating cell which is a ________

A

Primitive lymphoid cell

54
Q

ALL accounts for about ____% of the acute leukemias

A

40%

55
Q

ALL is the most frequent type in children _____ old

A

under 15 years old

56
Q

ALL is the principal cause of cancer deaths in childhood, with a peak incidence at age of ______, but it can affect persons of all ages

A

4 yrs old

57
Q

ALL has ____ subtypes immunologically

A

5 (early b pre, pre-B, mature B, and T cell)

58
Q

________ being the subtype with best prognosis in ALL

A

Hyperdiploidy (>50 chromosomes per leukemic cell)

59
Q

In ALL enlargement of _____, _____, and _____ is more common than AML

A

lymph nodes, liver, spleen

60
Q

The best prognosis group for ALL is children aged _______ with ______

A

2-10 with pre-B cell type

61
Q

Acute myelogenous leukemia (AML) has the proliferating cell which is a…

A

Primitive myeloid cell

62
Q

AML has a cytoplasmic inclusions called _______

A

Auer rods

63
Q

Out of all subtypes of AML _____ is most predictive of prognosis

A

The karyotype

64
Q

AML usually affects an _____ population, with a median age of ____ years

A

older adult, 50 yrs old

65
Q

AML can also proliferate in soft tissue including _____, producing ______

A

gingivae,

Granulocytic sarcoma

66
Q

_______ is the undergoing evaluation and treatment for AML

A

Bone marrow treatment

67
Q

The proliferating cell of Chronic Lymphocytic Leukemia (CLL)?

A

Mature-appearing, but immunologically incompetent, lymphocyte

These cells are Monoclonal (derived from same precursor cell)

68
Q

CLL has more than ___% are B-cell type, and commonly express ______ kappa surface immunoglobulin

A

95%, IgM

69
Q

CLL accounts for _____ of chronic leukemias and most common in adults over ____ yrs

A

2/3

60 yrs old

70
Q

CLL has a male:female ratio of…..

A

2:1

71
Q

CLL can have involvement of…

A

spleen, liver, and lymph nodes

72
Q

_______ develops in most patients

A

hypogammaglobulinemia

73
Q

Median survival of CLL is ____ yrs

A

4-6 yrs

74
Q

Chronic Myelogenous leukemia (CML) has a proliferating cell called

A

immature hematopoietic cell

75
Q

with CML, stem cell pool is increased ______

A

10-20 times normal

76
Q

CML has all myeloid cell types present esp. ____, ____, and _____

A

myelocytes, eosinophils, and basophils

77
Q

CML has a specific chromosomal abnormality called ______

A

philadelphia chromosome [t(9;22)],

occurs in all the proliferating cells

78
Q

CML has the chromosomal abnormality results in fusion of ______, which mimic the _____

A

BCR-ABL genes

mimic the effects of growth factor activation, driving the proliferation

79
Q

The fusion gene is not ____ to CML

A

unique

80
Q

CML accounts for ____ of chronic leukemias

A

1/3

81
Q

CML usually occurs in adults from ______ yrs of age

A

25-60

82
Q

The terminal phase of the disease marked by a relative increase in peripheral blood and bone marrow, and decreased response to treatment is known as ______

A

blast crisis

83
Q

CML has the stage equivalent to an ____, and is of myeloid lineage in _____ and lymphoid lineage in _____

A

acute leukemia
2/3
1/3

84
Q

Initial therapy of CML is with targeted inhibitors of the _______ tyrosine kinase, which induce complete remission in a high % of patients.

A

BCR-ABL

85
Q

_____ maybe performed in CML patients, but risky in older patients

A

Bone marrow transplant

86
Q

Plasma cell disorders result from…

A

clonal expansion of immunoglobulin-secreting cells

87
Q

The secreted immunoglobulin results in increases in _______ and may have adverse effects on ___ and _____ function

A

serum monoclonal protein (M component)

renal, neurologic

88
Q

Multiple myeloma has a proliferating cell which is a _____

A

plasma cell that produces immunoglobulin

89
Q

Only one immunoglobulin type is produce by the neoplastic cells. ____ is IgG, ____ IgA, and remainder it is only ____ or ____ light chain

A

60%
20-25%
kappa or lambda

90
Q

When only light chains are produced, patients can excrete the low MW light chains in the urine is called….

A

Bence Jones Proteinuria

91
Q

______ is often present in multiple myeloma, and _____ may form from the monoclonal protein

A

Hypercalcemia

Amyloid

92
Q

Average age of _____ are suffering from multiple myeloma

A

70 years old

93
Q

Patients with multiple myeloma often present with _____, ______ and _____

A

Bone pain, hypercalcemia, and renal disease

94
Q

As tumor cells proliferate in multiple myeloma, complications with _____, _____, and _____ develop due to destruction of normal marrow by the tumor

A

recurrent infections, anemia, and thrombocytopenia

Pathology EX 2 (3 decks)

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