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WBC Disorders > WBC Part 5 > Flashcards

WBC Part 5 Flashcards

1
Q

what is a Reed-Sternberg cell

A

the neoplastic cell seen in Hodgkin lymphoma

makes up the minority of the cell population

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2
Q

how does hodgkin lymphoma spread?

A

contiguous fashion

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3
Q

most cells that make up Hodgkins lymphoma are what and where do they come from

A

reactive cells recruited by cytokines released by the Reed-Sternberg cells

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4
Q

where are Reed-Sternberg cells derived from

A

germinal center or post germinal center B cells

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5
Q

all Reed-Sternberg cells have identical what and what does this show

A

rearranged Ig genes that show evidence of somatic hypermutation

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6
Q

what is the size of the Reed-Sternberg cell in relation to a RBC

A

RS is 15-45 micrometers

RBC is 6-7 micrometers

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7
Q

what is the classical appearance of the nucleus of a Reed-Sternberg cell

A

bi-lobed to multi-lobed nucleus

“Owl Eyes”

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8
Q

What flow cytometry results would one expect to see in Hodgkin Lymphoma due to classic Reed-Sternberg cells

A

CD15+
CD30+
negative for CD45, B and T cell antigens

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9
Q

What flow cytometry results would one expect to see in NodularLymphocyte predominate hodgkin lymphoma (NLPHL) due to it’s Reed-Sternberg cells (L&H variant that looks like popcorn)

A

CD45+
Bcl-6+
B-cell antigen +
Negative for CD15 and CD30

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10
Q

what is Ann Arbor Classification

A

staging (most important prognostic factor)
based on spread of the Hodgkin lymphoma
on a scale of I-IV (III is when it crosses midline)
A or B if w/ or w/o “B-symptoms”

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11
Q

what age(s) is Hodgkin lymphoma common

A

bimodal age

most patients young, second peak after 55

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12
Q

what is a common hodgkin lymphoma presentation

A

mediastinal adenopathy w/ enlarges mediastinum
painless localized or generalized adenopathy
+/- B symtoms

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13
Q

CD15+
CD30+
negative for CD45, B and T cell antigens

A

Hodgkin Lymphoma due to classic Reed-Sternberg cells

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14
Q

what is the most common hodgkin lymphoma?

A

Nodular Sclerosis Hodgkin Lymphoma (NSHL)

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15
Q

what is seen in Nodular Sclerosis Hodgkin Lymphoma (NSHL)

A

cervical, supraclavicular, and mediastinal adenopathy
lacunar cells (RS variant) and bands of polarizing fibrosis
rare EBV association

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16
Q

what is seen in Mixed Cellularity Hodgkin Lymphoma (MCHL)

A 
second most common
EBV associated
older age, B symptoms
diffuse effacement by heterogeneous cellular infiltrate
classic Reed-Sternberg cells plentiful
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17
Q

Lymphocyte rich Hodgkin Lymphoma (LRHL) is characterized by what?

A

EBV association
diffuse effacement with age modularity if residual follicles are present
many mononuclear and classic RS cells
lymphocytes make up background

18
Q

Lymphocyte dDepleted Hodgkin Lymphoma(LDHL) is characterized by what

A

numerous RS cells and few background lymphocytes
older patients, HIV+ patients
EBV associated

19
Q

Nodular Lymphocyte Predominant Hodgkin lymphoma (NLPHL) is characterized by what

A 
effacement by small lymphs and some benign histiocytes
L&H variant RS cell (popcorn)
no EBV association
can transform to DLBCL
cervical or axillary adenopathy
20
Q

what leukopenia (define)

A

low WBC count

21
Q

Leukocytosis (define)

A

high WBC count

22
Q

how does one calculate absolute count of something (say neutrophils)

A

WBC x % cells (Ex: WBC x % neutrophils)

23
Q

in lymphopenia CBC and smear show what

A

decreased lymphocytes

24
Q

what some causes of lymphopenia

A 
drugs: chemotherapeutic or glucocorticoids
systemic illness
congenital immunodeficiency disease
autoimmune (SLE)
malnutrition
25
Q

in neutropenia what would one see in CBC and smear

A

decreased neutrophils

26
Q

in neutropenia due to inadequate production what would one see in the bone marrow

A

hypocellularity because of loss of granulocytic precursors

27
Q

in neutropenia due to inadequate production can be caused by what

A

stem cell suppression (all lines affected)
granulocytic precursor suppression
Inherited condition with gene defects

28
Q

in neutropenia due to inadequate production because of stem cell suppression occurs in what conditions

A

aplastic anemia

marrow infiltrative processes

29
Q

in neutropenia due to inadequate production because of granulocytic precursor suppression occurs in what conditions

A

infection
drugs (shame, phenothiazines, thiouracil, sulfonamides, aminopyrine)
large Granulocytic Lymphocytic Leukemia (LGLL)

30
Q

in neutropenia due to inadequate production because of inherited condition with gene defects occurs in what conditions

A

Kostmann Syndrome

31
Q

in neutropenia due to ineffective production what would one see in the bone marrow

A

hypercellularity- make a lot that die before entering blood

32
Q

neutropenia due to ineffective production is caused by what

A

B12 deficiency
Folate deficiency
Myelodysplastic syndrome

33
Q

in neutropenia due to accelerated removal/destruction what would one see in the bone marrow

A

hypercellular- trying to compensate for peripheral loss

34
Q

neutropenia due to accelerated removal/destruction can be caused how?

A

immune mediated
splenic sequestration
increased peripheral utilization

35
Q

neutropenia due to accelerated removal/destruction because of immune mediated paths occurs in what conditions

A

drugs (aminopyrine, thiouracil, sulfonamides)
associated with autoimmune disorder (SLE)
idiopathic

36
Q

neutropenia due to accelerated removal/destruction because of splenic sequestration occurs in what conditions

A

enlarged spleen- increased destruction

37
Q

neutropenia due to accelerated removal/destruction because of increased peripheral utilization occurs in what conditions

A

overwhelming infections

38
Q

the main cause of neutropenia in neonates and children is what

A

infection

39
Q

the main cause of neutropenia in adults is what

A

drugs

40
Q

neutropenia may be treated with what

A

G-CSF

41
Q

in a patient with neutropenia and an infection what would one see

A

mucosal ulcers (often oropharynx)
severe invasive infections of bladder, kidney, and lungs
sites of infections show numerous organisms with little host leukocytic response

WBC Disorders (8 decks)

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