WBC Part 5 Flashcards
what is a Reed-Sternberg cell
the neoplastic cell seen in Hodgkin lymphoma
makes up the minority of the cell population
how does hodgkin lymphoma spread?
contiguous fashion
most cells that make up Hodgkins lymphoma are what and where do they come from
reactive cells recruited by cytokines released by the Reed-Sternberg cells
where are Reed-Sternberg cells derived from
germinal center or post germinal center B cells
all Reed-Sternberg cells have identical what and what does this show
rearranged Ig genes that show evidence of somatic hypermutation
what is the size of the Reed-Sternberg cell in relation to a RBC
RS is 15-45 micrometers
RBC is 6-7 micrometers
what is the classical appearance of the nucleus of a Reed-Sternberg cell
bi-lobed to multi-lobed nucleus
“Owl Eyes”
What flow cytometry results would one expect to see in Hodgkin Lymphoma due to classic Reed-Sternberg cells
CD15+
CD30+
negative for CD45, B and T cell antigens
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)
CD45+
Bcl-6+
B-cell antigen +
Negative for CD15 and CD30
what is Ann Arbor Classification
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”
what age(s) is Hodgkin lymphoma common
bimodal age
most patients young, second peak after 55
what is a common hodgkin lymphoma presentation
mediastinal adenopathy w/ enlarges mediastinum
painless localized or generalized adenopathy
+/- B symtoms
CD15+
CD30+
negative for CD45, B and T cell antigens
Hodgkin Lymphoma due to classic Reed-Sternberg cells
what is the most common hodgkin lymphoma?
Nodular Sclerosis Hodgkin Lymphoma (NSHL)
what is seen in Nodular Sclerosis Hodgkin Lymphoma (NSHL)
cervical, supraclavicular, and mediastinal adenopathy
lacunar cells (RS variant) and bands of polarizing fibrosis
rare EBV association
what is seen in Mixed Cellularity Hodgkin Lymphoma (MCHL)
second most common EBV associated older age, B symptoms diffuse effacement by heterogeneous cellular infiltrate classic Reed-Sternberg cells plentiful
Lymphocyte rich Hodgkin Lymphoma (LRHL) is characterized by what?
EBV association
diffuse effacement with age modularity if residual follicles are present
many mononuclear and classic RS cells
lymphocytes make up background
Lymphocyte dDepleted Hodgkin Lymphoma(LDHL) is characterized by what
numerous RS cells and few background lymphocytes
older patients, HIV+ patients
EBV associated
Nodular Lymphocyte Predominant Hodgkin lymphoma (NLPHL) is characterized by what
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
what leukopenia (define)
low WBC count
Leukocytosis (define)
high WBC count
how does one calculate absolute count of something (say neutrophils)
WBC x % cells (Ex: WBC x % neutrophils)
in lymphopenia CBC and smear show what
decreased lymphocytes
what some causes of lymphopenia
drugs: chemotherapeutic or glucocorticoids systemic illness congenital immunodeficiency disease autoimmune (SLE) malnutrition
in neutropenia what would one see in CBC and smear
decreased neutrophils
in neutropenia due to inadequate production what would one see in the bone marrow
hypocellularity because of loss of granulocytic precursors
in neutropenia due to inadequate production can be caused by what
stem cell suppression (all lines affected)
granulocytic precursor suppression
Inherited condition with gene defects
in neutropenia due to inadequate production because of stem cell suppression occurs in what conditions
aplastic anemia
marrow infiltrative processes
in neutropenia due to inadequate production because of granulocytic precursor suppression occurs in what conditions
infection
drugs (shame, phenothiazines, thiouracil, sulfonamides, aminopyrine)
large Granulocytic Lymphocytic Leukemia (LGLL)
in neutropenia due to inadequate production because of inherited condition with gene defects occurs in what conditions
Kostmann Syndrome
in neutropenia due to ineffective production what would one see in the bone marrow
hypercellularity- make a lot that die before entering blood
neutropenia due to ineffective production is caused by what
B12 deficiency
Folate deficiency
Myelodysplastic syndrome
in neutropenia due to accelerated removal/destruction what would one see in the bone marrow
hypercellular- trying to compensate for peripheral loss
neutropenia due to accelerated removal/destruction can be caused how?
immune mediated
splenic sequestration
increased peripheral utilization
neutropenia due to accelerated removal/destruction because of immune mediated paths occurs in what conditions
drugs (aminopyrine, thiouracil, sulfonamides)
associated with autoimmune disorder (SLE)
idiopathic
neutropenia due to accelerated removal/destruction because of splenic sequestration occurs in what conditions
enlarged spleen- increased destruction
neutropenia due to accelerated removal/destruction because of increased peripheral utilization occurs in what conditions
overwhelming infections
the main cause of neutropenia in neonates and children is what
infection
the main cause of neutropenia in adults is what
drugs
neutropenia may be treated with what
G-CSF
in a patient with neutropenia and an infection what would one see
mucosal ulcers (often oropharynx)
severe invasive infections of bladder, kidney, and lungs
sites of infections show numerous organisms with little host leukocytic response
