WBC Part 6 Flashcards
in lymphocytosis what would one expect CBC and smear to show
increased lymphocytes
Lymphocytosis can be due to what two morphologies
reactive and non-reactive
reactive lymphocytosis occurs in what conditions
acute viral illness (EBV, CMV)
drug reactions
non-reactive lymphocytosis occurs in what conditions
transient stress (MI, seizure, trauma)
whooping cough (Bordetella pertussis)
persistent polyclonal B-cell lymphocytosis (female smokers)
neoplastic (ALL, CLL)
infectious mononucleosis infects where
oropharynx (pharyngitis), tonsils, and adenoids
liver
B cells
what kind of lymphocytes are seen in the blood in response to infectious mononucleosis
virus specific CD8+ T cells (Atypical lymphocytes)
the mono spot test detects what
IgM antibodies that cross react with sheep or horse red blood cells (heterophile antibodies)
what are the normal pools of neutrophils
marrow pool (BM)-75% marginating pool (blood vessels)- cells adherent to blood vessel walls circulating pool (blood)- same size as marginating pool
demargination of neutrophils occurs after how long and due to what
minutes
due to epinephrine, acute stress, exercise
release of neutrophils from marrow pool occurs after how long and due to what
hours
due to steroids, infection/inflammation
increased bone marrow production of neutrophils occurs after how long and due to what
days
due to sustained inflammation, G-CSF (secreting tumors or therapy), lithium
splenomegaly occurs in mono why?
T-cell hyperplasia in periarterial lymphatic sheath (PALS)
what are some toxic changes that occur in neutrophils
toxic granulation Dohle bodies (endoplasmic reticulum) Vacuolization of the cytoplasm Left Shift LAP Test
what is a left shift seen in neutrophils
presence of granulocytic precursors in the blood
eosinophilia due to reactive processes occurs in what conditions
allergic response
medication/drug hypersensitivity
connective tissue disease
parasitic infection
eosinophilia due to neoplastic processes occurs in what conditions
T-Cell LPD
Hodgkin lymphoma
Hypereosinophilic syndrome
chronic eosinophilic leukemia
monocytosis occurs due to what
chronic infection or inflammatory disorders
neoplasms
when one notices lymphocytosis in a patient what should one suspect
acute viral states
neoplastic (ALL, CLL)
when one notices neutrophilia with left shift what should be suspected
leukemoid reaction (acute bacterial infections) neoplastic process (CML or other myeloproliferative neoplasm)
the characteristics of the neoplasm of abnormal hematopoiesis depend on
the stage at which the cell is when it escaped from normal control
the effect this stage has on differentiation
divisions between entities can sometimes be blurred
common myeloid stem cell and common lymphoid stem cells are examples of what kind of stem cells
multipotent stem cells
what cells cannot self-renew, but actively differentiate
morphologically recognizable precursors (blasts)
Acute Myeloid Leukemia (AML) can be due to what
acquired genetic alteration causing impaired maturation of leukemic cells
mutations of genes involved in signal transaction allow for survival and proliferation of neoplastic clone
what acquired genetic alteration causing impaired maturation of leukemic cells are seen in AML
RUNX1, RARA, NPM1
what mutations of genes involved in signal transaction allow for survival and proliferation of neoplastic clone in AML
FLT3, JAK2, KIT
over 20% blasts in peripheral blood or bone marrow is seen in what
Acute Myeloid Leukemia (AML)
myeloblasts are usually characterized by positive cytoplasmic staining for what
myeloperoxidase (MPO)
what are Auer Rods
crystal aggregates of MPO (azurophilic granules)
Acute Monocytic Leukemia is due to proliferation of what and lacks what
proliferation of monoblasts
usually lack MPO
Acute Myeloid Leukemia due to myeloblast proliferation has what morphology
Auer rods MPO + CD34+ CD13+ CD33+ NSE-
Acute Myeloid Leukemia due to monoblast proliferation has what morphology
CD11b+ CD14+ HLADR+ NSE + MPO -
Acute Promyelocytic Leukemia (APL) is characterized by what
t(15;17) which involved retinoid acid receptor (RAR)
Auer rods MPO + CD34+ CD13+ CD33+ NSE-
Acute Myeloid Leukemia due to myeloblast proliferation
CD11b+ CD14+ HLADR+ NSE + MPO -
Acute Monocytic Leukemia
Acute Myeloid Leukemia due to monoblast proliferation
Acute Monocytic leukemia tends to infiltrate what part of the body
gums
In Acute Promyelocytic Leukemia (APL) what is the chimeric protein and what does it block
PML/RARA
blocks maturation and promyelocytes (blasts) build up
how is Acute Promyelocytic Leukemia (APL) treated
all trans retinoic acid (ATRA) which is a vitamin A analog
the FAB (French American British) classification of Acute Myeloid Leukemias is based on what
morphology, differentiation, phenotype
M0-M7
M3 is Acute Promyelocytic Leukemia (APL)
Auer rods are diagnostic for what
Acute Myeloid Leukemia
Acute Promyelocytic Leukemia (APL) is associated with what
disseminated intravascular coagulation (DIC) due to release of procoagulants and fibrinolytic by the neoplastic cells
t(15;17) is what and associated with what
PML/RARA fusion protein
Acute Promyelocytic Leukemia (APL)
AML with myelodysplasia related changes has what kind of prognosis
poor
a tissue mass of blasts is known as what
Granulocytic sarcoma
