WBCs and Neoplasia Ch 12 & 40 Flashcards
WBC lines from bone marrow stem cells
Myeloid Line
Lymphoid Line
Myeloid Lines
- Erythroblast
- Megakaryoblast
- Myeloblast
- Monoblast
Erythroblast line differentiates into:
Reticulocytes then Erythrocytes (Red Blood cells)
Megakaryoblast line differentiates into
Megakaryocytes then thrombocytes (Platelets)
Myeloblast line differentiates into
Basophils, Eosinophils, and Neutrophils, Neutrophils into Bands (immature) and Segs
WBC normal range
4000-11000
>11000 = leukocytosis
<4000 = leukopenia
Neutrophils Range
1500-7700
>7700 = neutrophilia
<1500 = neutropenia
Neutrophilia caused by:
- Infection
- Inflammation
- Malignancy
- Smoking
- Stress
- Drugs
- –Glucocorticoids, lithium, epinephrine (think RAAS)
- –Steroids elevate WBC count
Neutropenia caused by:
- deficiency in bone marrow (most common cause)
- viral infection
- Drugs
- –allopurinol, tegretol, NOTABLY chemo drugs
- We use reverse Isolation precautions
Hematologic Neoplasms are
Lymphomas and Leukemias that affect blood, bone, and lymph
Lymphomas Informatics
More common than leukemias
Too many lymphoblasts
Abnormal proliferation of B/T lymphocytes
Typically develop in lymph nodes but can be in any lymph tissue
Starts in immune system and affects lymph nodes/lymphocytes
Severity is based on origin and how quickly it progresses
Leukemias Informatic
Develop in precursors stem cells from bone marrow from a specific blast line
Cells are in immature form, blasts.
• Proliferate but do not turn into mature cells
Cancer of developing WBC within bone marrow
Signs and Symptoms of Lymphomas or Leukemias
Anything related to bone marrow suppression Low RBC (anemia) Low WBC (leukopenia) Low platelets (thrombocytopenia) Enlarged lymph nodes Bruising Fatigue Malaise
Cancerous Neoplasms are what and do what
abnormal mass of tissue that grows in an uncoordinated manner and proliferates
-they compete for space, blood supply, oxygen and nutrition
Cancerous neoplasm looks
distinctly different than normal cells
- non-uniform
- disorganized
- misshapen
- fails to function like normal cells
Diagnosis of cancer relies on what
biopsies and analysis of tissue
Benign Tumors
- well differentiated
- remain localized
- cohesive
- well-demarcated from surrounding tissue
- not invasive
- does not travel
Malignant Tumors
- goes from well-differentiated to poorly differentiated
- invasive and destructive to surrounding tissue
- lacks adhesion to tumor mass and can break away easily (metastasis)
- travels via lymphatic system or bloodstream
Gleason Grading Scale
- the poorer the differentiation, the worse the prognosis
- 1: well differentiated
- 2: moderately differentiated
- 3: poorly differentiated or anaplastic
Differentiation means
how much or how little the tumor tissue looks like the normal tissue it comes from
Differentiation - Alex’s definition
refers to the extent that neoplastic cells resemble normal cells both structurally and functionally
Anaplasia Definition
Lack of differentiation, a term that indicates total cellular disorganization, abnormal cell appearance, and cell dysfunction
TNM Staging
T = Tumor Size N = Lymph Node Involvement M = Metastasis
All cancers originate from:
a change in DNA
Cancer can be ____ or ____ (____)
hereditary or sporadic (acquired during the person’s lifetime)
Two major classes of cancer genes
- Tumor Suppressor Gene (TP53)
- oncogenes
Tumor Suppressor Gene is called
“the guardian of the genome”
Tumor suppressor gene does what
- normally functions to restrain cell growth
- can become defective and lose ability to inhibit cell growth/division and allowing cancer formation
- TP53 gene, most common, controls cell apoptosis
Damaged DNA>Defective TP53 gene =
defective cells still proliferate unchecked and progress to malignancy
Proto-oncogenes
- stimulate and regulate cell movement through the cell cycle
- results in cell growth and proliferation (normal)
- when mutated, the become oncogenes that stimulate constant, unrelenting cell proliferation and cycling
VEGF
vascular endothelial growth factor
VEGF does what
allows metastasized cells to make their own blood vessels to integrate into our blood vessels
Metastasized cells do what
- cells penetrate through basement membrane and move through lymph and blood to other locations
- cells embed where nutrients are (blood supply, oxygen)
- secretes VEGF to develop its own blood vessels to integrate in ours
Paraneoplastic syndrome
-a syndrome that is a consequence of cancer in the body (the signs and symptoms)
Paraneoplastic syndrome is due to what
production of chemical signal molecules, such as hormones or cytokines by tumor cells or an immune response against the tumor
A common Neoplastic Syndrome involves
involves secretion of endocrine hormones unrelated to the cancer tumor
Cancer cachexia characterized by
-a wasting syndrome characterized by weight loss, anorexia, asthenia, and anemia
asthenia
abnormal physical weakness or lack of energy
Cancer cachexia pathogenicity
multifactorial due to complex interaction of tumor and host factors
Cancer cachexia symptoms
weight loss, muscle loss, lack of appetite, fatigue, anemia
Theorized cause of cancer cachexia
originates with cytokines and mediators released by white blood cells attacking the tumor
Tumor cell markers are what
products of cancer cells such as hormones, enzymes, genes, antigens, or antibodies that are found in blood, spinal fluid, or urine
Some Tumor cell markers are called what and why
oncofetal antigens because they are normally found during fetal development
Main Tumor Markers
CEA (carcinoembryonic antigen) -overall tumor marker AFP (alpha-fetoprotein) CA125 -overall tumor marker PSA (prostate surface antigen)
Prostate Surface Antigen is associated with what type of cancer?
Prostate
Overall Tumor Markers
CEA and CA125
CEA is in what kinds of cancers?
- Lung
- Breast
- Pancreas
- Colon
- Ovarian
AFP is a marker specific to what cancers?
Liver Cancer
Testicular Cancer
CA125 is a marker specific to what cancers?
- Lung Cancer
- Breast Cancer
- Pancreas Cancer
- Ovarian Cancer
Cell Cycle Stages in order?
G0, G1, S, G2, M
Leukemoid Reaction
> 50,000 myeloblasts