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Systemic Pathology > White Blood Cell Disorders > Flashcards

White Blood Cell Disorders Flashcards

1
Q

What cells are produced in the lymphoid lineage?

A

Lymphocytes such as B and T cells

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2
Q

Where do B and T cell precursors mature?

A

B cells in the bone marrow and T cells in the thymus

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3
Q

What makes up the primary lymphoid system?

A

The thymus and the bone marrow

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4
Q

Where are mature lymphocytes contained (general)?

A

Secondary or peripheral organs

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5
Q

What 5 organs make up the peripheral lymphoid system?

A

Tonsils, spleen, lymph nodes, adenoids, Peyer’s patches

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6
Q

B cells are for what kind of immunity? How and what do they attack?

A

Humoral immunity, they secrete antibodies that attack extracellular pathogens such as bacteria

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7
Q

T cells are for what kind of immunity? How and what do they attack?

A

For cellular immunity, they attack intracellular pathogens like viruses with cytokines or lysis proteins

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8
Q

The concave side of the lymph node contains?

A

The hilum

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9
Q

The hilum contains?

A

Veins, arteries, and efferent lymphatics

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10
Q

What is on the convex side of the lymph node?

A

The capsule

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11
Q

The capsule contains?

A

Afferent lymphatics

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12
Q

Where is lymph filtered through in a lymph node, what cells are contained here?

A

The follicles, B cells reside here

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13
Q

Where does lymph drain and what cells are contained here?

A

The sinuses and parafollicular cortex which contains T cells

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14
Q

What two cells are contained within germinal centers?

A

centrocytes and centroblasts

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15
Q

Which of these cells is “cleaved”?

A

Centrocytes

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16
Q

What cells are generated by secondary follicles that secrete antibodies?

A

Plasma cells

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17
Q

Where is MALT found?

A

GI, respiratory, and urinary tracts

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18
Q

What 3 things make up MALT?

A

Tonsils in Waldyer’s ring, Peyer’s patches, appendix

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19
Q

What is neutrophilia?

A

When there is excess production of neutrophils

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20
Q

What are the 5 possible causes of neutrophilia?

A

Infection, medication such as growth factors, inflammatory disorders like autoimmune, tumors, and acute tissue necrosis

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21
Q

What is lymphocytosis?

A

There is an abnormally high lymphocyte count

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22
Q

What is the usual cause of lymphocytosis in kids?

A

Bordatella pertusis

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23
Q

What are 3 possible causes of lymphocytosis?

A

Viral infection, chronic immune stimulation from TB for example, lymph proliferative disorders

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24
Q

What type of lymphocyte does pertussis cause to be produced?

A

Small mature ones but a lot of them

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25
Q

Epstein-barr causes the production of what type of lymphocytes?

A

Reactive and atypical. They are large and oddly shaped. See darkening at the periphery known as dutch skirting

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26
Q

HIV and rheumatoid arthritis cause production of what type of lymphocytes

A

Large and granular

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27
Q

What are the most common sites of chronic lymphadenitis?

A

Inguinal and axillary lymph nodes

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28
Q

What is lymphoma?

A

Proliferation of precursors or lymphocytes in tissue mass

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29
Q

What is leukemia?

A

Proliferation of neoplastic cells in the blood or bone marrow

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30
Q

What type of cell makes up the majority of neoplasms?

A

B cells

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31
Q

When do these develop?

A

Before 6 years of age

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32
Q

Describe what happens to the cells?

A

They are arrested in a stage preceding surface expression of immunoglobulin

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33
Q

When is the peak incidence of T cell neoplasms?

A

In adolescence or when the thymus reaches its maximum size

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34
Q

What is a possible emergency caused by T cell neoplasms?

A

Compress the tracheae and large vessels of the neck

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35
Q

What cells are involved in non-Hodgkin lymphoma?

A

Mature B, T, and NK cells

36
Q

What cells are involved in Hodgkin lymphoma?

A

Certain B cells

37
Q

What are the clinical presentations for lymphoma?

A

Weight loss, fever, night sweats, painless lymphadenopathy

38
Q

Where do Hodgkin and non-Hodgkin lymphomas typically turn up?

A

Hodgkin is usually in nodal sites. Non-Hodgkin in extra nodal sites such as the GI tract, skin, or CNS

39
Q

How is immunophenotyping used to diagnose lymphoma?

A

Look at antigen expression, cells that are neoplasm derived will all express the same antigens

40
Q

What is the definitive way to diagnose lymphoma?

A

Excisional lymph node biopsy

41
Q

What hormone should be tested for in lymphoma patients?

A

LDH, high levels mean the tumor is aggressive

42
Q

What viruses should lymphoma patients be tested for?

A

Hepatitis B and C as they may cause lymphoma

43
Q

What is the most common leukemia of adults in the western world?

A

Chronic lymphocytic leukemia

44
Q

CLL is basically the same thing as what type of lymphoma?

A

Small lymphocytic lymphoma

45
Q

What is the difference between the two?

A

Where the cells are, leukemias occur in blood and bone marrow, lymphomas are in the lymphatic system

46
Q

Who is usually afflicted with chronic lymphocytic lymphoma?

A

Males older than 65

47
Q

What are signs of CLL?

A

Usually asymptomatic but might see lymphadenopathy and hepatosplenomegaly

48
Q

What are complications of CLL in relation to other blood cells?

A

Lymphomas produce antibodies that destroy RBCs and platelets so you may see anemia and thrombocytopenia

49
Q

The presence of what two cells indicates CLL?

A

Smudge cells and prolymphocytes

50
Q

What organelle is very prominent in pro lymphocytes?

A

The nucleolus

51
Q

What is a risk of CLL, it may transform into?

A

Higher grade lymphomas such as Richter’s syndrome or diffuse large cell lymphoma

52
Q

Follicular lymphoma occurs in the?

A

Germinal centers

53
Q

Mostly nodal or extra nodal?

A

Most nodal but may occur in the spleen, bone marrow, blood, or Waldeyer’s ring

54
Q

What causes follicular lymphoma?

A

A translocation from chromosome 14 to 18. The BCL-2 gene fuses with IgH locus which leads to over expression of BCL-2. BCL-2 prevents apoptosis

55
Q

Histologically what is diagnostic of follicular lymphoma?

A

Small cleaved lymphoid cells

56
Q

Is follicular lymphoma curable?

A

It is indolent meaning its not an aggressive disease but not exactly curable either

57
Q

Where does Burkitt’s lymphoma originate?

A

Germinal center but its aggressive and will often be found in extra nodal sites

58
Q

Who gets Burkitt’s lymphoma?

A

Children and young adults

59
Q

What does Burkitt’s lymphoma manifest itself as?

A

A large maxillary or mandibular mass in Africa. In the western world a mass in the bowels, ovaries, or retroperitoneum

60
Q

What causes Burkitt’s lymphoma?

A

A translocation of the myc gene from chromosome 8 to 14, possible 2 or 22 as well. Specifically one with antibody activity

61
Q

What does c-myc do?

A

It promotes cell division

62
Q

The presence of what cell indicates Burkitt’s lymphoma?

A

Tingible body macrophages all over the node

63
Q

What is a common cause of Burkitt’s lymphoma in Africa?

A

Epstein-Barr virus

64
Q

Who is extra nodal NK/T cell lymphoma typically seen in?

A

Asian and South American men

65
Q

NK/T cell lymphoma is associated with which virus?

A

The Epstein Barr virus

66
Q

What is a major feature of NK/T cell lymphoma?

A

Angiodestruction

67
Q

Multiple myeloma is a disease of what cell?

A

Plasma cells

68
Q

Who typically gets multiple myeloma?

A

Black men around 70 years old

69
Q

What is overproduced in multiple myeloma? What organ does this affect?

A

Immunoglobulin paraprotein or M protein of the IgG type which may cause kidney damage

70
Q

How does M protein affect RBCs?

A

See rouleaux or stacks of RBCs

71
Q

How does multiple myeloma affect bones?

A

Usually involves bone marrow leading to bone lytic lesions, pathologic fracture and chronic pain

72
Q

Aside from bone what else does multiple myeloma cause?

A

Increased calcium levels, renal dysfunction (2nd most common cause of death), anemia

73
Q

How is multiple myeloma treated?

A

Bone marrow transplant or chemo

74
Q

Who does Hodgkin lymphoma affect?

A

There is a bimodal age distribution, one peak in the 20’s and another between 50-60

75
Q

How does Hodgkin lymphoma present itself?

A

A non-tender, rubbery neck mass

76
Q

What lymph nodes are affected in Hodgkin lymphoma?

A

80% of the time its the cervical lymph nodes, the other 10-20% is the axillary or inguinal

77
Q

What are the B symptoms of Hodgkin lymphoma and what does this indicate?

A

Fever, weight loss, and night sweats. This indicates a more aggressive disease

78
Q

What are the 4 subtypes of classical Hodgkin lymphoma?

A

Nodular sclerosis, mixed cell, lymphocyte depleted, lymphocyte rich

79
Q

Which type of Hodgkin lymphoma is associated with HIV?

A

Lymphocyte depleted

80
Q

What type of cell is often present in lymphoma masses?

A

Reed-Sternberg cell

81
Q

These RS cells express what antigens that are unique?

A

CD15 and CD30

82
Q

What is the precursor to a Reed Sternberg cell?

A

Hodgkin cell

83
Q

What types of cells are present in nodular sclerosis?

A

Inflammatory and RS cells

84
Q

What cells are present in the lymphocyte rich and depleted types?

A

Lymphocytes and RS cells

RS cells and Hodgkin cells

85
Q

What are the complications of Hodgkin lymphoma?

A

They are mostly due to treatment and include other cancers, accelerated atherosclerosis and pulmonary fibrosis

86
Q

What is the typical treatment for Hodgkin lymphoma?

A

Chemotherapy plus ABVD and involved field radiation therapy

87
Q

What is a treatment for recurrent Hodgkin lymphoma?

A

Autologous bone marrow or hematopoietic stem cell transplant

Systemic Pathology (11 decks)

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