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Pathology 2 > White Blood Cells, LN, Spleen And Thymus > Flashcards

White Blood Cells, LN, Spleen And Thymus Flashcards

0
Q

Causes of neutropenia

A

Inadequate or ineffective granulopoeisis

Accelerated removal/destruction

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1
Q

Clinically significant reduction in neutrophils

A

Agranulocytosis

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2
Q

Drugs that cause ineffective granulocytosis
Idiosyncratic and Dose related
Example of dose related

A

Chemotherapeutic drugs

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3
Q

Conditions responsible for accelerated destruction in neutropenia

A

CML
MDS
Vit B12 deficiency

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4
Q

Dry tap on BMA

A

Hypocellular marrow
Neutropenia
Effect of chemotherapeutic drug

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5
Q

WBC count
Leukocytosis
Leukomoid reaction

A

> 11,000

>50,000

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6
Q

Differentiates leukomoid reaction from CML

A

Neutrophil alk phos
Inc leukomoid
Dec CML

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7
Q 
Type of leukocytosis in 
Allergic disorders
Chronic infections
Parasitic infections
Bacterial infections
Viral infections
Myeloproliferative disorders
A 
Eosinophilic
Monocytic
Eosinophilic
Neutrophilic
Lymphocytic
Basophilic
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8
Q

Patches of dilated ER that appear as sky blue cytoplasmic puddles

A

Dohle buddles
Toxic granule
Leukocytosis

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9
Q

Primary follicles of the lymph nodes enlarge to become germinal centers

A

Lymphadenitis

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10
Q

Nodes become swollen gray red and engorged

Abscess formation

A

Acute lymphadenitis

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11
Q

Hard nontender swelling of inguinal and axillary LN

A

Chronic lymphadenitis

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12
Q

Three key forms of chronic lymphadenitis

A

Follicular hyperplasia
Paracortical hyperplasia
Sinus histiocytosis

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13
Q

Composed of zones with proliferating blast like B cell, B cells with cleaved nuclear contours, and phagocytic macrophages containing nuclear debris of B cells

A

Dark zones centroblast
Light zones centrocytes
Tingible body macrophages

Follicular hyperplasia

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14
Q

T cell region encroaches on B cell regions seen in viral infections and drugs

A

EBV
Phenytoin
Paracortical hyperplasia

Chronic lymphadenitis

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15
Q

Increase in the number and size of macrophages that line lymphatic sinusoids
Seen in breast cancer

A

Sinus histiocytosis

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16
Q

Types of neoplastic WBCs

A

Lymhoid
Myeloid
Histiocytoses

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17
Q

Leukemia

Lymphoma

A

Neoplasms in BM. Tumor cells in blood

Tumor masses

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18
Q

Acute leukemia

Chronic leukemia

A

Blasts, pedia, short and drastic course

Mature, adult, long but less devastating course

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19
Q

85% of immature lymphoblasts found in Acute Lymphoblastic Leukemia is

A

B ALLs

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20
Q

Most common cancer of children

A

ALL

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21
Q

Hypercellular marrow packed with lymphoblasts with more condensed chromatin, less conspicuous nucleoli and smaller cytoplasm that lacks granules

A

ALL

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22
Q

Bone marrow involvement in childhood

Mediastinal mass in adolescent males

A

ALL

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23
Q

Leukemia most responsive to chemotherapy

A

ALL

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24
Q

Sanctuary sites of ALL

A

CNS

Testes

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25
Q

T (12,21)

A

ALL

Better prognosis

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26
Q

DOC for ALL
WOF
Vehicle for delivery to sanctuary sites

A

Asparaginase
Pancreatitis
Ommaya reservoir

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27
Q

Hypercellular marrow packed with GREATER THAN 20% myeloblasts with less condensed chromatin, more conspicuous nucleoli and purplish cytoplasm

A

AML

Blasts are absent from blood

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28
Q

Distinct needle like azurophilic granules

A

Auer rods

APML

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29
Q

Pancytopenia

Spontaneous mucosal and cutaneous bleedong

A

AML

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30
Q

Leukemia with highest incidence of DIC

A

APML

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31
Q

APML translocation

A

T (15,17)

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32
Q

Only human cancer treated by vitamins

All trans retinoic acid

A

APML

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33
Q

Philadelphia chromosome

T (9,22)

A

CML

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34
Q

Hypercellular marrow with LESS THAN 10% myeloblasts
Very low alkaline phosphatase
WBC>100,000

A

CML

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35
Q

Scattered macrophages with abundant wrinkled green blue cytoplasm

A

CML

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36
Q

WHO criteria for accelerated phase

A 
10-19% myeloblasts
>20% basophils
PC1,000,000 unresponsive to tx
Cytogenetic evolution
Inc splenomegaly or WBC count
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37
Q

Final phase of evolution of CML wherein myeloblasts or lymphoblasts are greater than 20%

A

Blast crisis

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38
Q

Development of solid focus of leukemia outside BM

A

Chloroma
Blast crisis
CML

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39
Q

DOC for CML

WOF

A

Imatinib (Gleevec)

Fluid retention, CHF

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40
Q

Peripheral blood leukocytosis
Absolute lymphocyte count
>4000
<4000

A

CLL

SLL

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41
Q

Most common leukemia of adults and elderly

A

CLL

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42
Q

LN infiltrates of small lymphocytes
Larger activated lymphocytes that gather in loose aggregates
Small lymphocytes disrupted in the process of making smears
Nucleated red blood cells

A

Proliferation centers
Smudge or basket cells

CLL

43
Q

CLL complication

Transformation into diffuse large B cell lymphoma

A

Richter syndrome

44
Q

Mature B cell tumor in the elderly with cells that have hairlike projections stained with TRAP

A

Hairy cell leukemia

45
Q

Leukemia with dry tap on BMA

A

Hairy cell leukemia

46
Q

Age brackets on leukemia

A

0-14 ALL
15-39 AML
40-59 AML CML
>60 CLL

47
Q

Large cells with multiple nuclei or single nuclei with multiple nuclear lobes
Owl’s eyes

A

Reed Sternberg cell

Hodgkin’s lymphoma

48
Q

Lymphoma that has multiple peripheral nodes mostly mesenteric
Extranodal
20-40 yo

49
Q

Lymphoma involving mostly chest LN with contiguous spread and frequent constitutional ssx
Bimodal
EBV
Good prognosis

50
Q

Chemotherapy regimen
HL
NHL

51
Q

Increased _ roughly correlates with good prognosis in HL

A

Lymphocyte to RS ratio

52
Q

Lacunar variant RS cells

Deposition of collagen bands

A

Nodular sclerosis

HL

53
Q

Plentiful RS cells admixed with lymphocytes

EBV

A

Mixed cellularity

HL

54
Q

Mononuclear variants of RS cells

A

Lymphocyte rich

HL

55
Q

Worst prognosis

Abundance of RS cells

A

Lymphocyte depleted

HL

56
Q

Popcorn cells

A

Lymphocyte predominant

HL

57
Q

T or F

Most NHLs are T cell origin

58
Q

T (14,18)

A

Follicular lymphoma

NHL

59
Q

Most common form of indolent NHL

Centrocyte morphology

A

Follicular lymphoma

60
Q

Most common form of NHL

Diffuse pattern of growth

A

Diffuse large B cell lymphoma

61
Q

Rapidly enlarging mass at a nodal or extranodal site

Massive hepatosplenomegaly

A

Diffuse large B cell lymphoma

62
Q

T (8,14)

A

Burkitt’s lymphoma

NHL

63
Q

High mitotic index
Numerous apoptotic cells
Nuclear remnants phagocytosed by interspersed macrophages with abundant clear cytoplasm

A

Burkitt cells with lipid droplets
Starry sky pattern

Burkitt’s lymphoma
NHL

64
Q

Most tumors manifest at extranodal sites

A

Burkitt’s lymphoma

NHL

65
Q

T (11,14)

A

Mantle cell lymphoma

66
Q

High cyclin D1
Homogenous production of small lymphocytes
No centroblasts
No proliferation centers

A

Mantle cell lymphoma

NHL

67
Q

Painless lymphadenopathy

A

Mantle cell lymphoma

NHL

68
Q

Painless lymphadenopathy

Painful on alcohol intake

69
Q

Neoplasm of CD4 T crlls
HTLV-1
Cloverleaf or flower cells

A

Adult T cell lymphoma

NHL

70
Q

Chronic proliferative Cutaneous T cell lymphoma

A

Mycosis fungoides

71
Q

Aggressive nodular eruptive variant

A

Mycosis fungoides d’emblee

72
Q

Diffuse erythema and scaling of the entire body surface

A

Sezary surface

Cutaneous T cell lymphoma

73
Q

Cerebriform nuclei

CD4 forming bandlike aggregates

A

Sezary Lutner cells

Cutaneous T cell lymphoma

74
Q

Invade epidermis as single cells and small clusters

A

Pautrier microabscesses

Cutaneous T cell lymphoma

75
Q

Neoplastic plasma cells synthesize excess light or heavy chains excreted in the urine

A

Bence Jones proteins

76
Q

Cytokine associated with plasma cell neoplasms

77
Q

HyperCalcemia
Renal insufficiency
Anemia
Bone lytic lesions and Bone pain

A

Multiple myeloma

78
Q

Destructive plasma cell tumors involving axial skeleton with lytic lesions and punched out defects

A

Plasmacytoma

Multiple myeloma

79
Q

Multiple nuclei
Prominent nucleoli
Cytoplasmic droplets containing Ig

A

Bizarre multinucleated cells

Multiple myeloma

80
Q

Fiery red cytoplasm

A

Flame cells

Multiple myeloma

81
Q

Multiple grapelike cytoplasmic droplets

A

Mott cells

Multiple myeloma

82
Q

Pink globular cytoplasmic inclusions

A

Russell bodies

Multiple myeloma

83
Q

Blue globular nuclear inclusions

A

Dutcher bodies

Multiple myeloma

84
Q

M proteins cause RBCs to stack

A

Rouleaux conformation

Multiple myeloma

85
Q

Clonal stem cell disorders with maturation defects

High risk of AML transformationw

A

Myelodysplastic syndrome

86
Q

Erythroblasts with iron laden mitochondria

Nuclear budding abnormalities

A

Ringed sideroblasts

MDS

87
Q

Neutrophils with 2 nuclear lobes

A

Pseudo Pelger Huet cells

MDS

88
Q

Megakaryocytes with single nuclear lobes or multiple separate nuclei

A

Pawn ball megakaryocytes

MDS

89
Q

Serum protein electrophoresis in Multiple myeloma

A

Monoclonal M protein spike

90
Q

Types of polycythemia

Dec plasma volume

A

Relative polycythemia

91
Q

Types of polycythemia
Inc plasma volume
Dec EPO

A

Polycythemia vera

92
Q

Types of polycythemia
Inc plasma volume
Inc EPO
Dec O2 Sat

A

Appropriate absolute

93
Q

Types of polycythemia
Inc plasma volume
Inc EPO
Inc O2 Sat

A

Inappropriate absolute

Ectopic EPO production from renal cell ca, wilms and HCC

94
Q

HCT>52%

A

Polycythemia vera

95
Q

Hypercellular marrow with inc red cell progenitors, inc reticulin fibers and some residual fat

A

Polycythemia vera

96
Q

Extensive marrow fibrosis

Inc extramedullary hematopoiesis

A

Spent phase

Polycythemia vera

97
Q

Marked thrombocytosis
Giant platelets
Erythromelalgia

A

Essential thrombocytosis

98
Q

Fibrotic obliteration of marrow space
Leukoerythroblastosis
Teardrop cells or dacrocytes
Normocytic normochromic anemia

A

Primary myelofibrosis

99
Q

Proliferative disorder of dendritic cells

A

Langerhans Cell Histiocytosis

100
Q

Pentalaminar tubules with dilated terminal end (tennis racket) containing LANGERIN protein

A

Birbeck granules

Langerhans cell histiocytosis

101
Q

Small yellow brown or rust colored foci in the spleen due to congestion

A

Gandy Gamna nodules

Congestive splenomegaly

102
Q

Jigsaw puzzle shaped masses

Swirling pattern of spindle shaped cells

103
Q

Myasthenia gravis

Associated cancer

104
Q

Paraneoplastic syndrome of thymoma

A

Pure red cell aplasia

Pathology 2 (20 decks)

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