White Blood Cells, LN, Spleen And Thymus Flashcards
Causes of neutropenia
Inadequate or ineffective granulopoeisis
Accelerated removal/destruction
Clinically significant reduction in neutrophils
Agranulocytosis
Drugs that cause ineffective granulocytosis
Idiosyncratic and Dose related
Example of dose related
Chemotherapeutic drugs
Conditions responsible for accelerated destruction in neutropenia
CML
MDS
Vit B12 deficiency
Dry tap on BMA
Hypocellular marrow
Neutropenia
Effect of chemotherapeutic drug
WBC count
Leukocytosis
Leukomoid reaction
> 11,000
>50,000
Differentiates leukomoid reaction from CML
Neutrophil alk phos
Inc leukomoid
Dec CML
Type of leukocytosis in Allergic disorders Chronic infections Parasitic infections Bacterial infections Viral infections Myeloproliferative disorders
Eosinophilic Monocytic Eosinophilic Neutrophilic Lymphocytic Basophilic
Patches of dilated ER that appear as sky blue cytoplasmic puddles
Dohle buddles
Toxic granule
Leukocytosis
Primary follicles of the lymph nodes enlarge to become germinal centers
Lymphadenitis
Nodes become swollen gray red and engorged
Abscess formation
Acute lymphadenitis
Hard nontender swelling of inguinal and axillary LN
Chronic lymphadenitis
Three key forms of chronic lymphadenitis
Follicular hyperplasia
Paracortical hyperplasia
Sinus histiocytosis
Composed of zones with proliferating blast like B cell, B cells with cleaved nuclear contours, and phagocytic macrophages containing nuclear debris of B cells
Dark zones centroblast
Light zones centrocytes
Tingible body macrophages
Follicular hyperplasia
T cell region encroaches on B cell regions seen in viral infections and drugs
EBV
Phenytoin
Paracortical hyperplasia
Chronic lymphadenitis
Increase in the number and size of macrophages that line lymphatic sinusoids
Seen in breast cancer
Sinus histiocytosis
Types of neoplastic WBCs
Lymhoid
Myeloid
Histiocytoses
Leukemia
Lymphoma
Neoplasms in BM. Tumor cells in blood
Tumor masses
Acute leukemia
Chronic leukemia
Blasts, pedia, short and drastic course
Mature, adult, long but less devastating course
85% of immature lymphoblasts found in Acute Lymphoblastic Leukemia is
B ALLs
Most common cancer of children
ALL
Hypercellular marrow packed with lymphoblasts with more condensed chromatin, less conspicuous nucleoli and smaller cytoplasm that lacks granules
ALL
Bone marrow involvement in childhood
Mediastinal mass in adolescent males
ALL
Leukemia most responsive to chemotherapy
ALL
Sanctuary sites of ALL
CNS
Testes
T (12,21)
ALL
Better prognosis
DOC for ALL
WOF
Vehicle for delivery to sanctuary sites
Asparaginase
Pancreatitis
Ommaya reservoir
Hypercellular marrow packed with GREATER THAN 20% myeloblasts with less condensed chromatin, more conspicuous nucleoli and purplish cytoplasm
AML
Blasts are absent from blood
Distinct needle like azurophilic granules
Auer rods
APML
Pancytopenia
Spontaneous mucosal and cutaneous bleedong
AML
Leukemia with highest incidence of DIC
APML
APML translocation
T (15,17)
Only human cancer treated by vitamins
All trans retinoic acid
APML
Philadelphia chromosome
T (9,22)
CML
Hypercellular marrow with LESS THAN 10% myeloblasts
Very low alkaline phosphatase
WBC>100,000
CML
Scattered macrophages with abundant wrinkled green blue cytoplasm
CML
WHO criteria for accelerated phase
10-19% myeloblasts >20% basophils PC1,000,000 unresponsive to tx Cytogenetic evolution Inc splenomegaly or WBC count
Final phase of evolution of CML wherein myeloblasts or lymphoblasts are greater than 20%
Blast crisis
Development of solid focus of leukemia outside BM
Chloroma
Blast crisis
CML
DOC for CML
WOF
Imatinib (Gleevec)
Fluid retention, CHF
Peripheral blood leukocytosis
Absolute lymphocyte count
>4000
<4000
CLL
SLL
Most common leukemia of adults and elderly
CLL