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clinical pathology > 15 - lymphoid and myeloid neoplasms > Flashcards

15 - lymphoid and myeloid neoplasms Flashcards

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1
Q

what are myeloid neoplasms

A

neoplasms of all non-lymphoid blood cells
—– arise from bone marrow

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2
Q

what are lymphoid neoplasms

A

neoplasms of lymphocyte origin, including plasma cells
— bone marrow (leukemia, multiple myeloma)
— lymph nodes, spleen, thymus
— tissue lymphoid populations, such as GI or skin

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3
Q

what does the term leukemia mean

A

the term leukemia refers to neoplastic cells in blood and/or marrow

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4
Q

where do true leukemias arise from

A

from the marrow

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5
Q

what is the difference between acute vs chronic leukemias

A
  • acute have many blast cells in marrow
  • chronic progresses more slowly
  • myeloid neoplasms much more difficult to treat
  • acute myeloid leukemia (AML) worst leukemia, chronic lymphocytic leukemia (CLL) best leukemia
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6
Q

what develops in the bone marrow but it not called leukemia

A

multiple myeloma

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7
Q

what method would you use to get a panel of antibodies (especially for lymphoid cells)

A

immunohistochemistry and flow cytometry

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8
Q

what are some cytochemical stains for myeloid cells

A

myeloperoxidase
nonspecific esterase

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9
Q

what is lymphoma

A

solid tumors that develop outside the marrow

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10
Q

what is lymphoid leukemia

A

refers to neoplasia in marrow and/or blood not associated with solid tumors
– acute lymphoblastic leukemia (ALL)
– chronic lymphocytic leukemia (CLL)

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11
Q

lymphoma with leukemia or lymphosarcoma cell leukemia

A

?

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12
Q

what can help differentiate lymphoma from leukemia

A

cluster of differentiation 34 (CD34) surface marker may help differentiate ALL (often positive) from lymphoma with leukemia (often negative)

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13
Q

what are 2 types of plasma cell tumors and where are they located

A
  • multiple myeloma develops within marrow

plasmacytoma develops outside the marrow

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14
Q

lymphoid markers

A
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15
Q

what is PCR for antigen receptor rearrangements (PARR)

A

It is an assay that assesses clonality in a population of lymphoid cells

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16
Q

what does PARR do and what it is used for

A

– amplifies DNA encoding the variable regions of B and T cell receptors
– differentiate inflammatory/reactive (PARR negative) vs. neoplastic (PARR positive) lymphocyte populations

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17
Q

when can you get false positives in PARR tests

A

false positive tests in small number of cases with ehrlichia canis, rickettsia rickettsia and borrelia burgdorferi in dogs

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18
Q

what are the reasons for marrow biopsy - ??

A

unexplained leukopenia and thrombocytopenia

rare abnormal “lymphocytes” in blood

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19
Q

what is present in bone marrow with acute lymphoblastic leukemia

A

neoplastic prolymphocytes or lymphoblasts present in bone marrow
—- differentiate from other blast cells using special stains and or CD surface markers

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20
Q

what are the types of ALL in cats

A

generally T-lymphocyte type (most FelV positive, some FIV positive)

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21
Q

what are the types of ALL in dogs

A

may be T-lymphocyte, B-lymphocyte, NK cell or null cell types

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22
Q

what is the difference between ALL lymphocytes and reactive lymphocytes in dogs blood

A

add photo

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23
Q

what is a PARR test used for

A

to differentiate reactive vs neoplastic lymphocytes

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24
Q

When is chronic lymphocytic leukemia primarily seen

A

in old animals

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25
what is seen with the lymphocytes in chronic lymphocytic leukemia
lymphocytosis involving normal-appearing lymphocytes
26
in chronic lymphocytic leukemia what lymphocyte type is more common (also what subset predominated in dogs vs cats)
T-lymphocyte type is more common than B lymphocyte type in dogs and cats - dogs: cytotoxic T lymphocyte (CD8+) subset predominates with granular lymphocyte morphology - cats: Th lymphocyte (CD4+) subset predominates
27
what type for CLL develops outside the marrow (ex in the spleen) with secondary involvement of the marrow
T-lymphocyte type CLL
28
B-type CLL in dogs have what accompanying it
monoclonal hyperglobulinemia
29
what are some classifications of lymphomas
add photo
30
in dogs with lymphoma when will you see neoplastic lymphocytes in the blood and in the marrow
neoplastic lymphocytes recognized in blood in 10%-20% of dogs with lymphoma neoplastic lymphocytes may be recognized in bone marrow at times when not appreciated in blood
31
what kind of lymphoma predominates canine cases
multicentric, intermediate to high grade lymphoma accounts for 80% of canine cases - often present with painless peripheral lymphadenopathy - most commonly (60-70%) diffuse large B-cell lymphomas - high-grade peripheral T-cell lymphomas have more variably- sized calls with irregular nuclei
32
what are some other forms of lymphoma
involving the thymus: CD3+, CD4-, CD8- skin: usually T-cell digestive system: usually T-cell liver/spleen: T-cell nervous system and other organs
33
what is seen in 20-40% of T-cell lymphomas
hypercalcemia
34
how does lymphoma generally present in felines
cats are generally ill with presented to the vet - superficial lymphadenopathy is uncommon - many tumor involve deep extranodal sites, especially in the gastrointestinal and upper resp tracks - tend to contain more heterogenous lymphoid populations than typically seen in dogs
35
what lymphoma predominated prior to widespread FeLV testing and vaccination
- mediastinal and multicentric forms - primarily in younger cats - most FeLV pos
36
what lymphoma predominated after widespread FeLV testing and vaccination
Alimentary form predominated (both B and T cells) - primarily in older cats - most FeLV neg
37
T/F FIV positive cats are 5x more likely to develop lymphoma than FIV and FeLV negative cats
true
38
what enzootic form can cause bovine lymphoma
- chronic bovine leukemia virus (BLV) infections ------ in mature cattle (peak 5-8 yrs old) ------ B cell type - multicentric form
39
In addition to lymphoma what does BLV also cause
BLV also causes a persistent benign lymphocytosis
40
what is associated with the sporadic form of bovine lymphoma
young cattle - multicentric calf, thymic and skin types not BLV associated, may be B or T cell
41
what is multiple myeloma or plasma cell myeloma
plasma cell tumor of bone marrow
42
what are the characteristic of multiple myeloma (plasma cell myeloma)
monoclonal hyperglobulinemia (IgG or IgA is usually present ---- (rarely biclonal protein, only light chains or heavy chains, or no monoclonal protein) - Bence-jones proteins (light chains) in urine at times - focal lytic or diffuse osteoporotic bone lesions are often present - plasma cell infiltrates may be found in other tissues including spleen, liver, lymph nodes, and kidneys ( especially cats)
43
what is seen with plasma cell tumors in cats
much more likely to exhibit metastasis, whether they begin within or outside the bone marrow - consequently, the term "myeloma-related disorders" has been used in cats -typically FeLV and FIV negative - atypical plasma cell morphology, a nonregenerative anemia and hypocholesterolemia are common - some cases also have light-chain proteinuria and thrombocytopenia
44
what term is often used in dogs with extramedullary plasma cell tumors
plasmacytoma
45
what is seen with plasmacytomas in dogs
generally benign solitary tumor(GI tract, oral cavity, skin, digits, and forelegs, ears) - usually no monoclonal hyperglobulinemia measured in serum in dogs
46
what is usually seen with cats and extramedullary plasma cell tumors
some skin tumors appear benign like dogs and other tumors are aggressive, producing paraprotein and quickly metastasizing
47
what are myeloid neoplasms
neoplastic disorders characterized by the purposeless proliferation of nonlymphoid marrow cells
48
myelodysplastic syndrome (MDS) appears to be...
clonal and may develop into acute myeloid leukemia
49
where do neoplastic transformations generally occur in myeloid neoplasms
in pluripotent progenitor cells
50
T/F abnormalities in more than one cell line are often present in myeloid neoplasms
true
51
T/F some myeloid neoplasms evolve into one another
true
52
what does the classification of acute vs chronic myeloid neoplasm depend on
depends on present blast cells in bone marrow
53
cats are generally FIV and FeLV neg or pos with myeloid neoplasms
positive
54
myeloid markers ?
55
what are the types of myeloid neoplasms (myeloproliferative disorders)
-myelodysplastic syndromes (MDS) - acute myeloid leukemias (AML) - myeloproliferative neoplasms (MPNs) - formerly chronic myeloproliferative disorders
56
what are some clinical signs of myeloid neoplasms
- unexplained or frequent infections - pale mucous membranes - slow healing ulcerations of mucous membranes or skin - lethargy, weight loss, fever - splenomegaly and/or hepatomegaly **** excluded primary erythrocytosis and thrombocythemia
57
what can be some blood findings with myeloid neoplasms
- anemia (generally severe) with no reticulocytosis - nucleated erythrocytes are often present in blood - moderate to marker anisocytosis may be present - MCV is often increased in cats - leukocyte counts may be low, normal, or high - platelet counts are frequently decreased - abnormal morphology may be present one or more blood cell lines
58
what can be found in the bone marrow with myeloid neoplasms
- usually hypercellular with increased cellularity in one or two cell lines and decreased cellularity in others - increased immaturity of cells (including increased blast cells) in one or more cell lines - myelofibrosis may occur as a secondary even - stainable iron may be increased
59
what are some characteristics of myelodysplastic syndromes
- likely clonal neoplastic disorder - nonregenerative anemia - generally, leukopenia and/or thrombocytopenia - bone marrow is often hypercellular - dysplastic cells in more than one hematopoietic cell line - less than 20% blasts cells
60
T/F MDS (<20% blasts) can transition to AML (>20% blasts)
true
61
what does acute myeloid leukemia look like on blood work and marrow exam
- non regenerative anemia - leukocyte counts may be low or normal, but more often are increased - platelet counts are usually decreased - abnormal blood cell morphology if generally present including blast cells - bone marrow is hypercellular with greater then 20% blasts - one, or sometimes two, cell types dominate the marrow cellularity
62
what will you see in the bone marrow with AMLs
20% or greater blasts in bone marrow
63
what will you see in the bone marrow with chronic myeloid neoplasms
much less than 20% blasts in marrow
64
what species is CML seen primarily
dogs
65
what can be seen on blood work with chronic myeloid neoplasms
- leukocyte count exceeds 50x10^3/uL - marked neutrophilic left shift - few or no myeloblasts in blood - increased blood monocytes, eosinophils, and/or basophils may be present - less than 20% myeloblasts in bone marrow
66
primary erythrocytosis
67
essential thrombocythemia

clinical pathology (18 decks)

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