WBC Pathoma Flashcards
Neutropenia
Pathology:
Causes:
Path:
Decreased circulating neutrophils
Causes:
1) Drugs (Chemo & alkylating agents)
2) Gram -ve sepsis
Path:
Decreased circulating neutrophils
Causes:
1) Drugs (Chemo & alkylating agents)
2) Gram -ve sepsis
Neutropenia
Lymphopenia
Pathology:
Causes:
Path:
Decreased circulating lymphocytes
Causes:
1) DiGeorge syndrome or HIV
2) exogenous corticosteroids or Cushing syndrome
3) SLE
4) Radiation
Path:
Decreased circulating lymphocytes
Causes:
1) DiGeorge syndrome or HIV
2) exogenous corticosteroids or Cushing syndrome
3) SLE
4) Radiation
Lymphopenia
INFECTIOUS MONONUCLEOSIS (IM)
Pathology:
Symptoms/Signs:
Causes:
Labs/Histological findings:
Complications
Path:
lymphocytic leukocytosis with reactive CD8+ T cells
Signs:
1) Pharyngitis
2) Hepatitis & Hepatomegaly
3) Splenomegaly
4) Generalized lymphadenopathy
Causes:
1) EBV (saliva #1)
2) CMV
Labs/Histo:
1) Monospot test detects IgM Abs that cross react with horse/sheep blood aka heterophile Abs(-ve test =CMV)
2) High WBC
Complication:
1) Splenic rupture
2) Rash with amoxicillin
3) Recurrence & B cell lymphoma
Path:
lymphocytic leukocytosis with reactive CD8+ T cells
Signs:
1) Pharyngitis
2) Hepatitis & Hepatomegaly
3) Splenomegaly
4) Generalized lymphadenopathy
Causes:
1) EBV (saliva #1)
2) CMV
Labs/Histo:
1) Monospot test detects IgM Abs that cross react with horse/sheep blood aka heterophile Abs(-ve test =CMV)
2) High WBC
Complication:
1) Splenic rupture
2) Rash with amoxicillin
3) Recurrence & B cell lymphoma
INFECTIOUS MONONUCLEOSIS (IM)
B-ALL
Pathology:
Lab findings:
Prognosis:
Path:
The most common type of ALL (neoplastic accumulation of lymphoblasts in bone marrow)
Labs:
lymphoblasts
(TdT+) that express CD10, CD19, and
CD20
Prognosis:
t(l2;2l) = good prognosis (Children)
t(9;22) = poor prognosis (adults aka philadelphia)
T-ALL
Pathology:
Lab findings:
Prognosis:
Path:
type of ALL (neoplastic accumulation of lymphoblasts in bone marrow) that affects teens as a mediastinal (thymic mass)
Labs:
lymphocytes with (TdT+) CD2 to CDS (e.g., CD3, CD4, CD7)
Path:
The most common type of ALL (neoplastic accumulation of lymphoblasts in bone marrow)
Labs:
lymphoblasts
(TdT+) that express CD10, CD19, and
CD20
Prognosis:
t(l2;2l) = good prognosis (Children)
t(9;22) = poor prognosis (adults aka philadelphia)
B-ALL
Path:
type of ALL (neoplastic accumulation of lymphoblasts in bone marrow) that affects teens as a mediastinal (thymic mass)
Labs:
lymphocytes with (TdT+) CD2 to CDS (e.g., CD3, CD4, CD7)
T-ALL
“Thymic-Teens Accumulate lots of Lymphocytes”
Acute Myeloid Leukemia
Pathology:
Lab findings:
Path:
Neoplastic accumulation of myeloblasts (> 20%) in the bone marrow, usually characterized by MPO staining
Older adults with average age of 50-60 years
Labs:
Auer rods (+ve MPo)
Path:
Neoplastic accumulation of myeloblasts (> 20%) in the bone marrow, usually characterized by MPO staining
Older adults with average age of 50-60 years
Labs:
Auer rods (+ve MPo)
Acute Myeloid Leukemia
Acute Promyelocytic Leukemia (APL)
Pathology:
Treatment:
“APT = Abnormal Promyelocytes & Translocation”
Path:
characterized by t(15;17) translocation leading to abnormal promyelocytes
Treatment with all-trans-retinoic acid (ATRA) to induce maturation and cell death
Path:
characterized by t(15;17) translocation leading to abnormal promyelocytes
Treatment with all-trans-retinoic acid (ATRA) to induce maturation and cell death
Acute Promyelocytic Leukemia (APL)
Acute Monocytic Leukemia:
Path:
proliferation of monoblasts, may infiltrate gums
Path:
proliferation of monoblasts, may infiltrate gums
Acute Monocytic Leukemia:
Acute Megakaryoblastic Leukemia:
proliferation of megakaryoblasts, associated with Down syndrome
proliferation of megakaryoblasts, associated with Down syndrome
Acute Megakaryoblastic Leukemia:
AML from Pre-Existing Dysplasia
Pathology:
Symptoms/Signs:
Complications:
Path: May arise from myelodysplastic syndromes, (exposure alkylating agents or radiotherapy)
Signs:
1) cytopenia’s
2) hypercellular bone marrow
3) abnormal cell maturation
4) increased blasts (< 20%)
Complication
1) Death from infection or bleeding
2) Progression to acute leukemia
Path: May arise from myelodysplastic syndromes, (exposure alkylating agents or radiotherapy)
Signs:
1) cytopenia’s
2) hypercellular bone marrow
3) abnormal cell maturation
4) increased blasts (< 20%)
Complication
1) Death from infection or bleeding
2) Progression to acute leukemia
AML from Pre-Existing Dysplasia
Chronic Lymphocytic Leukemia (CLL)
Pathology:
Symptoms/Signs:
Lab findings:
Complications
Path:
Neoplastic proliferation of CD5 and CD20 co-expressing naive B cells,
Signs:
1) generalized lymphadenopathy (small lymphocytic lymphoma)
Labs:
Blood smear shows increased lymphocytes and smudge cells
Complications:
1)Hypogammaglobulinemia
2) Autoimmune hemolytic anemia
3) Transformation to diffuse large B-cell
lymphoma (Richter transformation) marked by enlargement of lymph node or spleen
Path:
Neoplastic proliferation of CD5 and CD20 co-expressing naive B cells,
Signs:
1) generalized lymphadenopathy (small lymphocytic lymphoma)
Labs:
Blood smear shows increased lymphocytes and smudge cells
Complications:
1)Hypogammaglobulinemia
2) Autoimmune hemolytic anemia
3) Transformation to diffuse large B-cell
lymphoma (Richter transformation) marked by enlargement of lymph node or spleen
Chronic Lymphocytic Leukemia (CLL)
Hairy Cell Leukemia
Pathology:
Symptoms/Signs:
Lab findings
Treatments:
Path:
Neoplastic proliferation of mature B cells with hairy cytoplasmic processes
Signs:
1) splenomegaly
2) “dry tap” on bone marrow aspiration
(NO lymphadenopathy)
Labs:
Cells are TRAP-positive
Treatments:
1) 2-CDA (cladribine)
2) an adenosine deaminase inhibitor (accumulates adenosine to toxic levels in neoplastic cells)
Path:
Neoplastic proliferation of mature B cells with hairy cytoplasmic processes
Signs:
1) splenomegaly
2) “dry tap” on bone marrow aspiration
(NO lymphadenopathy)
Labs:
Cells are TRAP-positive
Treatments:
1) 2-CDA (cladribine)
2) an adenosine deaminase inhibitor (accumulates adenosine to toxic levels in neoplastic cells)
Hairy Cell Leukemia
Adult T-Cell Leukemia/Lymphoma (ATLL)
Pathology:
Symptoms/Signs
Path:
Neoplastic proliferation of mature CD4+ T cells
Associated with HTLV-(Japan and the Caribbean)
Signs:
1) Rash
2) Lymphadenopathy
3) Hepatosplenomegaly,
4) Lytic bone lesions with hypercalcemia
Path:
Neoplastic proliferation of mature CD4+ T cells
Associated with HTLV-(Japan and the Caribbean)
Signs:
1) Rash
2) Lymphadenopathy
3) Hepatosplenomegaly,
4) Lytic bone lesions with hypercalcemia
Adult T-Cell Leukemia/Lymphoma (ATLL)
Mycosis Fungoides
Pathology/Symptoms:
Lab findings:
Pathology/Signs:
Neoplastic proliferation of mature CD4+ T cells in the skin, causing rash, plaques, and nodules
Lab findings:
1) Pautrier micro abscesses (Aggregates of neoplastic cells in the epidermis)
Complication:
Sezary syndrome