2-Lymphoproliferative Disorders and Myeloid Neoplasms

Question 0

What are 2 things that can help to diagnose leukemia?

Answer 0

• Finding characteristic cells in blood, bone marrow or other organs
• Associated hematologic abnormalities

Question 1

The presence of neoplastic cells on peripheral blood and/or bone marrow or spleen is known as what?

Answer 1

Leukemia

Question 2

What are 4 forms of traditional identification of cell types in leukemia?

Answer 2

• Morphologic appearance
• Cytochemical staining properties
• Electron microscopic appearance
• Monoclonal antibody binding to antigens

Question 3

What are 3 forms of classification of leukemia based on the number of circulating neoplastic cells?

Answer 3

• Leukemic leukemia
• Subleukemic leukemia
• Aleukemic leukemia

Question 4

What are 2 more common classifications of leukemia?

Answer 4

• Acute

- Chronic

Question 5

What are 2 ways to differentiate between acute and chronic leukemia?

Answer 5

• Degree of differentiation or maturity of cells

- Clinical course of disease

Question 6

What are 2 characteristics of acute leukemias?

Answer 6

• Neoplastic cells are immature (blasts)

- Survival time is usually short

Question 7

What are 2 characteristics of chronic leukemias?

Answer 7

• Mature well-differentiated cells predominate

- Patient survival times is usually long

Question 8

Where are 5 possible location of neoplastic cells seen with leukemia?

Answer 8

• Blood
• Usually bone marrow
• Maybe spleen
• Liver
• Lymph nodes

Question 9

T/F: All lymphomas are malignant.

Answer 9

True

Question 10

What are 2 types of proliferative disorders?

Answer 10

• Lymphoproliferative disorders

- Myeloproliferative disorders

Question 11

What are 2 examples of lymphoproliferative disorders?

Answer 11

• Neoplasms of lymphocytes

- Neoplasms of plasma cells

Question 12

What type of proliferative disorder involves neoplasms arising from bone marrow stem cells and involve neutrophils, monocytes, erythrocytes, and rarely eosinophils and basophils.

Answer 12

Myeloproliferative disorders

Question 13

If lymphocyte concentration is greater than what value, can you be sure it is a leukemia?

Answer 13

> 35,000/ul

Question 14

If a dog has what lymphocyte value and is Ehrlichia negative, this indicates leukemia?

Answer 14

> 15,000/ul

Question 15

What does ALL stand for?

Answer 15

Acute Lymphoblastic Leukemia

Question 16

What do you need to differentiate acute lymphoblastic leukemia (ALL) from?

Answer 16

Stage V lymphoma

Question 17

65% of dogs presenting with multicentric lymphoma are what?

Answer 17

Leukemic

Question 18

50% of dogs with ALL have what?

Answer 18

Lymphadenopathy

Question 19

What are 4 CBC abnormalities that can be seen with ALL?

Answer 19

• Anemia
• Thrombocytopenia
• Lymphocytosis (usually)
• Lymphoblasts in blood

Question 20

What is the prognosis with ALL?

Answer 20

Poor

Question 21

Is the clinical course of ALL usually slow or rapid?

Answer 21

Rapid

Question 22

How well does ALL respond to therapy?

Answer 22

Poorly responsive

Question 23

What type of cats get ALL?

Answer 23

Younger and FeLV positive

Question 24

What does CLL stand for?

Answer 24

Chronic lymphocytic leukemia

Question 25

How do lymphocytes appear with CLL?

Answer 25

Small and appear well differentiated.

Question 26

What species is CLL more common in?

Answer 26

Dogs

Question 27

What must CLL be differentiated from?

Answer 27

Other causes of lymphocytosis.

Question 28

If over how many lymphs is leukemia indicated?

Answer 28

>35,000 lymphs

Question 29

What is the maximum amount of lymphocytes seen with excitement lymphocytosis?

Answer 29

20,000/ul

Question 30

What can cause a strong lymphocytosis in cats?

Answer 30

Bartonellla henselae

Question 31

What is often seen with chronic ehrlichiosis?

Answer 31

Large granular lymphocytes

Question 32

Is excitement lymphocytosis common or rare in dogs?

Answer 32

Rare

Question 33

What are 6 possible clinical signs that can be seen with CLL?

Answer 33

- Lethargy - Anorexia - Pale mucosal membranes - Lymphadenopathy - Splenomegaly - Hepatomegaly

Question 34

Lymphocytosis can range from what?

Answer 34

Slightly greater than reference interval to >300,000/ul

Question 35

Can anemia and thrombocytopenia be seen with CLL?

Answer 35

Yes

Question 36

What can you see an increased number of in bone marrow? | What percentage?

Answer 36

- Small lymphs | - 25-100%

Question 37

Rarely, with CLL you will see what type of gammopathy?

Answer 37

Monoclonal

Question 38

Cats with CLL are usually FeLV positive or negative?

Answer 38

Negative

Question 39

Which is more common in dogs and cats, T-cell CLL or B-cell CLL?

Answer 39

T-cell CLL

Question 40

What are 4 classification of CLLs?

Answer 40

- CD8+ T-cell - CD21+ B-cell - CD4-8-5+ T-cell (aberrant T-cell) - CD34+ (undifferentiated progenitor)

Question 41

What type of an outcome does the expression of CD34 predict?

Answer 41

Poor outcome

Question 42

If the CD8+ and lymphocyte concentration is under what value is a shorter survival time predicted?

Answer 42

<30,000/ul

Question 43

A similar outcome is seen with which 2 classifications of CLLs?

Answer 43

- CD4-8-5+ | - CD8+

Question 44

Which survive longer, CD21+ B-cell patients with small or large lymphocytes?

Answer 44

Small lymphocytes

Question 45

Which survive longer with B-cell leukemia, young or old dogs?

Answer 45

Old dogs

Question 46

T/F: Dogs with T-cell CLL and no anemia survive longer.

Answer 46

True

Question 47

What does PCR detect?

Answer 47

Antigen receptor rearrangements

Question 48

What can PCR be used to identify?

Answer 48

Clonal, neoplastic population of cells.

Question 49

What can PCR differentiate?

Answer 49

Non-neoplastic from neoplastic

Question 50

What can PCR differentiate lymphoproliferative disorders form?

Answer 50

Those that are neoplastic.

Question 51

Proliferation of plasma cells at various sites in the bone marrow and eventually other tissues is seen with what condition?

Answer 51

Multiple Myeloma

Question 52

Release in to the peripheral blood occurs occasionally, but usually in very small numbers is seen with which condition?

Answer 52

Multiple Myeloma

Question 53

Survival time with multiple myeloma is less if what other condition is present?

Answer 53

Leukemia

Question 54

With multiple myeloma, clinical signs are related to the presence of what?

Answer 54

Neoplastic plasma cells in the marrow and other tissues.

Question 55

Which immunoglobulin is more likely to result in hyperviscosity of the blood with multiple myeloma?

Answer 55

IgM

Question 56

With multiple myeloma, what percentage of plasma cells are seen in the bone marrow? How are they usually arranged?

Answer 56

- >20% | - Usually in aggregates

Question 57

Multiple myeloma lab findings must be differentiated from what?

Answer 57

Chronic antigenic stimulation

Question 58

What type of gammopathy is seen with multiple myeloma?

Answer 58

Monoclonal or biclonal

Question 59

Which 3 immunoglobulins are referred to as "paraproteins"?

Answer 59

- IgG - IgA - Occasionally IgM

Question 60

What can be seen in the urine with multiple myeloma?

Answer 60

Bence-Jones proteins

Question 61

What type of lesions are common to see in the bones with multiple myelomas?

Answer 61

Lytic lesions

Question 62

A platelet function abnormality can be seen with multiple myeloma due to the presence of what?

Answer 62

Protein

Question 63

Where is the best place to do a bone marrow aspirate with multiple myeloma?

Answer 63

Site of lytic lesion in bone

Question 64

What are 6 clinical sings seen with multiple myelomas? | Which one is most often the presenting complaint the owner brings the patient in for?

Answer 64

- Lethargy - Anorexia - Lameness - Bleeding from the nares (presenting complaint) - Polyuria - Polydipsia

Question 65

What are 2 fundoscopic changes that can be seen with multiple myeloma?

Answer 65

- Retinal hemorrhages | - Engorged retinal blood vessels

Question 66

Renal disease is sometimes seen with multiple myeloma due to what?

Answer 66

Proteins interfere with tubular and glomerular function.

Question 67

Renal disease with multiple myeloma may be secondary to what?

Answer 67

Hypercalcemia

Question 68

What causes the CNS signs that can be seen with multiple myeloma?

Answer 68

Hyperviscosity

Question 69

Bleeding disorders occur in what fraction of dogs with multiple myeloma?

Answer 69

1/3

Question 70

Platelet function defects seen with multiple myeloma due to what?

Answer 70

Immunoglobulins

Question 71

What are 4 things that can be seen with multiple myeloma in cats?

Answer 71

- Atypical plasma cell morphology - Anemia - Bone lesions - Organ involvement (very common in cats)

Question 72

What are 4 indications of multiple myeloma?

Answer 72

- Monoclonal gammopathy - Increased plasma cells in bone marrow - Lytic lesions in bones (+/-) - Bence-Jones proteins in urine