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Oral Pathology Exam 2 > 5 Hematologic Diseases (Malignancies) > Flashcards

5 Hematologic Diseases (Malignancies) Flashcards

(58 cards)

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1
Q

malignant lymphoproliferative disorder

A

hodgkin’s lymphoma

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2
Q

Reed-Sternberg cell, likely of B-cell origin, only makes up 1-3% of cells in the enlarged nodes

A

hodgkin’s lymphoma

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3
Q

approx 9,000 cases annually

A

hodgkin’s lymphoma

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4
Q

EBV linkage suggested

A

hodgkin’s lymphoma

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5
Q

male predilection

A

hodgkin’s lymphoma

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6
Q

Two age peaks of hodgkins lymphoma

A

15-35 and > 50

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7
Q

Clinical findings: persistently enlarging lymph nodes start off freely moveable but become fixed and matted to adjacent tissue

A

hodgkin’s lymphoma

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8
Q

30-40% of patients have other symptoms –> night sweats, weight loss, fever, generalized itching

A

hodgkin’s lymphoma

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9
Q

survival rate of hodgkins lymphoma stage I/II vs III/IV

A

Stage I or II = 80-90% relapse free 10-yr survival rate

Stage III/IV = 55-75% 10-yr survival

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10
Q

Clinical findings: an enlarging nontender discrete mass in one lymph node region

A

Hodgkin’s lymphoma

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11
Q

In 70-75% of cases of Hodgkin’s lymphoma, this is the initial site of presentation. What are other sites of involvement?

A
  • cervical and supraclavicular lymphadenopathy
  • axillary lymphadenopathy
  • mediastinal lymphadenopathy
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12
Q

lymphoreticular malignancy, most often arise within lymph nodes and grow into solid masses

A

non-Hodgkin’s lymphoma

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13
Q

malignant cells do NOT usually circulate in the peripheral blood

A

non-Hodgkin’s lymphoma

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14
Q

70,000 cases/year in the US, 1/3 die of it each year

A

non-Hodgkin’s lymphoma

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15
Q

What does non-Hodgkin’s lymphoma originate from?

A

B-lymphocytes (85% of US cases)

T-lymphocytes (less common)

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16
Q

classification of non-Hodgkin’s lymphoma

A
  • low, intermediate, or high grade (indicate increasing aggressiveness)
  • REAL classification
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17
Q

extranodal site of development, make up 20-40% of lymphomas in US

A

non-Hodgkin’s lymphoma

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18
Q

can develop in the soft tissues or centrally within the jaws, present as nontender diffuse swellings

A

non-Hodgkin’s lymphoma

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19
Q

Oral manifestations:

  • nontender diffuse swellings
  • hard palate, buccal vestibule, gingiva
  • erythematous
  • purplish-blue
  • may be ulcerated
  • surface telangiectasia
A

non-Hodgkin’s lymphoma

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20
Q

tx of non-Hodgkin’s lymphoma

A

radiation, chemo, or a combo

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21
Q

high grade B cell lymphoma, linked to EBV infection as etiologic agent (90% of tumor cells express the EBV nuclear antigen)

A

Burkitt lymphoma

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22
Q

more common in males, children

A

Burkitt lymphoma

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23
Q

areas of the world with an increased prevalence of Burkitt lymphoma

A

sub-Saharan Africa, northeastern Brazil, immunodeficiency type

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24
Q

ill-defined, ragged radiolucency on radiographs

Study These Flashcards
A

Burkitt lymphoma

25
malignancy of hematopoietic stem cell origin (one stem cell undergoes malignant transformation and proliferates within the marrow, overflows into the peripheral blood stream)
leukemia
26
2.9% of all cancers, 4.1% of all cancer deaths
leukemia
27
more frequently with certain genetic syndromes and alterations, also caused by environmental agents (benzene, pesticides, ionizing radiation, viruses)
leukemia
28
13 cases/100,000 people annually
leukemia
29
classification system of leukemia
Clinical course: A or C: acute vs chronic - acute = aggressive course, more lead to death, more common in children - chronic = slow course but still fatal, more common in adults Cell or origin: M or L: myeloid or lymphocytic/lymphoblastic - myeloid = broader age range, kids to age 40 - lymphocytic = most common type, older adults - lymphoblastic = children
30
first genetic abnormality of leukemia reported
CML- 9:22 translocation ("Philadelphia chromsome")
31
symptoms result from crowding out of normal red and white blood cells from the marrow, malignant cells replace normal cells and results in myelophthisic anemia
leukemia
32
specific anemia related to cancer (leukemia, multiple myeloma)
myelophthisic anemia
33
symptoms include fatigue, dyspnea with mild exertion, fever, frequent infections (intraoral herpes, candidiasis)
leukemia
34
frequent oral infections that occur in leukemia patients
intraoral herpes | candidiasis
35
easy bruising and bleeding from thrombocytipenia, spontaneous gingival bleeding can be seen
leukemia
36
cancerous cells can infiltrate the oral mucosa and cause diffuse, boggy swelling of the soft tissues (may simulate periapical disease clinically and radiographically)
leukemia
37
When malignant leukemia cells infiltrate organs:
splenomegaly hepatomegaly lymphadenopathy
38
dx of leukemia
presence of poorly differentiated leukemic cells in the peripheral blood and bone marrow
39
tx of leukemia
- chemo (induction or maintenance) - radiation - bone marrow transplant
40
induction vs maintenance chemo for tx of leukemia
Induction chemo- rapidly destroying the atypical cells - hige dose toxic chemotherapeutics - hopefully destroys all of the cancerous cells and puts the patient into remission - transfusions with platelets - encourage excellent OH to help prevent oral infections Maintenance chemo- lower dose - maintains remission following induction therapy
41
Why must radiation AND chemo be used to treat leukemia?
for the CNS --> many chemotherapeutics do not cross the BBB
42
malignancy of plasma cell origin, originates in bone (single malignant precursor cell gives rise to the entire proliferation, cells spread throughout the body and produce proteins, abnormal immunoglobulins, that deposit in soft tissue as amyloid)
multiple myeloma
43
~22,000 cases diagnosed annually
multiple myeloma
44
age = 60-70
multiple myeloma
45
2x more common in blacks than whites
multiple myeloma
46
most common hematologic malignancy in black patients
multiple myeloma
47
Clinical symptoms: - bone pain - pathologic fracture from tumor destruction of bone - fatigue (myelophthisic anemia) - petechial hemorrhages in soft tissues (10-15% of patients) due to accumulation of the light chain proteins - kidney failure due to overload of light chain proteins - increased Bence Jones proteins in the urine (30-50%)
multiple myeloma
48
rad: multiple, well-defined, punched-out radiolucencies, 30% of patients have jaw lesions
multiple myeloma
49
30% of patients have jaw lesions
multiple myeloma
50
tx of multiple myeloma
- chemotherapy + corticosteroids (60% of patients respond however most experience relapse) - bisphosphonate medications given to reduce the possibility of myeloma related fractures but do not increase survival - otherwise healthy patients under age 55-65 can try aggressive chemo and bone marrow transplantation (5 yr survival = 50%)
51
solitary/unifocal monoclonal, neoplastic proliferation of plasma cells usually arising within bone
plasmacytoma
52
most common site of plasmacytoma
spine
53
Name the hematologic malignancy: 55 yo average age, M: F = 2:1
plasmacytoma
54
symptoms include swelling or bone pain, can develop outside of bone as a soft tissue mass (extramedullary = 25% occur in the head and neck)
plasmacytoma
55
rad: well-defined, unilocular radiolucency, punched-out RL, may have ragged irregular borders
plasmacytoma
56
tx of plasmacytoma
radiation therapy (50% of patients show disseminated disease within 2-3 years)
57
increased Bence Jones proteins in the urine (30-50%)
multiple myeloma
58
Multiple myeloma cells produce proteins (abnormal immunoglobulins) that deposit in soft tissue as amyloid. What % of myeloma patients have deposition of amyloid on soft tissues due to accumulation of the light chain proteins? What is a symptom that arises from this deposition?
10-15% kidney failure due to overload of light chain proteins (increased Bence Jones proteins in urine 30-50%)

Oral Pathology Exam 2 (8 decks)

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