Chapter 13 hematologic disorders Flashcards by Cutler Frandsen

What is a general term for a decrease in volume of RBCs or in the concentration of hemoglobin?

-Anemia

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What does hematocrit =?

-Volume of RBCs

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What are some underlying diseases that anemia might be associated with?

Renal failure
Liver disease
Chronic inflammatory conditions
Malignancies
Vitamin or mineral deficiencies

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What are the general symptoms of anemia?

Tiredness
Headache
Fainting/feeling lightheaded
Pallor

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What are oral symptoms of anemia?

Glossodynia (pain)
Glossopyrosis (burning)
Tongue atrophy (bald)

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What is a hematologic disorder characterized by a markedly decreased number of circulating blood platelets?

-Thrombocytopenia

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What is the result of thrombocytopenia?

-Abnormal bleeding

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What are the decrease in platelets in thrombocytopenia due to?

Reduced production
Increased destruction
Sequestration in the spleen

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What is a normal platelet count?

200,000-400,000

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Clinical evidence of thrombocytopenia is not seen until platelet count is below what?

100,000/mm3

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In thrombocytopenia patients, the small capillaries leak blood which result in what?

-Petechiae (small breakage and leakage of capillaries)

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What is the order of advancement of thrombocytopenia clinically?

Petechiae
purpura (fused petechiae)
ecchymosis

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What do special types of thrombocytopenia include?

Thrombocytic thrombocytopenia (TTP)

- idiopathic thrombocytopenic purpura (ITP)

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When does idopathic thrombocytopenic purpuara occur?

-In childhood after a viral infection

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Thrombocytic thrombocytopenia is a serious disorder of coagulation and is probably due to what?

-Endothelail damage

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What is enlargement of the lymphoid tissue?

-Lymphoid hyperplasia

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Aggregates of lymphoid tissue are most commonly seen where?

Oropharynx
Soft palate
Lateral tongue
Floor of mouth

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With acute infection, the lymphoid hyperplasia appear as what?

-Enlarged, tender, soft, freely movable nodules

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With chronic infections, the lymphoid hyperplasia appear as what?

-Enlarged, nontender, firm, freely movable nodules

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If you have tonsillar asymmetry what could is possibly be?

Metastatic tumor
Lymphoma
Lymphoid hyperplasia

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Agranulocytosis means what?

-Without granulocytes (usually neutrophils)

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What does agranulocytosis lead to/have associated with it?

Neutropenia

- Lymphopenia

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What is agranulocytosis induced by?

-Drugs for anticancer treatments

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What are the oral symptoms of agranulocytosis?

-Necrotizing, deep, punched-out ulcerations of the buccal mucosa, tongue and palate

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What represents several types of malignancies of hematopoietic stem cell derivation?

-Leukemia

What is the philadelphia chromosome related to?

-Chronic myeloid leukemia has a translocation of the chormosomal material between the long arms of chromosomes 9 and 22

What are some environmental factors that might lead to leukemia?

- Exposure to pesticides and or benzene | - Ionizing radiation

What type of leukemia is a more common childhood malignancies?

-Acute lymphoblastic leukemia

What is the most common type of leukemia?

-Chronic lymphocytic leukemia (occurs in adulthood)

What virus can cause leukemia?

-Human T-cell leukemia virus type 1

The leukemic cells may infiltrate the oral soft tissues to produce a boggy (doughy), non-tender swelling that is termed what?

-Granulocytic sarcoma

What are langerhan cells?

-Dendritic mononuclear cells normally found in the epidermis, mucosa, lymph nodes, and bone marrow

T/F Langherhans cells are antigen presenting cells

True

What is eosinophilic granuloma of bone?

-One or multiple lesions with no visceral involvement

What are the subtypes of langerhan cell histiocyotsis?

- Eosinophilic granuloma of bone - Acute disseminated histiocytosis - Chronic disseminated histiocytosis

What is acute disseminated histiocytosis?

-Disease involves bone, skin, and viscera

What is acute disseminated histiocytosis aka?

-Letterer-Siwe disease

What is chronic disseminated histiocytosis?

-Disease involves bone, skin, and viscera

What is Chronic disseminated histiocytosis aka?

-Hand-Schuller-Christian disease

Where are langerhan cell histiocytosis most commonly found?

- Skull - Ribs - Vertebrae - Mandible

In an X-ray what might make you think of langerhan cell histiocytosis?

- Sharply demarcated "punched-out" radiolucencies - Occasionally may be ill-defined - Mandibular lesions appear "scooped out" because the superficial alveolar bone is destroyed - Extensive alveolar bone involvement that looks like a tooth floating in air

Langerhan cells contain rod shaped cytoplasmic structures known as what?

-Birbeck granules (found via electronmicroscopy)

Identification of what cell is necessary to confirm langerhan cell histiocytosis?

-Lesional Langerhan cell

More than half of patients with Langerhan cell histiocytosis are how old?

-Younger than 15

What is a malignant lymphoproliferative disorder?

-Hodgkin's lymphoma

What are the neoplastic cells in Hodgkin's lymphoma known as?

-Reed-Sternberg cells

What virus is associated with Hodgkin's lymphoma?

-EBV (Epstein Barr Virus)

Where does Hodgkin's lymphoma usually begin?

-Lymph nodes

What gender is Hodgkin's lymphoma more common in?

-Males

Where are most of the lymph nodes involved in Hodgkin's lymphoma at?

-Cervical and supraclavicular nodes

What do Reed-sternberg cells appear as?

-Owl's eyes

What is non-Hodgkin's lymphoma aka?

-Lymphoma

What type of cell are most non-Hodgkin's lymphomas from?

-B-lymphocyte origin

Intraoral soft tissue lesions in non-Hodgkin's lymphoma typically appear as nontender diffuse swelling affecting what locations?

- Posterior hard palate - Gingiva - Buccal vestibule

Swelling in non-hodgkins' lymphoma are characteristically what when applying pressure?

-Boggy

What is the most common type of lymphoma of the oral cavity?

-Diffuse large B cell lymphoma

Mycosis fungoides is so named because it clinically resembles what?

-Fungal infection

What is the most common cutaneous lymphoma?

-Mycosis fungoides

What type of cell is mycosis fungoides?

-A T cell lymphoma

What is an aggressive expression of mycosis fungoides that represents dermatopathic T cell leukemia?

-Sezary syndrome

What is a propensity to invade the epidermis of the skin known as?

-Epidermotropism

What is Epidermotropism associated with?

-Mycosis Fungoides

The atypical lymphocytes in mycosis fungoides form small intraepithelial aggregates termed what?

-Pautrier's microabscesses

What is a malignancy of B cell origin?

-Burkitt's lymphoma

What virus is associated with Burkitt's lymphoma?

EBV

What is the average age of someone who gets burkitt's lymphoma?

-7

What is a "starry-sky" pattern in histology associated with?

-Burkitt's lymphoma

What is the cell that creates the "starry-sky" pattern in Burkitt's lymphoma?

-Macrophages