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BOD 3 > Hematopoietic Diseases > Flashcards

Hematopoietic Diseases Flashcards

1
Q

Where does hematopoiesis occur in the fetus

A

it begins in the yolk sac and then it shifts to the spleen and liver and then to the fetal bone marrow

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2
Q

T/F Horses release reticulocytes into circulation

A

F- they do not

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3
Q

What species is the central area of pallor most apparent?

A

Dogs

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4
Q

What is the mean red blood cell lifespan?

A

150 days: Horses and cattle
100 days: dogs
70 days: cats

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5
Q

T/F- dogs have a very large storage pool of neutrophils

A

T

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6
Q

T/F- cats have more marginal neutrophils relative to circulating neutrophils

A

T- threefold more marginal neutrophils relative to circulating neutrophils

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7
Q

How does the ratio of fat to hematopoietic cells change as an animal matures?

A

Young age - 25:75 fat to hematopoietic cells
Mid age - 50:50
Old age- 75:25
*Older animals have more fat in their bone marrow

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8
Q

What is the ratio of myeloid to erythroid in normal bone marrow

A

1:1 but can vary

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9
Q

What areas is hematopoietic marrow concentrated in adults?

A

spine, pelvis, sternum, ribs, calvarium, and proximal end of limb bones

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10
Q

Where does extramedullary hematopoiesis (EMH) primarily occur in adults?

A

primarily in the spleen

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11
Q

Extramedullary hematopoiesis (EMH)

A

the body’s compensatory response to deficient erythropoiesis by the bone marrow or accelerated destruction of erythrocytes and refers to deposits of erythroid precursors in sites other than the bone marrow and peripheral blood.
-Primarily in the spleen

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12
Q

Hematopoiesis

A

lipolysis + myeloid (bone marrow) expansion in residual red (hematopoietic) marrow

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13
Q

Myelofibrosis

A

a degenerative change to bone marrow that occurs due to a scar formation after necrosis due to a high concentration of growth factors with marrow injury or activation or idiopathic

causes: leukemias, infiltrative metastatic neoplasia, BVDV, E. canis, FeLV, Sepsis, Drugs or toxins (carprofen, chemo, estrogen, metronidazole, mitotane, phenobarbital, heavy metals)
irradiation
Chronic hemolytic anemia (chronic overstimulation)

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14
Q

What are the infectious agents that can result in myelofibrosis

A

BVDV
Ehrichia canis
FeLV
Sepsis from infection

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15
Q

What are the 7 causes of myelofibrosis

A

1) Leukemia
2) Infiltrative metastatic neoplasia
3) Infectious (BVDV, E. canis, FeLV)
4) Sepsis
5) Drugs/ Toxins
6) Irradiation
7) Chronic hemolytic anemia (chronic overstimulation)

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16
Q

What drugs/toxins can result in myelofibrosis?

A

-Carprofen
-Chemo agents
-Estrogen
-Metronidazole
-Mitotane
-Phenobarbital
-Heavy metals

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17
Q

What is the result to the bone marrow due to emaciation/starvation

A

Gelatinous transformation (serous atrophy of fat)

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18
Q

Gelatinous transformation

A

the serous atrophy of fat that occurs die to an animal being starved. Bone marrow is replaced with a mucinous material that shakes like gelatin

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19
Q

What percent of fat in their bone marrow do animals suspected to be starved to death have?

A

20% residual fat in their bone marrow
you can submit to NDSU Veterinary diagnostic laboratory to confirm the bone marow fat percentage

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20
Q

Disease causes of thrombocytopenia

A

immune-mediated destruction
hemorrhage
disseminated intravascular coagulation

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21
Q

Disease causes of neutropenia

A

immune mediated
tissue demand (depends on the storage pool)

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22
Q

What is the stimulus of erythropoiesis and where is it produced

A

Erythropoietin (produced in the kidney) due to hypoxia

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23
Q

What is the stimulus of thrombopoiesis and where is it produced

A

Thrombopoietin- produced in the liver and kidney under constant stimulation

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24
Q

Where is thrombopoietin produced

A

in the liver and kidney under constant stimulation

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25
Q

What is the growth factor for lymphopoiesis of B cells?

A

IL-4

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26
Q

What is the growth factor for lymphopoiesis of T cells?

A

IL-2

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27
Q

What is the growth factor for lymphopoiesis of NK cells?

A

IL-15

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28
Q

Is lymphopoeisis primarily dependent on medullary or extramedullary production

A

extramedullary production

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29
Q

What are the three ways we can get anemia

A

1) increased destruction/lysis of RBC
2) Increased loss/hemorrhage
3) Decreased RBC production

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30
Q

Regenerative anemia causes ____________

A

erythroid hyperplasia in the bone marrow

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31
Q

How does non-regenerative anemia occur

A

due to a bone marrow insult resulting in erythroid hypoplasia or aplasia in the bone marrow

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32
Q

What are the clinical abnormalities of hemorrhage under regenerative process

A

1) Chronicity- can have iron deficiency anemia
2) Decreased plasma or serum protein concentration
3) Increased urea nitrogen relative to creatinine

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33
Q

How does blood in upper GI tract result in elevated blood urea?

A

RBCs are lysed where Hb is absorbed as amino acids.
Amino acids travel in the portal vein to the liver where it is converted into the urea

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34
Q

What are the 4 clinical/pathologic abnormalities of hemolytic anemia under regenerative process

A

1) Icterus
2) Hyperbilirubinemia (Hb > heme> bilirubin)
3) Hemoglobinuria
4) Splenomegaly (congested in spleen)

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35
Q

What will happen in the bone marrow under regenerative anemia

A

there will be erythroid hyperplasia as a response

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36
Q

What are 6 causes of non-regenerative anemia?

A

1) Infectious
2) Toxins/Medications
3) Estrogens
4) Chronic kidney disease (decreased erythropoietin)
5) Iron deficiency (anemia of inflammatory disease)
6) Cancer

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37
Q

Pure Red Cell Aplasia

A

absence of erythropoiesis and severe non-regenerative anemia
Primary: destruction of early erythroid progenitor cells
Secondary: admin of rhEPO, parvo virus, FeLV subgroup C

Bone marrow: absence of erythroid precursors +/- lyphocytosis, plasmacytosis, thrombocytosis, myeloid hyperplasia

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38
Q

What can result in aplastic anemia in cattle/sheep?

A

1) Bracken fern
2) Trichloroethylene

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39
Q

what 4 infectious agents can result in aplastic anemia

A

Ehrlichia (dogs and cats)
Parvovirus (dogs and cats)
FeLV/FIV
Equine Infectious Anemia

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40
Q

What drugs can result in aplastic anemia in dogs/cats

A

Antimicrobial agents
Chemotherapeutic agents
Estrogen (dogs)
Phenylbutazone (dogs and horses)

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41
Q

What effect does Aflatoxin B have on hematopoeisis

A

It causes aplastic anemia in horses, cattle, dogs, and pigs

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42
Q

What affect does parvo/ feline panleukopenia virus have on the bone marrow?

A

Virus has a tropism for mitotically active cells
Oronasal entry to tonsils and Peyer/s patches
Lymphatic spread to the thymus, spleen, and lymph nodes
Virally induced lymphocytosis
Panleukopenia- lymphocytosis in lymphoid tissue and destruction of myeloid precursors in the bone marrow

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43
Q

Immune-mediated neutropenia

A

immune destruction of neutrophils or their precursors- causes are similar to other immune-mediated cytopenias
Bone marrow: granulocytic hypoplasia or hyperplasia with maturation arrest, aplasia, lymphocytosis and plasmacytosis
Diagnosis of exclusion and response to immunosuppressive therapy

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44
Q

Immune-mediated thrombocytopenia

A

Often times primarily idiopathic**
Can also be:
-Infectious (EIA, Ehrlichiosis)
-Drug induced (Cephalosporins and sulfonamides)
-Neoplasia
-Other immune mediated diseases

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45
Q

What are the 4 ways you can get an Erythrocytosis?

A

1) Dehydration (relative)
2) Epinephrine mediated splenic contraction (relative)
3) Epo-mediated eythroid hyperplasia
4) Erythroid neoplasia (uncommon) - polycythemia vera or acute myeloid leukemia-erythroid leukemia

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46
Q

Polycythemia vera

A

an uncommon chronic erythroid leukemia that results in a marked increased in red cell mass and absence of hypoxemia or other tumors
Normal or decreased plasma erythropoietin concentration

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47
Q

What will the plasma erythropoeitin concentration be in a patient with polycythemia vera

A

Normal to decreased plasma Epo concentration

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48
Q

Although uncommon, what two erythroid neoplasias can result in erythrocytosis

A

1) Polycythemia vera (chronic erythroid leukemia)
2) Acute myeloid leukemia- erythroid leukemia

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49
Q

What are the two causes of relative erythrocytosis

A

1) Water losses (dehydration/ also with increased total protein)
2) Splenic contraction - mostly horses (some dogs)

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50
Q

What are the causes of Secondary Absolute Erythrocytosis

A

*Stimulated by EPO
1) Hypoxia (Appropriate stimulation)
2) Renal cysts/tumors or liver tumor (inappropriate EPO stimulation)

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51
Q

What is the cause of primary absolute erythrocytosis

A

*Independent of EPO action
-Polycythemia vera (chronic erythroid leukemia)

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52
Q

What is the cause of persistent lymphocytosis in cattle?

A

Bovine leukemia virus (a retrovirus)
tropism for B lymphocytes

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53
Q

What are the non-neoplastic causes of lymphocytosis in dogs/cats?

A

Age/antigenic stimulation (cats)
Epinephrine (cats)
Chronic inflammation
Ehrlichia canis infection
Hypoadrenocorticism (Addisons)
Paraneoplastic lymphcytosis
Hyperthyroidism (cats)

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54
Q

A neoplastic disease originating in the bone marrow- unregulated growth of hematopoietic stem cells

A

Myeloproliferative disease (common myeloid progenitor cell)

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55
Q

A neoplastic disease of lymphocytes (plasma cells)
includes both lymphoma and leukemia

A

Lymphoproliferative disease

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56
Q

A diverse group of hematologic disorders characterized by ineffective production of hematopoietic cells

A

Myelodysplastic syndrome

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57
Q

Myelodysplastic syndrome

A

clonal myeloid proliferation with ineffective hematopoiesis in the bone marrow resulting in cytopenia of one or more cells line
dysplasia of myeloid (bone marrow) cells
Less than 20% blastocytes in the bone marrow

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58
Q

What infectious disease is associated with myelodysplastic syndrome (dysplasia of myeloid cells due to clonal myeloid proliferation with ineffective hematopoeisis in the bone marrow resulting cytopenia of one or more cell lines

A

FeLV

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59
Q

Acute Leukemia

A

Leukemia with an aggressive clinical course (median survival time of 9 days up to 56 days with treatment)
>20% blast cells in the bone marrow
Expression of CD34 antigen by flow cytometry
pancytopenia- anemia, neutropenia, thrombocytopenia
Median age 7-8 years but wide range in dogs

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60
Q

What will the flow results be of a patient with acute leukemia

A

they will have a CD34+ lymphocytosis

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61
Q

How do you diagnose Chronic Lymphocytic Leukemia in dogs

A

5000 neoplastic cells/uL
CD8 lymphocytosis (T cell)
CD21 lymphocytosis- CLL/SLL (B cell chronic lymphocytic leukemia/small cell lymphocytic lymphoma)
*Other cytopenias usually not present

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62
Q

What is the most common CLL (Chronic Lymphocytic Leukemia) in cats

A

CD4 (T cell) lymphocytosis

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63
Q

What are the prognostic factors in dogs with B cell chronic lymphocytic leukemia?

A

overall median survival time was 300 days (1-1644 days)
Boxers have significant shorter survival time (MST 187)
Non-boxers MST=423 days
High lymphocyte count >60,000 lymph/uL associated with significantly shorter survival
HIgher Ki-67 associated with a worse survival

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64
Q

What breed has a significant shorter survival time for B cell chronic lymphocytic leukemia

A

Boxers

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65
Q

What is commonly found upon necropsy of an animal with chronic lymphocytic leukemia

A

-Splenomegaly
-Anemia
-Lymphadenopathy
-High cellular bone marrow

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66
Q

What is commonly found upon necropsy of an animal with acute lymphocytic leukemia

A

-Pale mucous membranes
-Bone marrow highly cellular but pancytopenia
-Splenomegaly
-Lymph node involvement
-Can infiltrate many organs

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67
Q

What is the importance of flow cytometry in diagnosing lymphoma

A

-A large number of antigens can be evaluated
-Distinguishes the homogenous from the heterogenous expansions
-Identifies aberrant antigen expression (CD34 expression in acute leukemia)
-Objective measure of size
-Provides prognostic information

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68
Q

Multiple myeloma is a tumor of the ______

A

plasma cells arising from the bone marrow

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69
Q

Multiple myeloma

A

a tumor of plasma cells arising from the bone marrow
-markedly increased plasma cells in the bone marrow >30%
-monoclonal gammopathy
-osteolysis from expansion
-light chain proteinuria

Clinical pathology:
-Hyperglobinemia
-Hypercalcemia
-Pancytopenia

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70
Q

Patients with multiple myeloma will have hyperglobinemia. Is this a monoclonalgammopathy of polyclonalgammopathy?

A

monoclonalgammopathy

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71
Q

What 4 clinical findings will you see with a patient with multiple myeloma

A

-Hyperglobinemia (monoclonal)
-Hypercalcemia (from osteolysis)
-Pancytopenia
-Light chain proteinuria

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72
Q

What will cytology of a patient with multiple myeloma look like

A

Tissue is expanded by plasma cells with condensed chromatin, expanded cytoplasm with a perinuclear clear zone

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73
Q

a lentivirus that causes anemia by immune-mediated hemolysis and decreased erythropoiesis resulting in icterus

A

Equine infectious anemia

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74
Q

What test do you diagnose Equine infectious anemia with?

A

Coggins Test

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75
Q

How is equine infectious anemia transmitted?

A

by biting flies

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76
Q

How long does Equine Infectious Anemia last?

A

it often subsides after a year and horses are lifelong carriers

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77
Q

What are the clinical signs of Equine Infectious Anemia

A

fever, depression, LN enlargement, splenic congestion, hemolytic crisis characterized by pale with mucosal hemorrhage and dependent edema, increased heart rate

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78
Q

What is your first differential for a horse that presents icteric with rapid breathing and an increased heart rate?
You detect swelling of the limbs
Peteciation of mucous membranes
Splenomegaly upon necropsy

A

Equine Infectious anemia

Swelling (edema from hemolytic crisis)
Peteciation (hemolytic crisis)
Splenomegaly (hemosiderosis congestion)

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79
Q

What is the causative agent of thrombocytopenic hemorrhagic syndrome in cattle?

A

Bovine Viral Diarrhea Virus (BVDV)

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80
Q

What CBC abnormalities does BVDV result in?

A

Thrombocytopenia, Neutropenia, Lymphopenia

Type II infected animals have impaired thrombopoesis (from megakaryocytic necrosis, pyknosis, and degeneration)

severely thrombocytopenic and neutropenic with multisystemic hemorrhagies (GI, spleen, gallbladder, urinary bladder, and LNs)

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81
Q

How does canine distemper virus impact the bone marrow cells?

A

it causes atrophy and necrosis of bone lining and bone marrow cells (may infect erythrocytes, leukocytes, and platelets
Results in:
Decreased peripheral neutrophils, lymphocytes, mono, platelets during viremia
Thrombocytopenia resulting from mebrane immune complex formation

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82
Q

What CBC abnormalities will you see with distemper virus?

A

-Neutropenia
-Lymphopenia
-Thrombocytopenia

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83
Q

How does FeLV impact the bone marrow

A

it disrupts normal hematopoiesis by inducing genetic mutations, infecting hematopoietic cells, dysmyelopoiesis with cytopenias and neoplastic transformation
can be associated with myelodysplastic syndrome

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84
Q

In regenerative anemia would you expect erythroid hyperplasia or hypoplasia in the bone marrow

A

fill in

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85
Q

When would SPE be used

A

Serum protein electrophoresis (SPEP) is a test that measures the amount of heavy chain monoclonal protein made by myeloma cells.

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86
Q

Why shouldnt you aspirate or do flow cytometry on a normal adult thymic tissue

A

There is low cellularity

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87
Q

Where do T cells expand in adult animals?

A

in the periphery with antigen stimulation

the thymus is replaced by adipose tissue

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88
Q

In a young animal, progenitor cells travel from the bone marrow to the thymus where they are released into the periphery as________

A

single positive T cells

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89
Q

What is a neoplasm of thymic epithelial cells called?

A

Thymoma

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90
Q

Flow cytometry on a thymic aspirate of thymoma will reveal what cell population?
How does this differ between the cells in the peripheral blood

A

Double positive T cells (reactive by neoplastic epithelial cells)

Peripheral blood will be SP and DN t cells (heterogenous) reactive lymphocytosis

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91
Q

What two autoimmune diseases can be paraneoplastic syndromes to thymomas

A

-Myasthenia gravis (auto-immunity to NMJ)
-Exfoliative dermatitis (auto-immunity to epidermis)

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92
Q

What is spleen function

A

1) filters blood of foreign material, microorganisms, and removes senescent and altered erythrocytes
2) Reservoir for blood - size and shape can vary markedly

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93
Q

What is function of red pulp of the spleen?

A

removal, storage, hematopoiesis, phagocytosis (PAMS)

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94
Q

What is the function of white pulp?

A

Production of B cells and plasma cells to produce antibody and memory lymphocytes

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95
Q

What are periarteriolar lymphoid sheaths

A

T cells areas that surround the central artery of the white pulp

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96
Q

What cells are in periarteriolar lymphoid sheaths of the white pulp

A

T cells

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97
Q

What cells are in the splenic follicles of the white pulp

A

B cells
eccentrically in PALS will form germinal centers when exposed to antigen
Foci can be evident grossly if expanded

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98
Q

What 5 reasons can result in diffuse, soft splenomegaly

A

*Congestion
1) Gastric volvulus with splenic entrapment
2) Splenic volvulus/torsion
3) Barbiturate euthanasia, anesthesia or sedation
4) Acute hyperemia (septicemia)
5) Acute hemolytic anemia

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99
Q

What is the most common non-neoplastic splenic lesions in dogs, especially in old ones, showing a splenic enlargement

A

Nodular lymphoid hyperplasia

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100
Q

What infectious agent of cattle and sheep can cause a dark red to black enlarged spleen, containing abundant unclotted blood

A

Bacillus anthracis (gram +, large, endospore forming bacillus)

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101
Q

Describe the pathogenesis of Bacillus anthracis and its effect on the sheep?

A

1) Spores are ingested
2) Replicate in the intestinal tract
3) Spread to the lymph nodes
4) Disseminate through bloodstream, causing septicemia
*Splenomegaly (dark to black and contain abundant unclotted blood)

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102
Q

T/F you can see intravascular free Bacillus anthracis in impression smears of the spleen AND peripheral blood

A

T

103
Q

What 5 reasons can result in diffuse and firm splenomegaly

A

1) Marked phagocytosis and proliferation of cells (chronic IMHA)
2) Diffuse granulomatous disease (diffuse or nodular)
3) Extramedullary hematopoiesis (diffuse or nodular)
4) Neoplasia (diffuse or nodular)
5) Storage disease of amyloidosis

104
Q

What will the texture of the spleen be with amyloidosis

A

Meaty texture splenomegaly

105
Q

What will the texture of the spleen be with ImhA

A

Meaty texture splenomegaly

106
Q

How do soft bloody nodules occur on the spleen (4 ways)

A

Due to hemorrhage or congestion
1) Hematomas
2) Incomplete contraction
3) Hemorrhagic infarcts
4) Hemangiosarcoma

107
Q

A dog presents in lateral recumbency, pale mucous membranes, increased CRT, abdominal fluid wave, and goes into cardiac arrest during examination. Upon necropsy, you notice multifocal dark patches on the lungs, pale adipose tissue, and a dark nodular spleen. What is the likely cause of death?

A

Hemangiosarcoma

108
Q

Hemangiosarcomas can commonly metastasize, where are common sites?

A

to the lung, liver, kidney, and brain

109
Q

What three breeds are the most commonly diagnosed breeds with Hemangiosarcoma

A

GlDR, GSHD, and labradors

110
Q

What are the most common primary sites for hemangiosarcoma to manifest

A

Spleen, Heart (right auricle), and liver

111
Q

What structure on the heart is common for hemangiosarcomas to manifest

A

The right auricle

112
Q

Hemangiosarcoma is neoplasia of the _________

A

endothelial cells

113
Q

Hemangiosarcomas

A

Neoplasia of the endothelial cells
*Tumors can rupture and cause bleeding into associated cavity
GLDR, GSHD, and labs are the most commonly diagnosed breeds
Weakness, distended abdomen, pale gums, collapse,
most common primary sites: spleen, heart (right auricle), and liver
Metastasis common to lung, liver, kidney, brain

114
Q

T/F Classic swine fever is eradicated in the US

A

T- eradicated in the US in 1978

115
Q

Classic Swine Fever

A

a highly contagious illness in pigs that varies with strain and immune status of herd
-Pyrexia, Hemorrhages and cyanosis, splenic infarction, infects and injures lymphoid tissue

116
Q

What affect does classic swine fever have on the spleen

A

It causes splenic infarction that infects and injures lymphoid tissue (Wedge shapes regions)
additionally hemorrhages and cyanosis

117
Q

What are the 4 ways you can get firm nodules in the spleen

A

1) Lymphoid and complex nodular hyperplasia
2) Primary or metastatic neoplasia (can be diffuse)
3) Granulomas or abscessation
4) Extramedullary hematopoiesis

118
Q

What are the 7 types of primary splenic neoplasia (nodular or diffuse)

A

1) Splenic stromal sarcoma
2) Histiocytic sarcoma
3) Hemangiosarcoma
4) Lymphoma
5) Myelolipoma
6) Mast cell tumor
7) Plasma cell neoplasia

119
Q

What are the causes of pyogranulomatous/ granulomatous disease of the spleen?

A

Bacteria
1) Mycobacteriosis
2) Tularemia
3) Yersiniosis
4) Brucellosis
Fungal
1) Blastomycosis
2) Histoplasmosis
3) Coccidiodosis
4) Sporotrichosis
Protozoa
1) Toxoplasmosis
2) Neosporosis
Viral
1) FIP
Abscesses or pyogranuloma
1) Streptococcous
2) Rhodococcus
3) Trueperella
4) Corynbacterium
*Typically systemic then go to the spleen

120
Q

What 4 ways can you get soft, bloody, cavitated splenomegaly

A

1) Hematomas
2) Incomplete contraction
3) Hemorrhagic infarcts
4) hemangiosarcoma

121
Q

What 4 ways can you get diffuse soft, bloody, cavitated splenomegaly

A

1) splenic entrapment/volvulus/torsion
2) Barbiturate euthanasia, anesthesia/sedation
3) acute hyperemia/septicemia
4) Acute hemolytic anemia

122
Q

Splenic mastocytosis (cats)

A

has cutaneous and visceral forms
Visceral: gastrintestinal and splenic neoplasia
Vomiting, diarrhea, weight loss, and weakness with visceral forms
GI disease associated with a poor prognosis
Splenic disease can have long survival times with splenectomy (metastasis absent)

123
Q

Histiocytic sarcoma

A

an interstitial dendritic cell that can arise from many tissues: skin, lung, meninges, lymph node, bone marrow, synovium

Lymph node involvement is common
Can be solidary lesion or multinodular
Common in Bernese Mountain Dogs, Rott, GLDR, and flat coated retrievers

124
Q

What breed is the poster child for histiocytic sarcomas

A

Bernese Mountain Dog

125
Q

What kind of histiocytic sarcoma has the worst prognosis

A

Hemophagocytic histiocytic sarcoma
macrophages of the spleen and bone marrow
Hemolytic regenerative anemia and thrombocytopenia (coagulopathy)
Diffuse splenomegaly and liver metastasis is common

126
Q

Accessory spleen

A

splenic tissue located separately from the anatomical location of the spleen
congenital or acquired

127
Q

What species are splenic fissures most common in?

A

Horses

128
Q

Splenic hemosiderosis

A

an increased amount of iron in the spleen, usually results from excessive erythrophagocytosis and breakdown of hemoglobin and may be observed in both benign and neoplastic splenic disorders.

129
Q

Siderotic plaques

A

rough, brown to yellow plaques along the serosal surface of the spleen
non-neoplastic/incidental

130
Q

What are the bacterial causes of splenitis

A

-Mycobacteriosis
-Tularemia
-Yersiniosis
-Brucellosis
Abscesses or pyogranulomas (pyogenic bacteria)
-Streptococcus
-Rhodococcus
-Trueperella
-Corynbacterium

131
Q

In regard to the thymus, all species have __________ lobes

A

thoracic lobes

132
Q

The thymus of ruminants and pigs have ____________ and __________ lobes

A

Cervical and thoracic lobes

133
Q

The thymus of cats and horses have _____________ lobes

A

variable and small cervical lobes

134
Q

T/F Dogs have a thymus with cervical lobes

A

F- they only have thoracic lobes

135
Q

Ruminant thymus has cervical and thoracic lobes with their thoracic lobe being located ________

A

dorsally

136
Q

Horse thymus has small cervical lobes (variable number) but their thoracic lobes are located

A

ventrally

137
Q

The dog thymus does not have cervical lobes but their thoracic lobe is located ________

A

ventrally

138
Q

What species has a thymus with thoracic lobes that are located dorsally

A

Ruminants

139
Q

What species have both cervical and thoracic lobes

A

Ruminants and pigs

140
Q

What is the cell of origin of a thymoma

A

epithelial cells

141
Q

What is the purpose of Hassell’s corpuscles?

A

they function in the development of a type of T cell that prevents autoimmune responses.

142
Q

What happens in the subscapular zone of the thymus

A

T progenitor cells enter from the bone marrow to then enter the cortex for positive and negative selection

143
Q

What happens in the cortex of the thymus

A

T cell recognize MHC but not self antigen (Positive selection)
T cell recognize MHC and self antigen (negative selection)

144
Q

What happens in the medulla of the thymus

A

5% of the remaining mature T cells leave thymus where they are distributed to the spleen and the lymph nodes

145
Q

Thymus involution

A

involution occurs following sexual maturity
-lymphoid and epithelial components are replaced by adipose and connective tissue
-T cells continue to circulate through splenic and lymph node T zones
Antigen-specific T cell expansion occurs with antigen presentation

146
Q

What happens to the lymphoid and epithelial components when the thymus involutes

A

It is replaced by adipose and connective tissue

T cells continue to circulate through splenic and lymph node T zones

147
Q

Thymic hypoplasia

A

seen in neonatal animals
results in immunodeficiency

148
Q

Thymic atrophy/necrosis

A

due to lymphocytolysis or inadequate supply from the bone marrow
-heavy metals, radiation, anti-cancer therapy, fungal toxins, viral disease

149
Q

How can we get thymic atrophic or necrosis

A

heavy metals, radiation, anti-cancer therapy, fungal toxins, viral disease

150
Q

Name 6 viruses that affect the thymus

A

1) Parvovirus (dogs and cats) -injury lymphoid tissue/necrosis
2) Canine distemper virus-injure lymphoid tissue
3) FIV - injure lymphoid tissue
4) Equine Herpes-Virus-1- injure lymphoid tissue
5) BVDV - injure lymphoid tissue
6) Porcine circovirus-2 -inflammation of the thymus

151
Q

What are 5 broad reasons for thymic enlargement in an adult

A

1) Hemorrhage
2) Inflammation
3) Neoplasia
4) Cysts
5) Hyperplasia

152
Q

How might thymic hemorrhage occur

A

-Anticoagulants (rodenticide toxicity)
-Trauma
-Idiopathic/spontaneous

153
Q

What causes multisystemic wasting syndrome in pigs

A

Porcine circovirus-2

154
Q

What virus causes:
-Enlarged lymph nodes, interstitial pneumonia, and poor body condition
Thymus atrophy to granulomatous inflammation with multinucleated cells with cytoplasmic viral inclusions

A

Porcine circovirus-2 (Post-weaning multisystemic wasting syndrome)

155
Q

What are your four top differentials for a mediastinal mass identified radiographically?

A

1) Thymoma
2) Lymphoma
3) Hemangiosarcoma
4) Neuroendocrine tumor

156
Q

What are 3 paraneoplastic syndromes associated with thymoma

A

1) Myasethenia gravis and megaesophagus (up to 40%)
2) Thymoma associated lymphocytosis
3) Exfoliative dermatitis- ulceration and scaling; individual epithelial cell necrosis

157
Q

T/F BLV in cattle is associated with thymic lymphoma

A

False

158
Q

Where are the T cells concentrated in a normal lymph node?

A

the paracortex

159
Q

Where are the B cells concentrated in a normal lymph node?

A

the germinal centers (cortex) - B cells react to antigen and produce AB

160
Q

What are of the lymph node do you have plasma cells and macrophages

A

the medulla
stimulated node cords are filled with antibody secreting plasma cells
Sinus histocytes on meshwork and phagocytize foreign material, cell debris, and bacteria

161
Q

How do the majority of lymphocytes enter the lymph node?

A

through high endothelial venues (HEV)

afferent lymphatic vessels in capsule and drain to sinuses

Exit at hilus efferent lymph vessel

162
Q

How do lymphocytes exit the lymph node

A

they exit at the hilus efferent lymph vessel

163
Q

what vessels enter lymph nodes

A

afferent lymphatic vessels

164
Q

lymphocenter

A

a group of nodes present in the same location and drain the same region

165
Q

Mesenteric lymphagiectasia

A

is a disorder characterized by dilation, obstruction, and/or dysfunction of the lymphatic vessels within the small intestine. Dogs with IL often suffer from diarrhea, weight loss, vomiting, and fluid accumulations secondary to protein loss from the intestine

166
Q

Enteric lymphangiectasia

A

caused by dilated lymphatics +/- obstructed or inflammated lymphatics
Diffuse, segmental, focal
Villous expansion by lacteal dilation (white spots)

Present with Chronic GI signs, fluid accumulation

167
Q

What is the most common cause of enteric lymphangiectasia?

A

Protein losing enteropathy- resulting in hypoproteinemia, hypocholesterolemia, lymphopenia, hypocalcemia

168
Q

Intestinal lipogranulomatous lymphangitis

A

inflammatory foreign body reaction to lipid-rich chyle
Chronic GI signs
focal or multifocal
White micronodules on the serosa of intestine and mesenteric fat

No PLE at presentatio n

169
Q

What breeds are most likely to have intestinal lymphangiectasia

A

Yorkshire Terriers
Norwegian Lundehund

170
Q

You have a Yorkshire terrier that presents with chronic diarrhea, wasting, hypoproteinemia, lymphopenia, hypocalcemia and hypocholesterolemia
Peripheral edema, ascites, hydrothorax
What is the likely diagnosis

A

Enteric lymphangiectasia

171
Q

Enteric lymphangiectasia, a protein-losing enteropathy. What else can also cause this?

A

-Lymphatic obstruction
-Increased lymphatic pressure due to inflammation
-Neoplasia
-Granulomatous infiltrates

172
Q

Lymphangiosarcoma

A

neoplasia of lymphatic endothelium

Clinical signs: pitting edema, mass/swelling cervical trunk or limb

multimodal therapy (sx and chemotherapy)

173
Q

What are the clinical signs of lymphangiosarcoma

A

pitting edema
mass.swelling cervical trunk or limb

174
Q

What are the causes of chylothorax

A

idiopathic
trauma
congestive heart failure (more common in cats)
chest tumors

175
Q

What are the clinical signs of chylothorax

A

-Difficulty breathing
-Coughing
-Difficult to auscultate the chest
-Atelectasis
-Can have lymphopenia due to loss of lymphocytes in the fluid

176
Q

What is lymphoid tissue that doesnt have a node but can react when it comes across antigen

A

MALT, BALT, GALT
tonsils, nasal cavity, conjunctiva, and urinary plater

177
Q

What do M cells found in the peyer’s patches do?

A

They deliver antigen to dendritic cells > peyer’s patches/MALT

178
Q

Peyer’s patches are overlaid by _________________ with numerous ___________ cells

A

follicle-associated epithelium with numerous M cells

179
Q

What are some bacteria that gain entery through M cells located in the Peyer’s patch

A

Salmonella, Listeria, Mycobacterium, and Yersinia

180
Q

Hemal nodes

A

prominent in ruminants but also in horses and primate

Sinuses filled with blood “miniature spleen” can filter blood and remove senescent erythrocytes

181
Q

What is present in ruminants, horses, and primates to function as a min spleen to filter blood and remove senescent erythrocytes

A

Hemal nodes

182
Q

What 6 reasons might cause lymph nodes to atrophy?

A

1) Primary immunodeficiency disease
2) Lack of antigenic stimulation
3) Viral infection
4) Cachexia and malnutriton
5) aging
6) Radiation

183
Q

What viral diseases can cause lymphoid injury?

A

1) Parvovirus
2) Distemper
3) FIV
4) Equine Herpes-1 Virus
5) BVDV

184
Q

Why are the mesenteric and oral nodes normally larger

A

because they are processing antigens and bacteria from the intestinal tract

185
Q

lymphofollicular hyperplasia

A

might be in pathology report
numerous prominent secondary follicles

186
Q

Paracortical hyperplasia

A

might be in pathology report

expansion of the paracortex

187
Q

Sinus histiocytosis

A

might be in pathology report
increased histocytes in the sinuses of the lymph node

188
Q

Sinus hemosiderosis

A

might be in pathology report
increased hemosiderin laden macrophages and erythrophagocytosis

189
Q

Sinus edema or erythrocytosis

A

might be in pathology report
expanded sinuses of the lymph node by edema or red blood cells

190
Q

acute lymphadenitis

A

results in lymphadenomegaly
affects lymph nodes draining the sites of infection
Red and edematous can have taut capsule, necrosis and lymphangitis
culture for bacteria, examine impression smears for bacteria, histopathology

Culture for bacteria, examine impression smears for bacteria, histopath

191
Q

What are differentials for a cat with peripheral lymphadenomegaly

A

-Lymphoma (not as common as cats, dogs have multinodal commonly)
-FIV
-Dental disease
-Immunization
-Bartonella
-Yersinia pestis
-Tularemia

192
Q

Yersinia pestis

A

a gran negative coccobacillus that is carried in the fleas of squirrels, praire dogs, rabbits, and woodrats
transmitted when eating an infected animal or bitten by an infected flea

Signs: pyrexia, loss of appetite, lethargy, enlarged lymph nodes
Need to start treatment early
Zoonotic

193
Q

What form of plague is transmitted through fleas/rodents?

A

The bubonic form- fever, headache, and swollen lymph nodes

194
Q

What form of the plague is transmitted through the skin

A

the septicemic form- fever, shock, and hemorrhage

195
Q

What form of the plague is transmitted through air droplets

A

Pneumonic form- fever, headache, and pneumonia

196
Q

What are the infectious causes of lymphadenitis

A

1) Yersinia pestis
2) Mycobacterium avium ssp paratuberculosis
3) Rhodococcus equi ssp. Equi
4) Histoplasmosis

197
Q

What causes Strangles in horses

A

Streptococcus equi ssp. Equi
-highly contagious

198
Q

Describe the pathogenesis of Strangles

A

1) Inhalation
2) Retropharyngeal and submandibular enlargement from LN abscesses
3) compress pharynx
4) ruptured abscess may spread blood or lymph to other organs
*Purpura hemorrhagica (hypersensitivity III, may result in necrotizing vasculitis with repeated exposure)

199
Q

Bastard Stangles

A

wen abscesses from Streptococcus equi ssp. equi ruptures and spread blood or lymph to other organs

200
Q

Purpura hemorrhagica

A

a type III hypersensitivity that occurs through multiple exposures to Streptococcus equ ssp. Equi
causes a necrotizing vasculitis

201
Q

Rhodococcus equi

A

affects foals up to 6 months of age. causes bronchopneumonia but 50% of foals can develop a pyogranulomatous ulcerative enterotyphlocoloties of the Peyer’s patches

202
Q

50% of foals with Rhodococcus equi can also develop what, in addition to the bronchopneumonia

A

Pyogranulomatous lymphadenitis of the mesenteric and colic lymph nodes

203
Q

A buffalo presents for necropsy. animal showed chronic wasting, intestine had a thickened mucosa
on histopath you see aggregates of epithelioid macrophages and multinucleated giant cells. There were acif-fast staining bacilli within epithelioid macrophages. What is the cause?

A

Johne’s disease (mycobacterium avium paratuberculosis)

204
Q

What is the causative agent of Johne’s disease

A

Mycobacterium avium paratuberculosis
causes enteritis and granulomatous lymphadentitis

205
Q

How would you identify Mycobacterium avium paratuberculosis on histopath

A

they are acid fast and within the macrophages

206
Q

Sheep and goats with Johne’s disease may have

A

granulomas with necrotic caseous centers and mineralization

207
Q

Mycobacterium bovis

A

bovine tuberculosis- lymph nodes are necrotic and suppurative/abscessed
chronic progressive disease
humans infected by consuming raw milk or milk products

208
Q

sheep presents with an abscess that is encapsulated and contains greenish thick, opaque fluid
mandibular lymph nod is enlarged. the contents are thick and inspissated and tan to white

A

Caseous lymphadentitis
Corynebacterium

209
Q

What can cause lymphoid depletion with granulomatous inflammation with multinucleated giant cells and cytoplasmic inclusion bodies

A

Porcine circovirus -2
Postweaning multisystemic wasting syndrome

210
Q

Porcine reproductive and respiratory syndrome virus (PRRS)

A

an arterivirus with a predilection for lymphoid tissues
Virus replicates in the macrophages of lymphoid tissues and lungs and may persist in tonsil and lung macrophages
Reduced phagocytic and function of macrophages
Intersititial pneumonia and generalized lymphadenopathy, tracheobronchial and mediastinal most commonly affected
Lymph nodes can be hemorrhagic or enlarged pale tan +/ cystic and firm

211
Q

Where does procine reproductive anf respiratory syndrome virus replicate

A

it replicates in macrophages of lymphoid tissues and lungs and may persist in tonsil and lung macrophages

-causes interstitial pneumonia and generalized lymphadenopathy

212
Q

Name an arterivirus with predilection for lymphoid tissues

A

Porcine reproductive and respiratory syndrome virus (PRRS)

213
Q

A histiocyte in the skin is called a

A

Langerhans cell

214
Q

a histiocyte in the tissue is called a

A

Macrophage

215
Q

What is the cellular origin of hemophagocytic histiocytic sarcoma

A

splenic macrophage

216
Q

What are the 4 categories that define the types of lyphoma

A

1) Anatomic location (multcentric, alimentary, mediastinal/thymic, spleen, cutaneous, etc)

2) Cellular origin: B lymphocyte vs T lymphocyte vs precursor

3) Histologic pattern- diffuse vs nodular

4) Biologic behavior (indolent-low grade to aggressive-high grade)

217
Q

What are the clinical signs of lymphoma

A

-Generalized lymphadenomegaly
-Thickened intestine, hepatomegaly, splenomegaly
-Advanced disease (aspiration of bone marrow, spleen, liver and LNs)
-Mild to moderate nonregenerative anemia is common
-Lymphopenia/lymphocytosis
-Hypercalcemia (mediastinal involvement)
-Hyperglobulinemia

218
Q

An excellent non-invasive method for peripheral lymphadenopathy and suspicion of lymphoma

typically need a significant neoplastic population within the sample
Cells must be viable
Samples include fresh peripheral blood, lymph node, and tissue aspirates
Some types of lymphoid neoplasia need histopathology for subtyping

A

Flow Cytometry

219
Q

T/F Cytology can provide a lymphoma diagnosis but cannot subtype lymphoma

A

T

220
Q

What thickness of tissue is needed for lymph node biopsy

A

at least 2mm thickness to assess tissue architectural
avoid compression of tissue (crush artifact)

221
Q

Why is it important to promptly transfer the tissue to the fixative when doing a lymph node biopsy

A

mitotic activity can be up to 40% decreased with mroe than 12 hour delay

222
Q

PARR

A

Can use a variety of different sample types (old or non-viable flow sample)

Diagnosis: distinguish between neoplasia and hyperplasia/reactive process, sensitive in a sample without a significant neoplastic process, no prognostic information

223
Q

T/F PARR tells you diagnosis but does not tell you prognosis

A

True

224
Q

T/F Both Flow Cytometry and PARR samples need to be viable

A

Only Flow Cytometry samples need to be viable
PARR samples do not need to be viable

225
Q

What are the different types of lymphoma in dogs?

A

-Multicentric: Diffuse large B cell is most common (Also Small B cell (MZL/DSBCL/FL) and PTCL, TZL)

-Enteric lymphoma: (T cell origin, small and large) and (Colonic large B cell)

-Cutaneous lymphoma: Cutaneous epitheliotropic T cell lymphoma most common

-Thymic lymphoma: T cell most common, Acute lekemia and PTCL can have mediastinal involvement

-Splenic lymphoma: Splenic marginal zone lymphoma are most common

226
Q

Which of the dog lymphomas can typically be diagnosed by flow cytometry

A

1) Multicentric lymphoma: Diffuse large B cell, Small B cell, PTCL, TZL

2) Thymic lymphoma: T cell, Acute leukemia and PTCL can have mediastinal involvement

227
Q

What is the most common type of lymphoma in cats

A

Enteric lymphoma
1) Small mucosal epitheliotropic T cell lymphoma- small intestine - good prognosis of 28 months
2) Large T cell transmural (poor)
3) Large B cell in stomach and large intestine (poor)

228
Q

Thymic lymphomas in cats are often associated with _________

A

FeLV or FIV

229
Q

How can histologic grade help to predict the outcome of feline intestinal T cell lymphoma

A

Transmural or Mucosal (Transmural = worst prognosis with lower survival probability)

Cell size (Large= worst prognosis with lower survival probability)

230
Q

Generally speaking: does large cell or small cell feline intestinal T cell lymphoma have a worst prognosis

A

Large cell

231
Q

What is the most common lymphoma in horses

A

T ell rich large B cell lymphoma- cutaneous

232
Q

In horses, GI lymphoma can also cause____________

A

a wasting syndrome

233
Q

What is the most common neoplasia in pigs

A

Lymphoma
(Females > Males)

234
Q

What is the most common kind of lymphoma in pigs

A

Multicentric visceral lymphadenopathy

235
Q

What is the most common lymphoma in goats

A

Mostly multicentric with involvement of thymus, liver, kidney and lung
T cell is more common than B cell

236
Q

Merek’s Disease

A

a gallid alphaherpes virus 2 that is highly contagious
matures in the feather follicle
enlarged peripheral nerves
diffuse or nodular lymphoid tumors

commonly present with unilateral paralysis
tumors can develop in heart, ovary, liver, lung, kidney, eyes, feather follicles, nervous system

237
Q

Lymphoid leukosis in chickens

A

a retrovirus that caused nodular lymphoid tumors
Bursa of Fabricus usually involved

238
Q

What infectious disease causes lymphoma and affects the bursa of fabricus

A

Lymphoid leukosis

239
Q

What infectious diseases causes enlarged peripheral nerves and diffuse or nodular lymphoid tumors in chickens

A

Mereck’s disease (gallid alphaherpes virus 2)

240
Q

How do patients with Mareck’s disease typically present?

A

with unilateral paralysis

241
Q

What is the phenotype of Bovine enzootic lymphoma caused by bovine leukosis virus (BLV)

A

B cell lymphoma

242
Q

What percent of cattle with bovine leukosis virus will develop lymphoma

A

Less than 5% of cattle
(30% will have a non-neoplastic persistent lymphocytosis)

243
Q

BLV associated lymphoma is more common in what kind of cattle

A

Adult dairy cattle

244
Q

BLV associated lymphoma

A

B cell phenotype
30% have non-neoplastic persistent lymphocytosis
5% infected will develop lymphoma
More common in adult dairy cattle
Common sites: lymph nodes, abomasum, uterus, and heart (HULA), other sites include retro-oribtal, renal and spinal cord, stomach

245
Q

Lymphoma (non-BLV associated) in cattle has what three components?

A

1) Thymic disease (<2 years of age): Respiratory distress

2) Multicentric disease (3-6 months old): liver, spleen, kidney, BM involvement

3) Cutaneous (1-3 years old)- plaques

246
Q

How do carcinomas typically metastasize?

A

to regional lymph nodes through the lymphatic cells

247
Q

Mast cell tumors and malignant melanomas are frequently metastatic to _____________

A

lymph nodes

248
Q

How do sarcomas typically metastasize?

A

hematogenous

249
Q

When is the PARR assay most useful?

A

When previous findings are concerning for lymphoid neoplasia but not definitive

250
Q

What disease is multicentric lymphoma associated with in cats?

A

FeLV or FIV

251
Q

A sheep presents with an enlarged lymph node or a mass in the cervical region. There are multiple animals with similar lesions on the farm. On cytology there are neutrophils with intracellular bacteria. What bacteria are you most concerned about.

A

Corynebacterium pseudotuberculosis

252
Q

What features are prognostic in feline intestinal lymphoma?

A

Transmural versus mucosal involvement
B cell versus T cell
Cell size of T cell lymphoma

253
Q
A

BOD 3 (5 decks)

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