Lecture 18: Hematopathology Flashcards
Types of RBC disorders
- Anemia
- Polycythemia
- Inclusions/infections
- Cytopenias
Anemia
Reduced oxygen carrying capacity: blood loss, hemolysis (in/extrinsic), impaired production
Polycythemia
Excessive RBCs that hinder flow; can be adaptive or pathological
Cytopenia
Marrow produces many cells but failure in maturation
How is bone marrow analyzed?
Aspirate smear or biopsy
Hypochromic microcytic anemia
Caused by iron deficiency; tiny pale RBCs
Megaloblastic anemias
Caused by Vit. B12, folate deficiency affecting maturation; immature cells w/ large nuclei
Sickle cell disease
Hereditary RBC disorder where beta globin chain substitution causes sickle shaped RBCs; complicated w/ infarcts, vaso-occlusive crises
Hemolytic anemia
Damage to RBCs mechanically or secondary to diseases (i.e. microthrombi)
Aplastic anemia
Non-functional marrow with injured/altered SCs -> reduced proliferative/differentiative capacity
Types of WBC disorders
Non-neoplastic: increased/decreased, immune mediated disease
Neoplastic: marrow or LN based
Dohle bodies
Neutrophils w/ reactive changes; response to infection
Categories of neoplastic WBC disorders (lymphomas)
By cell: T, B, T+NK
Maturity: precursor (immature) or peripheral (mature)
Hodgkins: Reed-Sternberg neoplasms
Examples of non-Hodgkin’s lymphomas
- Follicular lymphoma
- Peripheral T cell lymphomas
Follicular lymphoma
- Neoplastic splenic follicles
- Bcl2 immunostain
Hodgkin lymphoma
- Polymorphous background
- Reed-Sternberg cell characteristics (many cytokines, mononuclear variant)
- Bimodal age incidence
Leukemias
- AML
- ALL
- CML
Acute Myelogenous Leukemia
- Auer rods
Acute Lymphoblastic leukemia
- Flow cytometry differentiates ML vs LL
- CD10, CD19, TdT, CD22 markers
Chronic Myelogenous Leukemia
- Chr. translocation (9:22); BCR/ABL protein kinase
- Leukocytosis, splenomegaly, blast crisis (can progress to acute phase AML, ALL)
- Gleevec treatment
Multiple myeloma
- Clonal expansion leading to IgG kappa expression alone (no variants)
- Osteolytic lesions, plasmacytoma clusters
Myelodysplastic disorders
- De novo or therapy related
- Older patients; lower blast count
- Varied risk of transformation to AML
Types of bleeding/clotting disorders
- Disseminated Intravascular Coagulation (DIC)
- Factor VIII deficiency
- von Willebrand’s disease
Disseminated Intravascular Coagulation
- Adhesion to endothelium generates microthrombi
