Flashcards in Lymphoreticular pathology Deck (26)
What makes up the primary immune system?
bone marrow, thymus
What makes up the secondary immune system?
lymph nodes, spleen, MALT
What cells are inside the bone marrow?
Haemopoietic stem cells
What can haemopoietic stem cells become?
MYLOID PROGENITOR CELLS - platelets, eosinophils, basophils, neutrophils, monocytes, erythrocytes
LYMPHOID PROGENITOR CELLS - T cells, B cells
What makes up a lymph node?
Afferent lymph vessel
Primary lymphoid follicle ( B cell area)
Secondary lymphoid follicle
Medullary cords (macrophages and plasma cell area)
How do we classify lymphoreticular disorders? (cancers)
Benign - reactive lymph node
Malignant - lymphocytic leukaemia, lymphomas, myeloma
What predisposes (causes) someone to lymphoreticular disorders?
Infective - acute (bacterial, viral), chronic (TB)
What is leukaemia?
Malignant clonal proliferation of one of the bone marrow cell lines - white blood cells
Acute (ALL, AML) or chronic (CLL,CML)
What causes leukaemia?
Damage to DNA during cell division
Acute lymphoblastic leukaemia
Overproduction and accumulation of cancerous, immature white blood cells (lymphoblasts)
Most common childhood
Cure 60- 90%
Age 2 - 10 yrs
Acute myloid leukaemia
Possible involvement of all cell lines
Overproduction of immature white blood cells, called myeloblasts or leukaemic blasts. These cells crowd the bone marrow, preventing it from making normal blood cells.
What are some oral signs of leukaemia?
What problems may occur secondary to treatment?
Bone marrow failure due to irradiation
Salivary gland damage
Chronic myloid leukaemia
Production of pleuripotent stem cells together with philadelphia chromosome (9 and 22 translocation)
Non specific symptoms - malaise, weight loss
Chronic lymphocytic leukaemia
Clonal proliferation of mature B cells
Painless, lymphadenopathy, recurrent infections, anaemia
What is a lymphoma?
Malignant proliferation in lymph nodes
Two forms : Hodgkins and Non - Hodgkins
What is the difference between leukaemia and lymphoma?
LEUKAEMIA - proliferation of WBC - circulating cells
LYMPHOMA - proliferation of cells originally in one place - static tumour
What is Hodgkins lymphoma?
Malignant proliferation of atypical lymphocytes with a reactive inflammatory background within a lymph node
M>F 20-30 yrs and then 50-60 yrs
Many types : nodular sclerosing, mixed cellularity, lymphocyte depletion, lymphocyte rich
Linked to EBV and HIV
Present with reed - sternberg cells which are multinucleatd enlarged leukocytes
Symptoms - lymphadenopathy, splenomegaly, sweats, fever, weight loss
What is Non - Hodgkins lymphoma?
Slow growing, incurable and non aggressive or fast growing, aggressive, cureable, sudden
Most common in B cell
Destruction of normal nodal architecture, capsular invasion, and extension to soft tissues
Can arise outside the lymph node
Symptoms - lymphadenopathy, lesions intra-orally,
Lined to Sjogrens syndrome
How does lymphadenopathy present?
Local or generalised
What is the cause of local lymphadenopathy?
What is the cause of generalised lymphadenopathy?
Lymphoma, RA, HIV
What is the prognosis for leukaemia?
Depends on the grade, type and stage
Stage 1 - involves single lymph node or localised organ
Stage 2 - 2+ lymph nodes on same side of diaphragm
Stage 3 - lymph nodes on both sides of diaphragm
Stage 4 - organs with or without lymph nodes, distal involvement
What is the treatment for leukaemia?
What is a multiple myeloma?
Proliferation of lymphoid cells where the malignant cells show differentiation towards plasma cells.
Common in the elderly
Plasma cells produce Ig's
Presents as jaw lesions, soft tissue mass, bone pain, tenderness, anaemia, impaired renal function