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WBC disorders Flashcards

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1
Q

what are lymphomas?

A

malignant proliferations of cells native to lymphoid tissue- lymphocytes and their precursors and derivatives

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2
Q

two main types of lymphomas?

A

hodgkins and non hodgkins

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3
Q

what is Leukemia

A

malignant proliferations of cells native to the bone marrow, which often spillover into the blood.

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4
Q

hodgkins lymphoma morphological features

A
  1. Reed-Sternberg cells admixed with a

2. variable inflammatory infiltrate

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5
Q

distinguishing features of hodgkins lymphoma compared to non hodgkins lymphoma

A

Hodgkin lymphoma (HL) is often accompanied by

  1. fever,
  2. arises in a single lymph node or chain of nodes,
  3. more common in young adults (average age 30 years),
  4. characterized by contiguous spread within lymph node groups ,
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6
Q

cause of hodgkins lymphoma

A

unknown

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7
Q

the neoplastic cell associated with hodgkins lymphoma

A

Reed-Sternberg cells

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8
Q

A diagnosis of Hodgkin lymphoma requires the presence of ______ in the appropriate histologic background:

A

RS cells

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9
Q

small or large numbers of RS cells are present in the involved node

A

small

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10
Q

RS cells characteristics

A
  1. large cell
  2. mirror image nuclei
  3. prominent nucleoli
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11
Q

Choice of therapy (chemotherapy, radiotherapy, or both) and prognosis are based on _____

A

stage

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12
Q

localized lymph node involvement, without systemic signs (fever, weight loss), and has a better prognosis denotes ____ stage

A

low stage disease

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13
Q

______-stage disease indicates widespread disease, often with bone marrow involvement, and has a worse prognosis.

A

high

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14
Q

All stages are further divided on the basis of absence (A) or presence (B) of _______

A

systemic symptoms,

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15
Q

Most patients have enlarged, painless, superficial ___________ as the initial manifestation of disease.

A

lymph node involvement

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16
Q

as disease progresses what happens

A
  1. involvement of other lymph nodes in chest and abdomen
  2. involve spleen and liver (seen with MRI)
  3. Complications with infections (decreased cell-mediated immunity), anemia, and thrombocytopenia can occur in advanced disease.
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17
Q

There is a low, but definite risk for developing ________ after treatment with chemotherapy and radiotherapy because of the bone marrow toxicities of the chemotherapeutic drugs used.

A

acute leukemia

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18
Q

choice of therapy

A

chemo, and to an lesser extent radiotherapy

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19
Q

There is more ______ diversity in NHL than in HD

A

morphologic

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20
Q

Non-Hodgkin lymphomas (NHL) arise in

A

lymphoid tissue– either in lymph nodes or lymphoid tissue of solid organ

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21
Q

NHL differences compared to Hodgkins lymphoma

A

NHLs tend to have

  1. multiple node involvement,
  2. more frequent extranodal spread and peripheral blood involvement
  3. affect all ages
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22
Q

what is required for diagnosis of NHL

A

histologic examination of involved tissue

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23
Q

The majority (85%) of NHL are clonal neoplasms of

A

B lymphocytes. remianing 15% is T cell involvment

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24
Q

B cells are involved with what

A

antibody production

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25
A _______ develops when there is a monoclonal expansion of lymphocytes that have been "arrested" (or have acquired a genetic rearrangement that alters growth regulation) at a particular stage in transformation.
lymphoma
26
T/F all lymphoid neoplasms are considered to arise from a single transformed cell.
TRUE
27
NHLs are classified on the basis of......
1. their morphology (microscopic appearance), 2. cell of origin (immunophenotype), 3. clinical features 4. genotype.
28
T/F There is MORE correlation between stage and prognosis in NHL than in HD
FALSE, theres less
29
Stage 1 NHL
Involves single lymph node region or extralymphatic organ or site
30
Stage 2 NHL
Involves two or more lymph node regions on same side of diaphragm alone or with involvement of contiguous extralymphatic organ or tissue
31
Stage 3 NHL
Involves lymph node regions on both sides of diaphragm which may include spleen.
32
Stage 4 NHL
Multiple or disseminated foci of involvement of one or more extra lymphatic organs or tissues with or without lymphatic involvement
33
in distinction to the group of diseases classified as leukemias, NHL's can.....
spread to involve 1. solid organs 2. GI tract 3. bones 4. nervous system
34
clinical presentation of NHL
1. painless enlarged lymph nodes 2. evidence of extranodal spread- enlarged liver or spleen 3. bone marrow involvement
35
what is the 'leukemic phase' of the disease
when you see Circulating lymphoma cells in the peripheral blood
36
T/F complications with infection and treatment options are similar to hodgkins lymphoma
TRUE
37
Leukemias are malignant neoplasms of....
hematopoietic tissue that arise in the bone marrow.
38
The malignant cells __________ in the _______, commonly producing a pattern of diffuse infiltration
proliferate in the bone marrow,
39
what happens to these proliferating cells in the bone marrow
There is often "spill over" of the proliferating cells into the blood and other organs.
40
This group of diseases can be roughly conceptualized both in terms of _____ and of ______ involved
onset | cell type
41
disease onset can be ____ or _____
acute or chronic
42
leukemia cell types involved
myelogenous (myeloid and monocytic) and lymphoid.
43
examples of leukemias basic classification
acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML).
44
acute leukemias characteristics
1. rapid 2. usually fatal, survival months 3. BLAST (immature cells) in blood and bone marrow (>20%) 4. increase white blood cell count
45
chronic leukemia characteristics
1. slow (indolent) 2. long survival, years 3. mature cells, NO BLAST 4. increase white blood cell count
46
Acute lymphocytic leukemia
1. 40% of acute leukemias 2. proliferating cell is a primitive lymphoid 3. principal cause of cancer deaths in childhood (<15 years old) 4. Five subtypes recognized immunologically (early B precursor, pre-B, mature B, and T cell)
47
T/F Cytogenetic analysis has prognostic significance
TRUE
48
what is more common in ALL than AML.
Enlargement of lymph nodes, liver and spleen, and nervous system involvement.
49
what group has the best prognosis?
children 2-10 with pre-B cell types
50
ALL associated with _____
children cancer
51
Acute myelogenous leukemia (AML)
1. proliferating cell is a primitive myeloid cell 2. Cytoplasmic inclusions called Auer rods 3. older adult population, with a median age of 50 years.
52
Cytoplasmic evidence of myeloid differentiation includes
includes the presence of several types of granules (myeloperoxidase) found in more mature myeloid cells.
53
T/F Auer rods are not used in diagnostic
FALSE, when present, they are
54
what is most predictive of prognosis of AML
karyotype
55
Sometimes the lesional cells will proliferate in ______, producing what is termed ________.
``` soft tissue (including the gingivae) granulocytic sarcoma ```
56
T/F Although many patients can obtain remission of disease after chemotherapy, the duration of remission is often transient.
TRUE
57
Infiltration of the gingivae is a feature commonly associated with _______
acute myelo-monocytic leukemias.
58
Clinical features result from
(1) impairment of marrow function as abnormal cells suppress growth of normal cells, (2) infiltration of body organs due to proliferation of the abnormal cells.
59
other clinical features
1. Anemia --> fatigue, pallor, weakness 2. Thrombocytopenia (decreased platelets) --> bleeding and bruises. 3. infection --> fever 4. organ enlargement (lymph nodes, spleen, liver) occurs as the abnormal cells proliferate in these sites --> abdominal pain, blocked vasculature or lymphatics
60
Plasma cell disorders result from clonal expansion of _____
immunoglobulin-secreting cells.
61
increase secretion of immunoglobulin results in what
increased serum monoclonal protein (M component)
62
monoclonal protein (M component) may have adverse effects on
renal and neurologic function.
63
what makes the diagnosis of Multiple Myeloma ?
Documenting 1. monoclonal protein 2. skeletal lesions
64
Multiple Myeloma proliferating cell is a
plasma cell that produces immunoglobulin
65
what characterizes myeloma
Multifocal destructive bone lesions characterize myeloma
66
how does bone lesion occur in myeloma?
secretion of osteoclast activating factors by the myeloma cells induces bone resorption
67
Patients often present with _____, _____, and ______
bone pain, hypercalcemia, and renal disease.

gen path 2 (8 decks)

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