WBC Pathology I Flashcards by Thea Guillermo

Histology morphology of the myeloblast:

Youngest
Scanty cytoplasm
Nucleolus

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How is the promyelocyte differentiated from the myeloblast?

Primary granules are present

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Immature WBC with specific granules:

Myelocyte

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First immature WBC to appear in the peripheral smear; equivalent to a reticulocyte:

Intermediate cell

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Most common cause of agranulocytosis:

Drug toxicity

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Pathogenesis of leukopenias:

Inadequate or ineffective granulopoiesis
Increased destruction
Splenic sequestration

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Kotsmann syndrome is:

Congenital inability to produce neutrophils

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Peripheral WBC count is influenced by:

Size of precursor storage pools
Rate of cell release
Proportion of cells in the marginal pool
Rate of cell extravasation

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Types of benign WBC proliferation in the bone marrow:

Leukocytosis

Leukemoid Reaction

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Causes of neutrophilia:

Bacterial infection
Tissue necrosis
Pyogenic infection

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Causes of lymphocytosis:

Chronic infection

Fungal, viral, immunologic reaction

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Causes of eosinophilia:

Asthma
Allergy
Parasitic infection

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Causes of monocytosis:

Chronic infection

Collagen disease

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Basophilia is often indicative of:

Myeloproliferative disorder

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PBS changes during a leukemoid reaction:

Toxic granules (Dohle bodies)
No blasts, but stab cells present

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B-cells are located in what area of the lymph node?

Follicular area

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T-cells are located in what area of the lymph node?

Parafollicular area

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Acute lymphadenitis in the cervical region indicates infection of:

Submandibular or neck area

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Infection in the extremities manifests as acute lymphadenitis in which regions?

Axillary and inguinal regions

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Three types of chronic lymphadenitis:

Follicular Hyperplasia
Parafollicular/Paracortical Hyperplasia
Sinus histiocytosis/reticular hyperplasia

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In follicular hyperplasia, activated B-cells are located in the ___ while inactivated B cells are located in the ___ area:

germinal center; thin marginal

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Two zones of germinal centers:

Centroblast (dark)

Centrocytes (light)

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B-memory cells originate in the:

Centrocytes of the germinal center

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Causes of follicular hyperplasia:

Rheumatoid arthritis
Toxoplasmosis
Early HIV

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Features favoring a non-neoplastic hyperplasia:

Preservation of LN architecture Variation in follicular shape and size Mitotic figures and phagocytic macrophages

Characteristic cells in parafollicular hyperplasia:

Immunoblasts

Causes of parafollicular hyperplasia:

Drugs IM Vaccines

Hypertrophy of these cells are characteristic of sinus histiocytosis/reticular hyperplasia:

Lymphatic endothelial cells | Increase in macrophages

Structures indicative of follicular hyperplasia, located in the centrocytes:

Tingible bodies (phagocytosed B-cells)

Categories of Neoplastic proliferative states:

Lymphoid Neoplasm Plasma cell dyscracias Myeloid neoplasms Histiocytoses

Originating cells of lymphoid neoplasm:

T-cells, B-cells, NK cells

3 categories of myeloid neoplasms:

Acute myeloid leukemia Myelodysplastic syndrome Chronic myeloproliferative disorders

Histiocytoses is a proliferation of these cells:

Macrophages and dendritic cells

Sinus histiocytosis is prominent in which cancers:

LN draining cancers (e.g. breast carcinoma)

Precursor B-cells cancers:

B Lymphoblastic Leukemia/Lymphoma (ALL)

Precursor T-cell cancers:

T lymphoblastic leukemia/lymphoma

Peripheral B-cell cancers:

``` Small Lymphocytic Leukemia Chronic Lymphocytic Leukemia Hairy cell leukemia Burkitt's Lymphoma Follicular Lymphoma ```

Peripheral T-cell cancers:

T-cell lymphoma Anaplastic Large Cell Lymphoma Mycosis Fungoides/Sezary Syndrome

Seen in all lymphocytic tumors, distinguishes from carcinoma:

CD 45 (Leukocyte Common Antigen)

Monocyte/macrophage antigens:

CD 14 | CD 64

Stem cell antigen:

CD 34

Markers are usually ___ in B-cell lymphomas and ___ in T-cell lymphomas:

high; low

Antigens seen in Hodkin's lymphoma:

CD 15 | CD 30

Pan-B marker:

CD 19

Peripheral T-cell marker:

CD 3

Precursor T-cell markers:

CD 1, 2, 5, 7

Germinal center B-cell marker:

CD 10

Characteristics of lymphoid tumors:

``` Monoclonal population Mostly B cells (90%) Unique clinical presentations Immune abnormalities Mimic normal counterpart behavior Protective Ig breakdown ```

Symptoms of lymphadenopathy:

Multiple, painless, large, COALESCENT lymph nodes

Lymphoid tumors are grossly ____ instead of ____, as in normal LN:

fleshy, nodular, white; | smooth and tannish

Main identification of precursor B/T cell neoplasms:

+ lymphoblasts | + TdT

Pre T-cell neoplasms usual manifest clinically as:

mediastinal mass

Cancer typically affecting adolescent males:

Acute lymphoblastic lymphoma

Cancer typically affecting 60 y/o males:

Small lymphocytic lymphoma | Mantle cell lymphoma

Difference in WBC count between SLL and CLL:

Decreased in SLL | Increased in CLL

SLL and CLL may spread from __ to __ and finally to __:

Lymph node; bone marrow; blood

What is SLL Richter syndrome:

Transformation of B-cell to prolymphocytes

Complication of SLL:

Autoimmune hemolytic anemia

Most common chromosomal abnormality in SLL:

Trisomy 12

CD markers present in SLL/CLL:

CD 19 CD 20 CD 23 CD 5

Characteristic histological finding of SLL/CLL:

Smudge cells (disrupted tumor cells)

Cancer affecting male and female middle aged individuals:

Follicular lymphomas

Genetic abnormality in follicular lymphoma:

t(14:18) bcl-2 protooncogene (apoptosis)

Distinguish histologically between follicular lympoma and follicular hyperplasia:

Well-defined germinal centers cannot be observed in follicular lymphoma

Germinal centers of follicular lymphoma are absent ___:

tingible bodies

Immunophenotype of follicular lymphoma:

CD 10 CD 19 CD 20 bcl-2 protein

If c-MYC gene is present, follicular lymphoma progresses to:

DLBL

Cancer with biphasic age profile:

Diffuse Large B-cell Lymphoma

Symptoms of DLBL:

Rapidly enlarging mass SINGLE nodal or extranodal site

DLBL genetic abnormality:

t(14:18) bcl 6

Immunophenotype of DLBL:

CD 19 CD 20 CD 10

Cancer common in children and young adults:

Burkitt's lymphoma

Histology of Burkitt's lymphoma:

Round cells interspersed with macrophages

Immunophenotype of Burkitt's lymphoma:

``` CD 10 CD 19 CD 20 bcl-6 IgM ```

Burkitt's genetic abnormality:

t(8:14) of c-MYC

Pattern characteristic of Burkitt's:

Starry sky appearance

Characteristic of marginal zone lymphoma:

Arise from chronic inflammatory disorder Remains localized May regress if treated very early

Genetic abnormaity in marginal zone lymphoma:

t(11:18) or t(14:18)

Immunophenotype of Mantle cell lymphoma:

CD 19 CD 20 CD 5 CD 23

Genetic abnormality of mantle cell lymphoma:

t(11:14), increased cyclin D1

Histological picture of mantle cell lymphoma:

homogenous small lymphocytes surround compressed germinal center

This distinguishes Sezary syndrome from mycosis fungoides clinically:

Sezary syndrome is more like an exfoliative erythroderma w/o tumor phase

3 clinical stages of mycosis fungoides:

Inflammatory phase Plaque phase Tumor phase

Symptoms of NK cell lymphoma:

Destructive sinus masses in nasopharynx, nose, oral cavity

Cancers associated with EBV:

Burkitt's lymphoma NK cell lymphoma Hodgkin's lymphoma

Biopsy in NK cell lymphoma would show:

(-) malignancy | (+) necrotic tissues

Genetic abnormality in anaplastic large cell lymphoma:

2p23 ALK gene

Hallmark cells in anaplastic large cell lymphoma:

Horseshoe-shaped nuclei and voluminous cytoplasm

CD4 T-cell cancers:

Mycosis fungoides | Adult T-cell lymphoma/leukemia

CD8 T-cell cancers:

Anaplastic large cell lymphoma

Only lymphoma directly associated with virus:

Adult T-cell lymphoma (HTLV-1)

Characteristic of T-cell lymphoma:

Skin lesions Hypercalcemia Clover leaf or flower cells Severe anaplasia

Characteristic of Hodgkin's Lymphoma

``` RS cells (only tumoral cells) Polymorphic cells Single axial LN chain affected Spread is contiguous Paravertebral nodes are affected Rarely extranodal ```

Hodgkin's Lymphoma is usually found in ___, except for the __ type:

males; nodular

Subtypes of Hodgkins lymphoma:

``` Nodular sclerosis Mixed cellularity Lymphocyte predominance Lymphocyte depletion Lymphocyte rich ```

Most common Hodgkins lymphoma subtype:

Nodular sclerosis

Nodular sclerosis Hodgkin's has which RS variants?

Lacunar cell and collagen band

Mixed cellularity Hodgkins has which RS variants?

Classic and mononuclear RC cells

Hallmark cell of Lymphocyte predominance Hodgkins:

Popcorn cells (lymphohistolic)

In Hodgin's lymphoma, the more lymphocytes present, the ___ the prognosis:

better

WBC Pathology I Flashcards

(100 cards)