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White Blood Cell Disorders Flashcards

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1
Q

What cells are produced in the lymphoid lineage?

A

Lymphocytes such as B and T cells

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2
Q

Where do B and T cell precursors mature?

A

B cells in the bone marrow and T cells in the thymus

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3
Q

What makes up the primary lymphoid system?

A

The thymus and the bone marrow

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4
Q

Where are mature lymphocytes contained (general)?

A

Secondary or peripheral organs

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5
Q

What 5 organs make up the peripheral lymphoid system?

A

Tonsils, spleen, lymph nodes, adenoids, Peyer’s patches

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6
Q

B cells are for what kind of immunity? How and what do they attack?

A

Humoral immunity, they secrete antibodies that attack extracellular pathogens such as bacteria

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7
Q

T cells are for what kind of immunity? How and what do they attack?

A

For cellular immunity, they attack intracellular pathogens like viruses with cytokines or lysis proteins

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8
Q

The concave side of the lymph node contains?

A

The hilum

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9
Q

The hilum contains?

A

Veins, arteries, and efferent lymphatics

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10
Q

What is on the convex side of the lymph node?

A

The capsule

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11
Q

The capsule contains?

A

Afferent lymphatics

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12
Q

Where is lymph filtered through in a lymph node, what cells are contained here?

A

The follicles, B cells reside here

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13
Q

Where does lymph drain and what cells are contained here?

A

The sinuses and parafollicular cortex which contains T cells

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14
Q

What two cells are contained within germinal centers?

A

centrocytes and centroblasts

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15
Q

Which of these cells is “cleaved”?

A

Centrocytes

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16
Q

What cells are generated by secondary follicles that secrete antibodies?

A

Plasma cells

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17
Q

Where is MALT found?

A

GI, respiratory, and urinary tracts

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18
Q

What 3 things make up MALT?

A

Tonsils in Waldyer’s ring, Peyer’s patches, appendix

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19
Q

What is neutrophilia?

A

When there is excess production of neutrophils

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20
Q

What are the 5 possible causes of neutrophilia?

A

Infection, medication such as growth factors, inflammatory disorders like autoimmune, tumors, and acute tissue necrosis

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21
Q

What is lymphocytosis?

A

There is an abnormally high lymphocyte count

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22
Q

What is the usual cause of lymphocytosis in kids?

A

Bordatella pertusis

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23
Q

What are 3 possible causes of lymphocytosis?

A

Viral infection, chronic immune stimulation from TB for example, lymph proliferative disorders

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24
Q

What type of lymphocyte does pertussis cause to be produced?

A

Small mature ones but a lot of them

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25
Epstein-barr causes the production of what type of lymphocytes?
Reactive and atypical. They are large and oddly shaped. See darkening at the periphery known as dutch skirting
26
HIV and rheumatoid arthritis cause production of what type of lymphocytes
Large and granular
27
What are the most common sites of chronic lymphadenitis?
Inguinal and axillary lymph nodes
28
What is lymphoma?
Proliferation of precursors or lymphocytes in tissue mass
29
What is leukemia?
Proliferation of neoplastic cells in the blood or bone marrow
30
What type of cell makes up the majority of neoplasms?
B cells
31
When do these develop?
Before 6 years of age
32
Describe what happens to the cells?
They are arrested in a stage preceding surface expression of immunoglobulin
33
When is the peak incidence of T cell neoplasms?
In adolescence or when the thymus reaches its maximum size
34
What is a possible emergency caused by T cell neoplasms?
Compress the tracheae and large vessels of the neck
35
What cells are involved in non-Hodgkin lymphoma?
Mature B, T, and NK cells
36
What cells are involved in Hodgkin lymphoma?
Certain B cells
37
What are the clinical presentations for lymphoma?
Weight loss, fever, night sweats, painless lymphadenopathy
38
Where do Hodgkin and non-Hodgkin lymphomas typically turn up?
Hodgkin is usually in nodal sites. Non-Hodgkin in extra nodal sites such as the GI tract, skin, or CNS
39
How is immunophenotyping used to diagnose lymphoma?
Look at antigen expression, cells that are neoplasm derived will all express the same antigens
40
What is the definitive way to diagnose lymphoma?
Excisional lymph node biopsy
41
What hormone should be tested for in lymphoma patients?
LDH, high levels mean the tumor is aggressive
42
What viruses should lymphoma patients be tested for?
Hepatitis B and C as they may cause lymphoma
43
What is the most common leukemia of adults in the western world?
Chronic lymphocytic leukemia
44
CLL is basically the same thing as what type of lymphoma?
Small lymphocytic lymphoma
45
What is the difference between the two?
Where the cells are, leukemias occur in blood and bone marrow, lymphomas are in the lymphatic system
46
Who is usually afflicted with chronic lymphocytic lymphoma?
Males older than 65
47
What are signs of CLL?
Usually asymptomatic but might see lymphadenopathy and hepatosplenomegaly
48
What are complications of CLL in relation to other blood cells?
Lymphomas produce antibodies that destroy RBCs and platelets so you may see anemia and thrombocytopenia
49
The presence of what two cells indicates CLL?
Smudge cells and prolymphocytes
50
What organelle is very prominent in pro lymphocytes?
The nucleolus
51
What is a risk of CLL, it may transform into?
Higher grade lymphomas such as Richter's syndrome or diffuse large cell lymphoma
52
Follicular lymphoma occurs in the?
Germinal centers
53
Mostly nodal or extra nodal?
Most nodal but may occur in the spleen, bone marrow, blood, or Waldeyer's ring
54
What causes follicular lymphoma?
A translocation from chromosome 14 to 18. The BCL-2 gene fuses with IgH locus which leads to over expression of BCL-2. BCL-2 prevents apoptosis
55
Histologically what is diagnostic of follicular lymphoma?
Small cleaved lymphoid cells
56
Is follicular lymphoma curable?
It is indolent meaning its not an aggressive disease but not exactly curable either
57
Where does Burkitt's lymphoma originate?
Germinal center but its aggressive and will often be found in extra nodal sites
58
Who gets Burkitt's lymphoma?
Children and young adults
59
What does Burkitt's lymphoma manifest itself as?
A large maxillary or mandibular mass in Africa. In the western world a mass in the bowels, ovaries, or retroperitoneum
60
What causes Burkitt's lymphoma?
A translocation of the myc gene from chromosome 8 to 14, possible 2 or 22 as well. Specifically one with antibody activity
61
What does c-myc do?
It promotes cell division
62
The presence of what cell indicates Burkitt's lymphoma?
Tingible body macrophages all over the node
63
What is a common cause of Burkitt's lymphoma in Africa?
Epstein-Barr virus
64
Who is extra nodal NK/T cell lymphoma typically seen in?
Asian and South American men
65
NK/T cell lymphoma is associated with which virus?
The Epstein Barr virus
66
What is a major feature of NK/T cell lymphoma?
Angiodestruction
67
Multiple myeloma is a disease of what cell?
Plasma cells
68
Who typically gets multiple myeloma?
Black men around 70 years old
69
What is overproduced in multiple myeloma? What organ does this affect?
Immunoglobulin paraprotein or M protein of the IgG type which may cause kidney damage
70
How does M protein affect RBCs?
See rouleaux or stacks of RBCs
71
How does multiple myeloma affect bones?
Usually involves bone marrow leading to bone lytic lesions, pathologic fracture and chronic pain
72
Aside from bone what else does multiple myeloma cause?
Increased calcium levels, renal dysfunction (2nd most common cause of death), anemia
73
How is multiple myeloma treated?
Bone marrow transplant or chemo
74
Who does Hodgkin lymphoma affect?
There is a bimodal age distribution, one peak in the 20's and another between 50-60
75
How does Hodgkin lymphoma present itself?
A non-tender, rubbery neck mass
76
What lymph nodes are affected in Hodgkin lymphoma?
80% of the time its the cervical lymph nodes, the other 10-20% is the axillary or inguinal
77
What are the B symptoms of Hodgkin lymphoma and what does this indicate?
Fever, weight loss, and night sweats. This indicates a more aggressive disease
78
What are the 4 subtypes of classical Hodgkin lymphoma?
Nodular sclerosis, mixed cell, lymphocyte depleted, lymphocyte rich
79
Which type of Hodgkin lymphoma is associated with HIV?
Lymphocyte depleted
80
What type of cell is often present in lymphoma masses?
Reed-Sternberg cell
81
These RS cells express what antigens that are unique?
CD15 and CD30
82
What is the precursor to a Reed Sternberg cell?
Hodgkin cell
83
What types of cells are present in nodular sclerosis?
Inflammatory and RS cells
84
What cells are present in the lymphocyte rich and depleted types?
Lymphocytes and RS cells RS cells and Hodgkin cells
85
What are the complications of Hodgkin lymphoma?
They are mostly due to treatment and include other cancers, accelerated atherosclerosis and pulmonary fibrosis
86
What is the typical treatment for Hodgkin lymphoma?
Chemotherapy plus ABVD and involved field radiation therapy
87
What is a treatment for recurrent Hodgkin lymphoma?
Autologous bone marrow or hematopoietic stem cell transplant

Systemic Pathology (11 decks)

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