Clin Path- Leukemia Neoplasia BM.txt
Card Set Information
Clin Path- Leukemia Neoplasia BM.txt
Neoplastic proliferation of cells of hematopoietic lineage within the BM.
Myeloid neoplasia affects what cell lines?
granulocytes, monocytes, erythrocytes, megakaryocytes
Describe the dyplastic morphologic changes that occur in the different myeloid leukemias.
Erythrocytes- dysynchrony of maturation of nucleus and cytoplasm, increased anisocytosis with reticulocytosis.
Granulocytes- hypo-/hypersegmented nucleus, atypical granulation, basophilia.
In acute myeloid leukemia, _____ of the nucleated cells in BM are immature (blasts).
Acute Undifferentiated Leukemia implies...
very early malignant transformation of stem cell
FeLV in cats is associated with... (3)
acute undifferentiated leukemia, acute erythroid leukemia (M6Er), myelodysplastic syndromes
Acute Myeloblastic Leukemia affects the ______ lineage.
M0 and M1 acute myeloblastic leukemias are characterized by...
>90% of nucleated BM cells are myeloblasts
M2 acute myeloblastic leukemia is characterized by...
20-90% nucleated BM cells are myeloblasts
M3 acute myeloblastic leukemia is characterized by...
maturation and atypical granulation of progranulocytes
M4 acute myelomonocytic leukemia is characterized by...
neoplastic cells are of mixed lineage
M5 acute monocytic leukemia is characterized by...
predominance of monoblasts and promonocytes
M6 acute erythroleukemia is characterized by...
>50% of nucleated BM cells are erythroid (>20% are myeloblasts and erythroblasts); dysplastic changes
M7 acute megakaryoblastic leukemia is characterized by...
>20% nucleated BM cells are megakaryoblasts
Chronic Myeloproliferative Neoplasms are characterized by...
<20% blasts in BM; no clinical signs
Chronic Myelogenous Leukemia is characterized by... (3)
marked neutrophilia with left shift, nonregenerative anemia, +/- monocytosis
Chronic myelogenous neoplasms have been associated with the presence of a ________, which prevents cells from undergoing _________.
Philadelphia chromosome; apoptosis
Chronic Eosinophilic Leukemia is found in _____ and is characterized by... (3)
cats; marked eosinophilia, anemia, GI symptoms
Chronic Basophilic Leukemia is rare but characterized by... (3)
marked basophilia with immature forms, anemia, +/- other leukocytoses
Chronic Monocytic Leukemia is characterized by...
Marked mature monocytosis
Chronic Myelomonocytic Leukemia is characterized by... (3)
Marked neutrophilia and monocytosis, both with left shift, dysplastic features
Essential thrombocytopenia is characterized by... (2)
marked thrombocytosis, megakaryocytes
Myelodysplastic Syndromes are characterized by... (6)
one or more persistent cytopenias, nonregenerative anemia, asynchronous maturation or maturation arrest, dysplastic morphologic abnormalities, increased apoptosis, clinical illness
Lymphocyte neoplasia that results in a solid mass.
Lymphocyte neoplasia that starts in the BM, usually resulting in circulating cells.
__________ is the most common hemolymphatic malignancy in dogs and cats.
Lymphoma is most common in _________ dogs and _____________ cats.
middle aged; young cats with FeLV and old cats without FeLV
FeLV is most often diagnosed in cats with _______________ lymphoma, wheres those with ____________ lymphoma are more often FeLV negative.
mediastinal or multicentric; alimentary or cutaneous
Bone lysis is associated with ______________.
Laboratory abnormalities associated with lymphoma include...
anemia, thrombocytopenia, leukocytosis, atypical cells, hemostatic abnormalities, hypercalcemia, hyperglobulinemia
Hypercalcemia due to lymphoma occurs typically with __________.
T cell malignancies
Hyperglobulinemia associated with lymphoma is typically due to ______________.
B cell and plasma cell neoplasias
Describe the 5 stages of canine lymphoma.
: single lymph node
: regional lymphadenopathy (restricted to one side of the diaphragm)
: generalized lymphadenopathy
: BM, CNS, or involvement of other extranodal sites
What are the substages of canine lymphoma?
: no clinical signs
: clinical signs of illness
Describe the 5 stages of feline lymphoma.
: single lymph node
: restricted to one side of the diaphragm
: Generalized lymphadenopathy (both sides of the diaphragm)
: Stages I-III plus liver or spleen involvement
: Stages I-III plus BM or CNS involvement
The majority of lymphoma cases in dogs are ___________.
________________ lymphoma is the most common histomorphological variant in dogs.
Diffuse large B cell
The multicentric form of lymphoma in dogs is characterized by... (3)
generalized lymphadenopathy, splenomegaly, hepatomegaly
Multicentric lymphoma in dogs has the best prognosis when it is of _______ origin.
The __________ form of lymphoma is the second most common in dogs and affects the ________ and _________.
alimentary; GI tract and lymph nodes
The ____________ form of lymphoma is the third most common in dogs and is characterized by dyspnea, coughing, regurgitation, cyanosis, and muffled heart sounds.
The __________ forms of lymphoma are the least common in dogs and carry the worst prognosis.
Extranodal forms of lymphoma in dogs commonly affect the... (5)
skin, CNS, eye, kidney, or myocaridium
__________ lymphoma is the most common presentation in cats and typically occurs in _____________ cats.
alimentary; older FeLV negative
Most alimentary lymphomas in cats occur in the ___________ and are of ______ origin; those that occur in the stomach are of ______ origin.
small intestine; B cell (40% T cell); B cell
The mediastinal form of lymphoma in cats is most often seen in _____________ cats; it is often accompanies by Horner's Syndrome, which is...
younger FeLV +; enophthalmia (sunken eye), miosis (small pupil), ptosis (droopy upper eyelid), prolapse of 3rd eyelid
The multicetric form of lymphoma in cats is most commonly seen in _______ cats.
What are the 2 types of plasma cell neoplasia?
plasmacytoma- solid mass
myeloma- infiltration in bone marrow or extramedullary sites
Plasma cell neoplasia maybe secretory or non-secretory, based on whether or not they...
Hyperglobulinemia is seen in plasma cell neoplasia that _________.
produce immunoglobulin (secretory)
Clonal proliferation of malignant lymphoid progenitor cells with poor or no differentiation.
Acute Lymphocytic Leukemia (ALL)
How is ALL differentiated from stage V lymphoma?
ALL are CD34+ and stage V lymphoma is CD34-
Clonal proliferation of malignant lymphocytes that appear small and well-differentiated.
Chronic Lymphocytic Leukemia (CLL)
CLL usually occurs in ________ dogs and is most often of _____ origin.
middle-aged to older; T cell
CLL in dogs that is of T cell origin shows what on a blood film?
What about B cell origin?
T cell- slightly larger with lightly basophilic cytoplasm
B cell- irregularities in the nuclear membrane
With CLL in cats usually occurs in _______ animals and is primarily a ________ disease.
middle-aged to older; CD4 T cell
In feline CLL, what irregularities are seen on the blood film?
irregularities in the nuclear membrane
Cytological examination of blood films and samples obtained by _________ are commonly used to diagnose lymphoma in dogs and cats.
fine needle aspirate (FNA)
What are the advantages of FNA for diagnosing lymphoma? Disadvantages?
Advantages- sampling blood, peripheral LN, effusions, and superficial masses is simple and relatively safe.
Disadvantages- does not allow assessment of tissue architecture
Plasma cell neoplasia is characterized by large numbers of _________.
With flow cytometry/immunophenotyping, cells are labeled with _______ to identify their ______; immunophenotyping works best for _____________.
antibodies; phenotype; lymphoid neoplasia
Examination of markers to identify the phenotype of a gated cell population- markers are recognized by antibodies that have fluorescent labels.
PCR for clonal antigen rearrangement (PARR) is based on __________ and only detects lymphocyte ______, which does not always equal neoplasia.
T and B cell antigen receptors; clonality
Most active hematopoiesis occurs in...
flat bones and extremities of long bones
What are 5 indications for a BM aspirate or biopsy?
1. nonregenerative anemia that is not due to chronic inflammatory disease, chronic renal failure, or iron deficiency
2. unexplained neutropenia or thrombocytopenia
3. suspected hematopoietic neoplasm
4. identify infectious agents
5. hyperproteinemia or hypercalcemia
3 locations for BM aspirate in dogs; 2 locations in cats; 2 locations in horses and cows?
dogs- iliac crest, proximal humerus, trochanteric fossa of the femur
cats- proximal humerus, trochanteric fossa
horses and cows- rib or sternum
Hypocellular BM occurs with...(4)
retrovirus, parvovirus, ehrlichia infection, estrogen toxicity
Hypercellular BM occurs with...(4)
erythroid or granulocytic hyperplasia, myeloproliferative diseases, and neoplasia
Megakaryocytes are increased in ________________.
On a blood smear, erythrocytic precursors have the following characteristics... (5)
intensely basophilic cytoplasm, no granules, central nucleus, round nucleus, dense chromatin
On a blood smear, granulocytic precursors have the following characteristics... (5)
lightly basophilic cytoplasm, granules, eccentric nucleus, round/oval/elliptical nucleus, finely stippled chromatin
3 scenarios with a normal M:E ratio?
normal BM, myeloid hyperplasia and erythroid hyperplasia (Immune mediated hemolytic anemia), myeloid hypoplasia and erythroid hypoplasia (estrogen toxicity)
Increased M:E ratio with no maturation abnormalities can occur with...
granulocytic hyperplasia and/or erythroid hypoplasia
With an increased M:E ratio with no maturation abnormalities, conclude granulocytic hyperplasia is the CBC shows _________ with a _________ and ___________.
leukocytosis; left shift; normal red cell mass
With increased M:E ratio with no maturation abnormalities, conclude erythroid hypoplasia is CBC shows ________ and a _________.
non-regenerative anemia; normal leukogram
With increased M:E ratio with no maturation abnormalities, conclude granulocytic hyperplasia and erythroid hypoplasia if CBC shows _______ and ________.
non-regenerative anemia; neutrophilic leukocytosis
With a increased M:E ratio with maturation abnormalities, hypercellular marrow with mostly immature granulocytes suggests...
peripheral consumption (from marked inflammation) or granulocytic leukemia
A decreased M:E ratio usually indicates...
increased erythrocyte production in response to a shortened RBC lifespan (hemolytic anemia)----> regenerative anemia
When in conjunction with disturbed maturation in cats, a decreased M:E ratio suggests...
myeloproliferative disorder of the red cell series called erythremic myelosis
Increased plasma cells can occur with ___________ or ___________.
inflammation (ehrlichia canis); multiple myeloma
Increased numbers of lymphocytes can occur with _________ or __________.
inflammation; lymphoid neoplasia
Hemosiderin is found in _____ but not usually in ______.
Increased hemosiderin occurs in dogs with _________.
Decreased hemosiderin occurs in dogs with ________.
iron deficiency anemia