Patho (chapter 11)
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those containing granules
bind neural, basic, or acidic dye components
stain purple and are lysosomes
responsible for maintaining normal host defenses against invading bacteria and fungi, cell debris, and a variety of foreign substances
increase during allergic reactions and parasitic infections
*During allergic reactions, they are thought to release enzymes or chemical mediators that detoxify agents associated with the reaction.
*In parasitic infections, the eosinophils use surface markers to attach themselves to the parasite and then release hydrolytic enzymes that kill it
specific granules of basophils stain blue with basic dye
*granules contain heparin (anticoagulant), histamine (vasodilator), and other mediators of inflammation
*involved in allergic and hypersensitivity reactions
most common of the agranulocytes; approx. 30% of the total blood leukocytes.
3 types of Lymphocytes
- B lymphocytes
- T lymphocytes
- Natural killer cells
The differentiate to form antibody-producing plasma cells and are involved in humoral-mediated immunity
differentiate in the thymus
*They activate other cells of the immune system (helper T cells) and are involved in cell-mediated immunity (cytotoxic T cells).
Natural killer cells
participate in innate or natural immunity and their function is to destroy foreign cells
largest of the WBCs
distinguished by a large ammount of cytoplasm and a darkly stained kidney-shaped nucleus.
They travel from the bone marrow to the body tissues, where they differentiate into various tissue phagocytes (histiocytes of loose connective tissue, microglial cells of the brain, Kupffer cells of the liver, and tissue macrophages.
*play an important role in immune responses by activating lymphocytes and by presenting antigen to T cells
a decrease in the absolute number of leukocytes in the blood
*this disorder may affect any of the specific types of WBCs but most often affect the neutophils
an abnormally low number of neurtrophils and is commonly defined as a circulating neutrophil count of less than 1500
denotes a virtual absence of neutrophils
all of the myeloid stem cells are affected, resulting in anemia, thrombocytopenia, and agranulocytosis
Periodic or cyclic neutropenia
an autosomal dominant disorder with variable expression that begins in infancy and persists for decades.
a rare inherited form of neutropenia
Infants with the syndrome have almost no neutrophils present that develop beyond the promyelocyte stage.
used to describe drug reactions that are different from the effects observed in most persons and that cannot be explained in terms of allergy
a self-limiting lymphoproliferative disorder caused by the Epstein-Barr virus
*can occur at any age, but principally in adolescents and young adults in developed countries.
THE KISSING DISEASE (MONO)
Incubation period of infectious mononucleosis
incubation period lasts 4-8 weeks
they are malignant neoplasms of cells originally derived from precursor myeloid or lymphoid tissue cells.
The leukemic cells may also infiltrate
the liver, spleen, lymph nodes, and other tissues throughout the body, causing enlargement of these organs
A rudimentary classification system divides leukemia into four types:
- acute lymphocytic leukemia
- chronic lymphocytic leukemia
- acute myelocytic leukemia
- chronic myelocytic leukemia
involve immature lymphocytes and their progenitors that originate in the bone marrow but infiltrate the spleen, lymph nodes, CNS, and other tissues
involve the pluripotent myeloid stem cells in bone marrow, interfere with the maturation of all blood cells, including the granulocytes, erythrocytes, and thrombocytes
the ABL gene is received at a specific site on 22q. The resulting BCR-ABL fusion gene codes for a novel protein that allows affected cells to bypass the regulated signals that control normal cell growth and differentiation, and instead undergo malignant transformation to become leukemic cells
acute lymphocytic (lymphoblastic) leukemia
*the most common cancer in children and adults
*ALL encompasses a group of neoplasms composed of precursor B (pre-B) or T (pre-T) lymphocytes referred to as lymphoblasts
a condition in which the circulating blast count is markedly elevated
*requires immediate and effective treatment to lower the blast count rapidly
occurs as the result of increased proliferation or increased breakdown of purine nucleotides secondary to the leukemic cell death that results from chemotherapy.
represents a clinically diverse group of either B-cell or T-cell neoplasms
*impairment of the immune system and infectious agents may play a role.
*can originate from malignant transformation of either the T or B cells during their differentiation in the peripheral lymphoid tissues
Mature B-Cell Lymphomas
- Follicular lymphomas
- Diffuse large B-cell lymphomas
- Burkitt lymphoma
- Mantle cell lymphomas
- Marginal zone lymphomas
derived from germinal center B cells and consist of a mixture of centroblasts and centrocytes
*affects lymph nodes, spleen, bone marrow, peripheral blood, head and neck region, gastrointestinal tract and skin
Diffuse large B-cell lymphomas
a heterogeneous group of aggressive germinal or postgerminal center neoplasms.
- *may be involved with EBV or HIV infections
- *it is a rapidly evolving, multifocal, nodal and extranodal tumor.
one of the most rapidly growing tumors of the NHLs, is also a disorder of germinal center B cells
*a destructive tumor in the jaw and other facial bones and the sporadic form typically presents with abdominal masses
Mantle cell lymphomas
- affect older people
- rapid rate of progression
- only one in five persons survives at least 5 years
Marginal zone lymphomas
*involves late-stage memory B cells that reside in the marginal zone or outermost compartment of the lymph node follicle.
a specialized form of lymphoma that features the presence of an abnormal cell called a Reed-Sternber cell.
large, atypical, mononuclear tumor cells
*these cells release factors that induce the accumulation of reactive lymphocytes, macrophages, and granulocytes, which typically make up greater than 90% of the tumor's cells
Monoclonal gammopathy of undetermined significance (MGUS)
characterized by the presence of the monoclonal immunoglobulin in the serum without other findings of multiple myeloma.
*considered a premalignant condition
Osteolytic bone lesions
- bone pain
- pathologic fractures
Failure of antibody production
Plasma cell secretion of paraproteins
- hyperviscosity of body fluids
- amyloid deposits in heart and kidney
Bone marrow infiltration
Bence Jones protein
Bone Marrow infiltration
- Anemia (fatigue, pallor)
- Neutropenia (decreased resistance to infection)
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