Term
| • Bone Marrow Aspirate Smear |
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Definition
| can assess frequency and appearance of all blood cell types; cytology |
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Term
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Definition
| can assess cellularity, detect lesions |
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Term
| cells in • Hematopoietic Tissue |
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Definition
has many stages of cell lineages:
o Stem cells & progenitor cells (BFU, CFU, Pre-T/B) – smallest proportion
o Lymphocytes, monocytes, & precursors – also a small proportion
o Erythroid precursors – larger fraction
o Granulocytes & precursors – largest portion of bone marrow; myeloid:erythroid = 3:1 |
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Term
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Definition
| % of fat in marrow about same as age, up to 50s/60s |
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Term
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Definition
| normal bone marrow is a good mixture of lineages; this is lost in malignancies |
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Term
| • Myeloproliferative Disorders (MPDs) - growth vs diffx, and features |
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Definition
acquired genetic defects of unregulated growth w/ normal diff
o Single lineage – transformed cells expand and differentiate along one lineage (at least initially)
o Lineage dominance – precursors begin to fill the marrow; spill into blood so peripheral counts rise and eventually acute leukemia in some cases |
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Term
| • Myelodysplastic Syndromes (MDSs) - growth vs diffx, and features |
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Definition
acquired genetic defects of unregulated growth w/ abnormal diff
o Dysplastic lineages – transformed cells produce morphologically aberrant cells in many lineages
o Dysplastic accumulation – dysplastic cells accumulate in marrow; spill into blood
o Leukemia/cytopenia – normal hematopoiesis suppressed, dysplastic cells replace acute leukemia in some cases |
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Term
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Definition
acquired genetic defects of unregulated growth w/ limited or no differentiation
o Lineage arrest – neoplastic cells arrested at early precursor “blast” stage along 1+ lineages
o Blast accumulation – blasts fill in marrow; spill into blood (not necessarily though)
o Leukemia/cytopenia - normal hematopoiesis suppressed, blasts replace
Lymphoid = acute lymphoblastic leukemias
Non-lymphoid = acute myeloid leukemias (myelogenous, myelocytic)
o Leukemic stem cells – only small % of leukemia cells are “leukemia stem cells”, which account for the propagation & survival of the leukemia must eradicate these cells to Tx!; arise by acquiring multiple defects |
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Term
| Hematopoietic Malignancies Outside Marrow: Lymphoid, Acquired genetic defect, viral transformation, classification |
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Definition
• Lymphoid – malignancies outside of marrow are primarily B/T cell lineages
• Acquired Genetic Defect – account for most malignancies outside marrow
• Viral Transformation – such as EBV in transplant px, account for some malignancies
• Classification – malignancies classified by cell lineage & appearance under microscope |
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Term
Non-Hodgkin’s Lymphomas
1. arises from?
2. presentation
3. bloodstream involvement?
4. metastases to? and what signals favor it? |
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Definition
• Non-Hodgkin’s Lymphoma – most arises from “mature” B/T cells found in 2o lymphoid organs
• Presentation – diagnosed as a tumor or tissue infiltrate:
o Tumor – lymphadenopathy, mediastinal mass, splenomegaly, GI tract infiltrate
o Infiltrate – cells infiltrate non-lymphoid organs such as skin, parotid glands, CNS, etc.
• Bloodstream – may be involved, an extension of 1o/2o lymphoid organs & bone marrow “leukemic phase”; some may present w/ blood involvement
• Metastases – can spread thru bloodstream to any organ; have lymph node preference (L-selectin, chemokine receptor 7), but any organ/tissue can be infiltrated eventually |
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