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Pathology Unit VI
Leukemia and Lymph Nodes
60
Pathology
Graduate
03/13/2013

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Term
General Location of Lymphatic tissue
Definition
scattered throughout the body as isolated cells, nonencapsulated collections of cells in mucous
membranes, or encapsulated organs - thymus, lymph nodes, spleen.
Term
General Function of Lymphatic tissue
Definition
defense against foreign materials (antigens). Involves presentation of an antigen by a macrophage to lymphocytes.
Term
List of the cells involved in the immune response
Definition
B lymphs, T lymphs (T cell subsets) and antigen presenting cells (macrophages)
Term
B- Lymphocytes description
Definition
derived from bone marrow; when stimulated, undergo proliferation and differentiation to
become plasma cells which make antibody; memory cells. The immune response associated with
production of antibody is known as a HUMORAL immune response.
Term
T- Lymphocytes description
Definition
derived from bone marrow, processed in thymus; function in regulating the immune
response by directing the activity of other cells. The immune response associated with T-lymphocyte activity
is known as a CELL-MEDIATED immune response
Term
T Helper Cell description
Definition
CD4, secrete lymphokines - substances that enhance immune
response (increase B-cell and macrophage activity). [Lymphocyte destroyed by human immunodeficiency virus (HIV-1).]
Term
Cytotoxic T cells
Definition
CD8, killer cells - can destroy virus-infected and malignant cells
(require activation by T helper).
Term
Suppressor T cells
Definition
CD8, thought to inhibit T helper cells (often classified in combination with cytotoxic cells).
Term
T Cell subset population
Definition
T helper cells, cytotoxic T cells and suppressor T cells
Term
Macrophages
Definition
- fixed and free phagocytic cells derived from monocytes. Appearance and
names vary - epithelioid macrophages (granulomatous inflammation), dendritic reticulum cells (lymph
nodes), histiocytes, Kupffer cells (liver), microglial cells (brain), Langerhans cells (skin).
Term
Other cells that act as antigen presenting cells
Definition
B lymphocytes, endothelial cells and other cells may act as antigen presenting cells
Term
Causes of Reactive Hyperplasia of lymph nodes
Definition
secondary to antigenic stimulus
Term
clinical symptoms of Reactive Hyperplasia of lymph nodes
Definition
granulomatous inflammation or acute lymphadenitis
Term
architectural changes of Reactive Hyperplasia of lymph nodes
Definition
lymphoid tissue enlarges
Term
causes of atypical hyperplasia of lymph nodes
Definition
reactive hyperplasia, lymphoma, infectious monucleosis, pastvaccine lymphoma or lymphogranuloma verereum
Term
clinical symptoms of atypical hyperplasia of lymph nodes
Definition
histologic change in lymph node
Term
architectural changes of atypical hyperplasia of lymph nodes
Definition
none
Term
Malignant lymphoma
Definition
heterogenous group of solid tumors if the lymphoid tissue
Term
General characteristics of malignant lymphoma
Definition
more frequent in adults, immunodeficiency is a risk factor, sometimes casued by a virus, can be hodgkin or non hodgkin
Term
classification of Hodgkin Lymphoma
Definition
proliferation of atypical malignant cells interspersed with infiltrate of various inflammatory cells (lymphs, eosinophils, plasma cells, histiocytes), baed in tissue reaction to R-S cells, more lymphocyte response yields a better prognosis
Term
incidence of Hodgkin Lymphoma
Definition
9290 new causes in 2013, two peak incidence (20’s and 60’s)
Term
etiology of Hodgkin Lymphoma
Definition
unknown, sometimes viruses (EBV or HTLV)
Term
pathogenesis of Hodgkin Lymphoma
Definition
malignant neoplasm of specialized cells
Term
morphology of Hodgkin Lymphoma
Definition
Reed-Sternberg cell (binucleate containing a single prominent eosinophilic nucleus)
Term
clinical course of Hodgkin Lymphoma
Definition
as disease progresses, normally does in a sequential contiguous fashion (neck, chest, abs)
Term
classification of non-Hodgkin Lymphoma
Definition
FAB classification into low, intermediate or high grade lymphoma based on differentiation
Term
incidence of non-Hodgkin Lymphoma
Definition
69740 new cases in 2013,
Term
pathogensis of non-Hodgkin Lymphoma
Definition
presents with weight loss and night sweats, malignant neoplasm of lymphoid cells growing as tissue mass
Term
morphology of non-Hodgkin Lymphoma
Definition
presents with weight loss and night sweats, malignant neoplasm of lymphoid cells growing as tissue mass
Term
clinical course of non-Hodgkin Lymphoma
Definition
low grade tumoes (usually follicular small cell) slowly progress and are incurable, high grde tumors (large cell) are rapid by can be cured by chemotherapy
Term
Leukemia
Definition
a neoplastic proliferation of one cell type that originates in the bone marrow
Term
general characteristics of leukemia
Definition
acute/chronic (immaure/mature cells), caused by unstable genetics in BM due to germ line mutations
Term
classification of leukemia
Definition
chronic or acute (depending on cell type)
Term
incidence of leukemia
Definition
increasing in last 50 years, 8-10 deaths/100,000, two population peaks (10’s and 60’s), 48610 new cases in 2013
Term
pathogenesis of leukemia
Definition
malignant cells from bone marrow proliferate and disseminate into circulation
Term
morphology of leukemia
Definition
proliferating cells, immature (or mature) cells in peripheral blood smear
Term
clinical course of leukemia
Definition
acute is short term with high risk of death is not treated, and chronic is longer term
Term
Chromosome abnormality found in 90% of the patients with CML
Definition
Philadelphia chromosome translocation (9:22)
Term
incidence of multiple myeloma
Definition
rare, increase risk with age
Term
pathogenesis of multiple myeloma
Definition
neoplastic proliferation of plasma cells in bone marrow
Term
morphology of multiple myeloma
Definition
abnormal plasma cells in bone marrow
Term
clinical course of multiple myeloma
Definition
excessive Ig production, bone pain, fractures, lytic lesions in bones
Term
incidence mycosis fungoides
Definition
uncommon, occurs in older males
Term
pathogenesis mycosis fungoides
Definition
cutaneous proliferation of T cells
Term
morphology mycosis fungoides
Definition
markedly convoluted nucleus (called cerebriform), band like dermal infiltrate of atypical lymphocytes mixed with histiocytes and other inflammatory cells
Term
clinical course of mycosis fungoides
Definition
skin involvement can move to involvement of lymph node, spleen and liver
Term
incidence of hairy cell leukemia
Definition
middle age to elderly people
Term
pathogenesis of hairy cell leukemia
Definition
proliferation of mononuclear cells with finger like projections, infiltrate the bone marrow and spleen and cause hypersplenism
Term
morphology of hairy cell leukemia
Definition
proliferation of mononuclear cells with finger like projections, infiltrate the bone marrow and spleen and cause hypersplenism
Term
clinical course of hairy cell leukemia
Definition
chronic, indolent
Term
Etiology of non- Hodgkin Lymphoma
Definition
increasing age, unknown, virsus
Term
Etiology of Leukemia
Definition
unstable genetics in the BM due to germ line mutations
Term
General incidence of metastatic tumors to the lymph nodes
Definition
more common than primary malignancies of lymph nodes
Term
clinical significance of metastatic tumors to the lymph nodes
Definition
carcinomas, indicated metastasis and malignancy
Term
A 62-year-old man has had back pain for 4 months. No abnormal findings were noted on physical examination, however his serum globulin was high from a monoclonal gammopathy. A chest radiograph showed no abnormalities of heart or lung fields, but there were several clear areas noted in the vertebral bodies. A sternal bone marrow aspirate was performed and yielded a dark red jelly-like material in the syringe. Which of the following cell types is most likely to be numerous on microscopic examination of this aspirate?
Definition
Plasma Cells
Term
Which is the lymphoma with the BEST prognosis
Definition
Small lymphocytic
Term
Chronic Leukemia has a ________ prognosis than acute leukemia
Definition
better
Term
The Philadelphia chromosome has been found in 90% of patients with
Definition
chronic myelogenous leukemia
Term
The Reed-Sternberg cell is characteristic of
Definition
Hodgkin disease
Term
Which of the following would be a typical response of a lymph node draining an infected area?
Definition
hyperplasia
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