1 / 46

Pathology 6 White blood cell and lymph node disorders (1)

Pathology 6 White blood cell and lymph node disorders (1). Toxic changes in neutrophils include all the following, except: Cytoplasmic basophilia Large basophilic granules Hypersegmentation Cytoplasmic vacuoles Dohle bodies. Large granular lymphoma is associated with Neutropenia

spencer
Télécharger la présentation

Pathology 6 White blood cell and lymph node disorders (1)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Pathology 6White blood cell and lymph node disorders (1)

  2. Toxic changes in neutrophils include all the following, except: • Cytoplasmic basophilia • Large basophilic granules • Hypersegmentation • Cytoplasmic vacuoles • Dohle bodies

  3. Large granular lymphoma is associated with • Neutropenia • Lymphocytopenia • Neutrophilia • Eosinophilia • Basophilia

  4. Monocyopenia is associated with which one of the following tumors • Lymphoplasmacytic lymphoma • Chronic lymphocytic leukemia • Large granular lymphoma • Hairy cell leukemia • Hodgkin lymphoma

  5. Nonneoplastic WBC disorders. • High number (cytosis) • Low number (cytopenia) • Abnormal function

  6. 5 major types of WBCs • Neutrophils • Lymphocytes • Monocytes • Eosinophils • Basophils

  7. What is the characteristic finding that lymphocytes display on peripheral blood in patients with pertussis? • Reactive lymphocytes • Lymphocytes with cleaved nuclei • Normal lymphocytes • Prominent nucleoli • Hairy cytoplasmic extensions

  8. Neutropenia • Decrease in the number of neutrophils • When severe, it is called agranulocytosis • Usually less than 500 • Increased risk of infection • Two major mechanisms • Decrease production • Increase peripheral destruction of neutrophils

  9. Decrease production • Marrow hypoplasia in patients who receive chemotherapy • Leukemia or other tumors replacing the marrow • Medications • Certain types of neoplastic lymphocytic proliferations such as large granular leukemia (LGL)

  10. Increased peripheral use • Autoimmune destruction • Overwhelming bacterial, fungal or rickettsial infection • splenomegaly

  11. Clinical manifestations • Infection, infection, infection!!! • bacterial • Fever, chills, malaise • Mucocutaneous necrotizing ulcers • High risk of sepsis

  12. Treat with broad spectrum antibiotics • Depending on the clinical setting, treat with G-CSF

  13. lymphocytopenia • Low number of lymphocytes • Less than 1000 in adults • Less than 3000 in children <2 years of age

  14. Increased risk of • Opportunistic infections • Autoimmune disorders • Malignancy

  15. Causes • Acquired: • HIV/AIDS • Protein malnutrition • Viral infections • Autoimmune disorders: SLE and RA • Certain leukemia or lymphoma tumors

  16. Inherited • Severe combined immunodeficiency • Wiscott-Aldrich syndrome

  17. Clinical manifestations • Infections with unusual microoganisms • Pneumocystis jiroveci • Fungal infections • CMV • Zoster These infection could be fatal • Risk of malignancies • Autoimmune disorders

  18. Symptoms of associated diseases • Small or absent tonsils or lymph nodes in HIV or immune deficiency diseases • Lymphadenopathy: again in early HIV or lymphoma • Eczema in WAS • Stigmata of pancytopenia in cases of leukemia

  19. Treatment • Treat infections • Treat underlying condition • IVIG for certain types of immune deficiency • Bone marrow transplantation

  20. Monocytopenia • In the setting of other pancytopenia • Associated with hairy cell leukemia

  21. eosinopenia • Can be found in healthy individuals • Of limited clinical significance • Steroid use • Acute inflammatory condition

  22. Basopenia • Limited clinical significance • Acute hypersensitivity • Thyrotoxicosis • Infection

  23. Neutrophilia • Increased number of neutrophils • Caused by • Acute bacterial infections • Sterile inflammation • Burns • Myocardial infarction • Morphology: TOXIC CHANGES

  24. Toxic changes • Occur in the setting of bacterial infection • Cytoplasmic basophilia • Vacuoles • Dohle bodies

  25. Lymphocytosis • Increased number of lymphocytes • Chronic bacterial infections • TB, brucella • Pertussis • Viral infection • Morphology depends on the cause

  26. Infectious mononucleosis • Reactive lymphocytes

  27. Pertussis

  28. Monocytosis • Increased number of monocytes • Chronic infections such as TB (associated with lymphocytosis) • Endocarditis • Rickettsial infection • Collagen vascular disease such as SLE • Inflammatory bowel disease • Certain myeloid leukemia with monocytic differentiation

  29. Eosinophilia • Allergic disorders • Parasitic infections • Medications • Collagen vascular disorders • Vasculitis • Atheroembolic disorders (transient) • Certain myelproliferative neoplasms • Certain lymphoma, specifically Hodgkin lymphoma

  30. Basophilia • Rare, • Usually in the setting of chronic myelogenous leukemia.

  31. Reactive lymphadenopathies

  32. Acute nonspecific lymphadenitis • Enlargement of a localized or generalized group of lymph nodes • Localized in cases of draining a site of infection • Generalized viral or bacterial infection

  33. Painful enlargement of the lymph nodes. • Histology: • Large follicles with germinal center formation • Frequent GC macrophages • Sinus enlargement with histiocytes • Parafollicular neutrophils, necrosis and possible pus formation

  34. Chronic Nonspecific Lymphadenitis • It assumes three patterns • Follicular hyperplasia • Paracortical hyperplasia • Sinus histiocytosis

  35. Follicular hyperplasia

  36. No neutrophils • Can be confused with follicular lymphoma (1) the preservation of the lymph node architecture; (2) variation in the shape and size of the germinal centers; (3) the presence of a mixture of germinal center lymphocytes of varying shape and size; (4) prominent phagocytic and mitotic activity in germinal centers. (5) BCL2 is negative in the follicles and positive in follicular lymphoma

  37. Paracortical hyperplasia • Viral infections • Medications • After vaccines

  38. Sinus histiocytosis

  39. Toxic changes in neutrophils include all the following, except: • Cytoplasmic basophilia • Large basophilic granules • Hypersegmentation • Cytoplasmic vacuoles • Dohle bodies

  40. Large granular lymphoma is associated with • Neutropenia • Lymphocytopenia • Neutrophilia • Eosinophilia • Basophilia

  41. Monocyopenia is associated with which one of the following tumors • Lymphoplasmacytic lymphoma • Chronic lymphocytic leukemia • Large granular lymphoma • Hairy cell leukemia • Hodgkin lymphoma

  42. What is the characteristic finding that lymphocytes display on peripheral blood in patients with pertussis? • Reactive lymphocytes • Lymphocytes with cleaved nuclei • Normal lymphocytes • Prominent nucleoli • Hairy cytoplasmic extensions

More Related