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Neoplastic proliferation of cells of hematopoietic lineage within the BM.
Leukemia
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Myeloid neoplasia affects what cell lines?
granulocytes, monocytes, erythrocytes, megakaryocytes
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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.
- Megakaryocytes- macroplatelets.
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In acute myeloid leukemia, _____ of the nucleated cells in BM are immature (blasts).
>20%
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Acute Undifferentiated Leukemia implies...
very early malignant transformation of stem cell
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FeLV in cats is associated with... (3)
acute undifferentiated leukemia, acute erythroid leukemia (M6Er), myelodysplastic syndromes
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Acute Myeloblastic Leukemia affects the ______ lineage.
granulocytic
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M0 and M1 acute myeloblastic leukemias are characterized by...
>90% of nucleated BM cells are myeloblasts
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M2 acute myeloblastic leukemia is characterized by...
20-90% nucleated BM cells are myeloblasts
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M3 acute myeloblastic leukemia is characterized by...
maturation and atypical granulation of progranulocytes
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M4 acute myelomonocytic leukemia is characterized by...
neoplastic cells are of mixed lineage
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M5 acute monocytic leukemia is characterized by...
predominance of monoblasts and promonocytes
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M6 acute erythroleukemia is characterized by...
>50% of nucleated BM cells are erythroid (>20% are myeloblasts and erythroblasts); dysplastic changes
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M7 acute megakaryoblastic leukemia is characterized by...
>20% nucleated BM cells are megakaryoblasts
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Chronic Myeloproliferative Neoplasms are characterized by...
<20% blasts in BM; no clinical signs
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Chronic Myelogenous Leukemia is characterized by... (3)
marked neutrophilia with left shift, nonregenerative anemia, +/- monocytosis
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Chronic myelogenous neoplasms have been associated with the presence of a ________, which prevents cells from undergoing _________.
Philadelphia chromosome; apoptosis
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Chronic Eosinophilic Leukemia is found in _____ and is characterized by... (3)
cats; marked eosinophilia, anemia, GI symptoms
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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
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Chronic Myelomonocytic Leukemia is characterized by... (3)
Marked neutrophilia and monocytosis, both with left shift, dysplastic features
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Essential thrombocytopenia is characterized by... (2)
marked thrombocytosis, megakaryocytes
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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.
lymphoma
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Lymphocyte neoplasia that starts in the BM, usually resulting in circulating cells.
Leukemia
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__________ is the most common hemolymphatic malignancy in dogs and cats.
Lymphoma
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Lymphoma is most common in _________ dogs and _____________ cats.
middle aged; young cats with FeLV and old cats without FeLV
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FeLV is most often diagnosed in cats with _______________ lymphoma, wheres those with ____________ lymphoma are more often FeLV negative.
mediastinal or multicentric; alimentary or cutaneous
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Bone lysis is associated with ______________.
multiple myeloma
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Laboratory abnormalities associated with lymphoma include...
anemia, thrombocytopenia, leukocytosis, atypical cells, hemostatic abnormalities, hypercalcemia, hyperglobulinemia
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Hypercalcemia due to lymphoma occurs typically with __________.
T cell malignancies
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Hyperglobulinemia associated with lymphoma is typically due to ______________.
B cell and plasma cell neoplasias
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Describe the 5 stages of canine lymphoma.
- Stage I: single lymph node
- Stage II: regional lymphadenopathy (restricted to one side of the diaphragm)
- Stage III: generalized lymphadenopathy
- Stage IV: hepatosplenomegaly
- Stage V: BM, CNS, or involvement of other extranodal sites
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What are the substages of canine lymphoma?
- Substage a: no clinical signs
- Substage b: clinical signs of illness
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Describe the 5 stages of feline lymphoma.
- Stage I: single lymph node
- Stage II: restricted to one side of the diaphragm
- Stage III: Generalized lymphadenopathy (both sides of the diaphragm)
- Stage IV: Stages I-III plus liver or spleen involvement
- Stage V: Stages I-III plus BM or CNS involvement
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The majority of lymphoma cases in dogs are ___________.
multicentric lymphoma
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________________ lymphoma is the most common histomorphological variant in dogs.
Diffuse large B cell
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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.
B cell
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The __________ form of lymphoma is the second most common in dogs and affects the ________ and _________.
alimentary; GI tract and lymph nodes
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The ____________ form of lymphoma is the third most common in dogs and is characterized by dyspnea, coughing, regurgitation, cyanosis, and muffled heart sounds.
mediastinal
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The __________ forms of lymphoma are the least common in dogs and carry the worst prognosis.
extranodal
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Extranodal forms of lymphoma in dogs commonly affect the... (5)
skin, CNS, eye, kidney, or myocaridium
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__________ lymphoma is the most common presentation in cats and typically occurs in _____________ cats.
alimentary; older FeLV negative
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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
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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
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The multicetric form of lymphoma in cats is most commonly seen in _______ cats.
FeLV+
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What are the 2 types of plasma cell neoplasia?
- plasmacytoma- solid mass
- myeloma- infiltration in bone marrow or extramedullary sites
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Plasma cell neoplasia maybe secretory or non-secretory, based on whether or not they...
produce immunoglobulin
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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-
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Clonal proliferation of malignant lymphocytes that appear small and well-differentiated.
Chronic Lymphocytic Leukemia (CLL)
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CLL usually occurs in ________ dogs and is most often of _____ origin.
middle-aged to older; T cell
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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
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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 _________.
plasma cells
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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.
flow cytometry
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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 ________________.
immune-mediated thrombocytopenia
-
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 ______.
dogs; cats
-
Increased hemosiderin occurs in dogs with _________.
inflammation
-
Decreased hemosiderin occurs in dogs with ________.
iron deficiency anemia
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