Clin Path- Leukemia Neoplasia BM.txt

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  1. Neoplastic proliferation of cells of hematopoietic lineage within the BM.
  2. Myeloid neoplasia affects what cell lines?
    granulocytes, monocytes, erythrocytes, megakaryocytes
  3. 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.
  4. In acute myeloid leukemia, _____ of the nucleated cells in BM are immature (blasts).
  5. Acute Undifferentiated Leukemia implies...
    very early malignant transformation of stem cell
  6. FeLV in cats is associated with... (3)
    acute undifferentiated leukemia, acute erythroid leukemia (M6Er), myelodysplastic syndromes
  7. Acute Myeloblastic Leukemia affects the ______ lineage.
  8. M0 and M1 acute myeloblastic leukemias are characterized by...
    >90% of nucleated BM cells are myeloblasts
  9. M2 acute myeloblastic leukemia is characterized by...
    20-90% nucleated BM cells are myeloblasts
  10. M3 acute myeloblastic leukemia is characterized by...
    maturation and atypical granulation of progranulocytes
  11. M4 acute myelomonocytic leukemia is characterized by...
    neoplastic cells are of mixed lineage
  12. M5 acute monocytic leukemia is characterized by...
    predominance of monoblasts and promonocytes
  13. M6 acute erythroleukemia is characterized by...
    >50% of nucleated BM cells are erythroid (>20% are myeloblasts and erythroblasts); dysplastic changes
  14. M7 acute megakaryoblastic leukemia is characterized by...
    >20% nucleated BM cells are megakaryoblasts
  15. Chronic Myeloproliferative Neoplasms are characterized by...
    <20% blasts in BM; no clinical signs
  16. Chronic Myelogenous Leukemia is characterized by... (3)
    marked neutrophilia with left shift, nonregenerative anemia, +/- monocytosis
  17. Chronic myelogenous neoplasms have been associated with the presence of a ________, which prevents cells from undergoing _________.
    Philadelphia chromosome; apoptosis
  18. Chronic Eosinophilic Leukemia is found in _____ and is characterized by... (3)
    cats; marked eosinophilia, anemia, GI symptoms
  19. Chronic Basophilic Leukemia is rare but characterized by... (3)
    marked basophilia with immature forms, anemia, +/- other leukocytoses
  20. Chronic Monocytic Leukemia is characterized by...
    Marked mature monocytosis
  21. Chronic Myelomonocytic Leukemia is characterized by... (3)
    Marked neutrophilia and monocytosis, both with left shift, dysplastic features
  22. Essential thrombocytopenia is characterized by... (2)
    marked thrombocytosis, megakaryocytes
  23. 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
  24. Lymphocyte neoplasia that results in a solid mass.
  25. Lymphocyte neoplasia that starts in the BM, usually resulting in circulating cells.
  26. __________ is the most common hemolymphatic malignancy in dogs and cats.
  27. Lymphoma is most common in _________ dogs and _____________ cats.
    middle aged; young cats with FeLV and old cats without FeLV
  28. FeLV is most often diagnosed in cats with _______________ lymphoma, wheres those with ____________ lymphoma are more often FeLV negative.
    mediastinal or multicentric; alimentary or cutaneous
  29. Bone lysis is associated with ______________.
    multiple myeloma
  30. Laboratory abnormalities associated with lymphoma include...
    anemia, thrombocytopenia, leukocytosis, atypical cells, hemostatic abnormalities, hypercalcemia, hyperglobulinemia
  31. Hypercalcemia due to lymphoma occurs typically with __________.
    T cell malignancies
  32. Hyperglobulinemia associated with lymphoma is typically due to ______________.
    B cell and plasma cell neoplasias
  33. 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
  34. What are the substages of canine lymphoma?
    • Substage a: no clinical signs
    • Substage b: clinical signs of illness
  35. 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
  36. The majority of lymphoma cases in dogs are ___________.
    multicentric lymphoma
  37. ________________ lymphoma is the most common histomorphological variant in dogs.
    Diffuse large B cell
  38. The multicentric form of lymphoma in dogs is characterized by... (3)
    generalized lymphadenopathy, splenomegaly, hepatomegaly
  39. Multicentric lymphoma in dogs has the best prognosis when it is of _______ origin.
    B cell
  40. The __________ form of lymphoma is the second most common in dogs and affects the ________ and _________.
    alimentary; GI tract and lymph nodes
  41. The ____________ form of lymphoma is the third most common in dogs and is characterized by dyspnea, coughing, regurgitation, cyanosis, and muffled heart sounds.
  42. The __________ forms of lymphoma are the least common in dogs and carry the worst prognosis.
  43. Extranodal forms of lymphoma in dogs commonly affect the... (5)
    skin, CNS, eye, kidney, or myocaridium
  44. __________ lymphoma is the most common presentation in cats and typically occurs in _____________ cats.
    alimentary; older FeLV negative
  45. 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
  46. 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
  47. The multicetric form of lymphoma in cats is most commonly seen in _______ cats.
  48. What are the 2 types of plasma cell neoplasia?
    • plasmacytoma- solid mass
    • myeloma- infiltration in bone marrow or extramedullary sites
  49. Plasma cell neoplasia maybe secretory or non-secretory, based on whether or not they...
    produce immunoglobulin
  50. Hyperglobulinemia is seen in plasma cell neoplasia that _________.
    produce immunoglobulin (secretory)
  51. Clonal proliferation of malignant lymphoid progenitor cells with poor or no differentiation.
    Acute Lymphocytic Leukemia (ALL)
  52. How is ALL differentiated from stage V lymphoma?
    ALL are CD34+ and stage V lymphoma is CD34-
  53. Clonal proliferation of malignant lymphocytes that appear small and well-differentiated.
    Chronic Lymphocytic Leukemia (CLL)
  54. CLL usually occurs in ________ dogs and is most often of _____ origin.
    middle-aged to older; T cell
  55. 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
  56. With CLL in cats usually occurs in _______ animals and is primarily a ________ disease.
    middle-aged to older; CD4 T cell
  57. In feline CLL, what irregularities are seen on the blood film?
    irregularities in the nuclear membrane
  58. Cytological examination of blood films and samples obtained by _________ are commonly used to diagnose lymphoma in dogs and cats.
    fine needle aspirate (FNA)
  59. 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
  60. Plasma cell neoplasia is characterized by large numbers of _________.
    plasma cells
  61. With flow cytometry/immunophenotyping, cells are labeled with _______ to identify their ______; immunophenotyping works best for _____________.
    antibodies; phenotype; lymphoid neoplasia
  62. Examination of markers to identify the phenotype of a gated cell population- markers are recognized by antibodies that have fluorescent labels.
    flow cytometry
  63. 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
  64. Most active hematopoiesis occurs in...
    flat bones and extremities of long bones
  65. 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
  66. 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
  67. Hypocellular BM occurs with...(4)
    retrovirus, parvovirus, ehrlichia infection, estrogen toxicity
  68. Hypercellular BM occurs with...(4)
    erythroid or granulocytic hyperplasia, myeloproliferative diseases, and neoplasia
  69. Megakaryocytes are increased in ________________.
    immune-mediated thrombocytopenia
  70. On a blood smear, erythrocytic precursors have the following characteristics... (5)
    intensely basophilic cytoplasm, no granules, central nucleus, round nucleus, dense chromatin
  71. On a blood smear, granulocytic precursors have the following characteristics... (5)
    lightly basophilic cytoplasm, granules, eccentric nucleus, round/oval/elliptical nucleus, finely stippled chromatin
  72. 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)
  73. Increased M:E ratio with no maturation abnormalities can occur with...
    granulocytic hyperplasia and/or erythroid hypoplasia
  74. 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
  75. With increased M:E ratio with no maturation abnormalities, conclude erythroid hypoplasia is CBC shows ________ and a _________.
    non-regenerative anemia; normal leukogram
  76. With increased M:E ratio with no maturation abnormalities, conclude granulocytic hyperplasia and erythroid hypoplasia if CBC shows _______ and ________.
    non-regenerative anemia; neutrophilic leukocytosis
  77. With a increased M:E ratio with maturation abnormalities, hypercellular marrow with mostly immature granulocytes suggests...
    peripheral consumption (from marked inflammation) or granulocytic leukemia
  78. A decreased M:E ratio usually indicates...
    increased erythrocyte production in response to a shortened RBC lifespan (hemolytic anemia)----> regenerative anemia
  79. When in conjunction with disturbed maturation in cats, a decreased M:E ratio suggests...
    myeloproliferative disorder of the red cell series called erythremic myelosis
  80. Increased plasma cells can occur with ___________ or ___________.
    inflammation (ehrlichia canis); multiple myeloma
  81. Increased numbers of lymphocytes can occur with _________ or __________.
    inflammation; lymphoid neoplasia
  82. Hemosiderin is found in _____ but not usually in ______.
    dogs; cats
  83. Increased hemosiderin occurs in dogs with _________.
  84. Decreased hemosiderin occurs in dogs with ________.
    iron deficiency anemia
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Clin Path- Leukemia Neoplasia BM.txt
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