Path II3

neoplasm of lymphocytes arising as a solid tissue mass in organs other than the bone marrow

• neoplasm od lymphoid cells that originates from bone marrow
• can be found in blood (leukemic) or not (aleukemic)

• usually leukocytosis
• undifferentiated blast cells in blood
• >20% nucleated cells are blasts and >50% total nonerythroid cells are nucleated cell pop
• blast cell origin cannot be determined by morphology alone

• slowly progresses
• older animals
• clonal neoplastic proliferations of mature granulocytes, monocytes, erythrocytes, or platelets
• leucocytosis
• bone marrow hypercellularity
• blast crisis- transformation to acute myeloid leukemia

• pre-leukemic condition
• <20% blast cells in bone marrow
• hypercellular bone marrow
• associated with FeLV
• possible leukopenia, anemia, thrombocytopenia
• anemia is nonreg, macrocytic, lack polychromasia, metarubricytes present
• macrocytosis, abnormal nuclear lobulation

• subset of CFU-GEMM
• common in dogs, common in skin (consider malignant)
• cats- skin or visceral (single= bengin, multiple= malignant)
• mast cell leukemia- formed bad in marrow and released into blood- GI common and release histamine

• cell of mac, dendritic, or langerhan cell lineage
• common in dogs
• cutaneous, canine cutaneous, systemic, sarcoma complex

• unique in young dogs
• neoplasm of dendritic Ag presenting and Langerhans cells
• benign
• solitary
• excision to cure
• spontaeously regress
• cherry red lesion

• benign
• multiple lesions
• wax and wane
• mostly reactive

• multiple lesions
• involves regional LN
• reactive

• solitary
• extends beyond regional LN and involves visceral tissues
• Bernese mountain dogs

• not normally present
• short life span (12-24hr)
• non degenerate- none septic mostly
• degenerate- sepsis

• not normally present
• casuses- hypersensitivity, allergic response, parasites, mast cell tumor, T cell lymphoma, fungal inf, idiopathic

• aka- histiocytes
• small numbers normally
• chronic infection
• causes- fungal inf, necrosis, foreign body, complex bac, neoplasia

• not normally present
• produce cytokines, Ag presenting

• not normally present
• frustrated phagocytosis
• granulomatous and pyogranulomatous

• not normally present
• granules may not stain in Diff- Quik
• cause- hypersensitivity, mast cell tumor

• not normally present
• cause- plasma cell tumor

• 85% neutrophils
• septic or mycotic?
• degenerate or nondegenerate neutrophils?
• usually acute

• 50% eosinophils
• could be suppurative and eosinophilic inf
• septic or mycotic?
• causes- parasite, hypersensitive, mast cell tumor, T cell lymphoma, allergic rxn, idiopathic

• neutrophils, mononuclear cells, eosinophils, mast cells
• chronicity

• neutrophils and macs
• multinucleated giant cells or epithelioid macs
• causes- foreign body, fungi

• lacks neutrophils
• multinucleated giant cells

inc in small lymphs and plasma cells in non-lymphoid tissue

• contamination- RBCs with platelets
• hemorrhage- erythrophagocytosis, hemosiderophages, hemosiderin

• dec plasma oncotic press
• inc hydrostatic press
• lyph obstruction
• inc vascular permeability

• low total protein and low nucleated cell counts
• non-inflammatory- hypoalbuminemia, lymph obstruction, inc blood press

• mildly inc nucleated cells and protein
• cause- R sided heart failure, neoplasia, infection (FIP)

• high total protein and nucleated cell counts
• mostly neutrophils
• cause- inflammation from sepsis, perforated intestine, neoplasia, necrosis
• suppurative, mixed cell, lymphocytic, eosinophilic?
• septic or mycotic?

• normal- transudate
• nucleated cell count normally higher
• modified transudate- impaction, gastritis, early GI lesions
• exudate- ruptured gut, intussusception, colitis

• causes- leakage secondary to trauma, heart failure, neoplasia, obstruction, idiopathic
• milky white fluid
• lipid will falsely inc TP
• tryglicerides higher in fluid than serum
• cholesterol lower in fluid than serum

• lots of RBCs
• erythrophogocytosis, hemosiderin, hemotoidin
• no inflammation
• no platelets

• clot tube
• microprotein- low
• pandy- est of Ig- none or trace
• cell count- few nucleated, no RBC
• pleocytosis- inc nucleated cells

• inc number nucleated cells in CSF
• microprotein usually also increased
• neutrophilic (IVD, immune mediated, FPT), eosinophilic, large mononuclear, mixed cell, lymphocytic

• highly viscous from hyaluronic acid
• mucin clot test
• TP and cell count- must add hyaluronidase to dec viscosity
• supurative, mononuclear, or mixed cell inf

• inc nucleated cell counts- primarily neutrophils
• sepsis- assume if horse
• immune mediated dz- assume if dog
• trauma

• monomorphic population
• benign-

• well differentiated
• slow growth
• uniform in size
• blue staining cytoplasm
• uniform N:C ratio
• no mitotic figures
• ddx: hyperplasia

• mitotic activity
• high cellularity
• abnormal cell type for that area
• monomorphic cells with pleomorphism
• anisocytosis and macrocytosis
• basophilic cytoplasm
• nuclear pleomorphism
• anisokaryosis
• variable N:C ratios
• multinucleation
• nuclear molding
• inc mitotic figures
• abnormal chromatin patterns
• macronucleoli
• multiple nucleoli
• abnormal shaped nucleoli
• anisonucleoliosis

• small, round cells
• highly cellular
• clustering nature
• benign- oma
• malignant- carcinoma
• ex- skin, intestine lining, lung, liver

• spindle or round cells
• low to mod cellularity
• not in cohesive sheets
• protein background
• benign- oma
• malignant- sarcoma
• ex- CT, bone, muscle, cartilage

• round cells
• high cellularity
• cells do not have cohesion
• cutaneous histiocytoma, lymphoma, cutaneous mast cell tumor, plasma cell tumor, transmissible venereal tumor, histiocytic neoplasia

• benign
• young dogs
• small button like raised mass
• Langerhan cells
• many lymphocytes present
• spontaneous regression

• malignant
• normal lymph tissue 90% small lymphocytes
• with lymphoma >50% immature lymphocytes

• benign or malignant (tx like malignant)
• cells with purple granules
• eosinophils may be present
• poor granulation= poor prognosis
• not as bad in cats

• benign or malignant
• cutaneous near footpad
• if in bone marrow- malignant
• flame cells

• malignant, but excellent prognosis
• dogs on genitalia or face
• spread by direct contact
• small peripheralized and uniformly sized and shaped clear cytoplasmic vacuoles

• malignant or benign
• spleen, bone marrow, lung, liver
• originate from macs

• neuroectoderm origin
• round, mesenchymal, epithelial
• greenish- black cytoplasm

• vasoconstriction
• platelet adhesion
• conformation change of platelets
• platelet aggregation
• clotting path activation
• fibrin meshwork
• resolution of clot formation thru fibrinolysis

• anticoagulant- antithrombin, tissue plasminogen activator, tissue factor pathway inhibitor
• procoagulant- prothrombin, vWF, plasminogen activator inhibitor, endothelin

• primary hemostasis
• live 7-10 days
• bind to vWF on endothelial collagen in damaged blood vessels
• conformational change enhances binding, expose phospholipids, release thromboxane/Ca/platelet activating factor
• form loose plug

• released from platelets
• vasoconstriction
• platelet aggregation

• secondary hemostasis
• named with a roman numeral
• non-activated or resting factor (ex- X, VII)
• activated factors (ex- Xa, VIIa)
• most factors made by liver (except IV, III)

fibrinogen (fibrin)

prothrombin (thrombin)

tissue factor

Ca

II, VII, IX, X, protein C&S

• all other factors have enzymatic activity so thy are not consumed in the reaction to activate the clotting path
• factors V and VIII are consumed so prone to consumption if liver cannot keep up prod

• XII, XI, IX, VIII
• HMWK and PK

• VII
• Ca

X, II, I

• tissue factor pathway inhibitor (TFPI)- inactivates VIIa
• antithrombin- inactivates IIa- amplified by heparan
• thrombomodulin- activates protein C which combines with S and inactivates V and VIII

• initially plasminogen activator inhibitor is released
• when healing tissue releases tissue factor plasminogen activator
• fibrin must be present for plasminogen to convert to plasmin
• plasmin breaks down clot
• plasmin is a protease so if free then alpha-2 antiplasmin inactivates it

• thrombocytopenia
• thrombocytosis

• hemorrhage when platelets are <25,000
• normal bone marrow response is megakaryocytic hyperplasia
• causes- sequestration, consumption (DIC), destruction (IMHA/IMT), hemorrhage, dec production

• reactive- most common, iron deficiency or anemia lead to erythroid hyperplasia and a piggyback megakaryocytic hyperplasia
• physiologic- splenic contraction, transient
• neoplastic- essential thrombocythemia (ET)

• hereditary primary platelet defects
• von Willebrand Disease
• acquired platelet dysfunction

• glazmann's thrombasthenia- otterhound, great pyrenees
• chediak-higashi syndrome- persian cat, hereford cattle

• appears as a platelet defect
• platelet numbers and fxn are normal
• produced and stored in endothelial cells and bound to VIII
• type I- fewer numbers of all sizes, doberman
• type II- loss of high molecular weight multimers, GSP, severe bleeding
• type III- loss of all multimers, scottish terrrier, shetland sheepdog, severe bleeding

• aspirin- loss of TxA2
• DIC

• assess formation of platelet plug only
• 2-4 min
• do not do if low platelets
• prolonged= vWD, qualitative platelet defects

• do not cause much bleeding bc alternate path
• XI- cattle
• XII- cats

• minor bleeding prob
• boxer, beagle, malamute

• severe bleeding
• boxer, cocker

• V, VII, IX, X
• protein C&S
• cause- rodenticide toxicity, moldy sweet clover

• Na citrate tube
• fill to proper level
• centrifuge ASAP
• measures time to form clot in tube
• platelets not present

• grey top
• whole blood
• must be less than 5% of normal (95% dec)- insensitive
• intrinsic and common path
• do not perform with severe thrombocytopenia

• intrinsic and common path
• must be less than 30% of normal (70% dec)

• VII and common path
• best test for vit K deficiency bc VII affected first
• nust be less than 30% of normal (70% dec)

specific breakdown product of cross linked fibrin and so measuring this substance is a better way to evaluate if fibrinolysis of the clot is occuring

increased= DIC, thrombotic dz, liver dz, hemorrhage

• inc platelet activity
• inc coag factors
• dec natural inhibitors

• percent activity compared to a normal standard
• hepatic insufficiency, protein losing nephropathy, DIC

• multifactoral- widespread fibrin formation
• consumption of platelets, coag factors, natural inhibitors, fibrinolytic factors
• results in thrombosis
• ischemia and anoxia leads to acidosis

• stagnant blood flow
• endothelial damage
• release of tissue factors

• petechia
• ecchymoses
• frank hemorrhage

• three of any of the following:
• thrombocytopenia
• prolonged PT/APTT
• inc D-dimer
• dec fibrinogen
• dec antithrombin
• schistocytes

• measurements are based on degree of activity not quantity
• international units per L
• do not have fxn in blood
• dec levels are non-diagnostic
• inc levels= damaged cells, induction, neoplasia, dec clearance, ingestion
• degree of enzyme elevation correlates to the degree of cellular damage (does not mean diffuse)
• 3-5 fold inc is significant

• lethargy
• dep
• icterus
• bleeding
• vomiting

• anemia, acanthocytes
• hypoproteinemia
• ammonium biurate crystals
• abnormal coagulation profiles
• transudate

• ALT, AST, GLD, SDH
• near vessels so quick inc in blood
• leakage from ruptured cells

• LALP
• GGT
• then ALT, AST, GLD, SDH
• intra or extrahepatic
• induction of enzyme activity by press

• hypoglycemia/albuminemia
• portosystemic shunt- microhepatica
• down reg of albumin
• chronic liver dz
• inc albumin loss
• horse albumin has long half life

• liver
• half life dog-3d, cat-3.5hr
• inc may result from glucocorticoid or anticonvulsant
• not run in LA

• mitochondria- liver and skeletal mm
• half life dog-12hr, cat-1.5hr, horse-8d
• not run in SA

• acute injury
• not run in SA

• intestine, liver, bone
• L-ALP half life dog-3d, cat-6hr
• corticosteroid induced ALP in dogs
• causes for inc= cholestasis (SA), phenobarb, young growing animal, mammary neoplasm, corticosteroid, hepatic lipidosis, hyperthyroidism

• liver, bile duct, renal
• half life 3d
• causes of inc= corticosteroids, colostrum, cholestasis (SA and horses), biliary neoplasia