White Blood Cell Disorders

White Blood Cell Disorders PowerPoint PPT Presentation

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White Blood Cells. Infection fighting cells of bloodExcess causes tissue infiltration/leukostasis4.4- 5.9 x 106/L (M)3.8 -5.2 x 106/L (F)Several Types of CellsGranulocytesLymphocytesMonocytes. Granulocytes. Produced in the Bone MarrowNeutrophilsLife span of 8 hoursBacteriocidalEosinophils

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White Blood Cell Disorders

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1. White Blood Cell Disorders Jonathan Ben-Ezra, M.D. Professor of Pathology MCV Campus of VCU

2. White Blood Cells Infection fighting cells of blood Excess causes tissue infiltration/leukostasis 4.4- 5.9 x 106/L (M) 3.8 -5.2 x 106/L (F) Several Types of Cells Granulocytes Lymphocytes Monocytes

3. Granulocytes Produced in the Bone Marrow Neutrophils Life span of 8 hours Bacteriocidal Eosinophils Basophils Approximately 2/3 of WBCs in Blood

4. Granulocytes Increased in Bacterial Infection May see early forms (left shift) Increased in Myeloid Leukemia

5. Lymphocytes B cells Antibody production T cells Fight viral infection Morphologically can’t distinguish between the two Approximately 30% of WBCs in PB Increased in viral infections and lymphoid leukemia

6. Monocytes Become tissue macrophages Involved in phagocytosis Approximately 15% of WBCs in PB

7. WBC Maturation

8. Leukemia Neoplastic Proliferations of WBCs in Blood and Bone Marrow Anemia, infection, bleeding Acute Leukemias Blast (precursor) cells Rapidly fatal if not treated Chronic Leukemias More mature cells Longer life expectancy

9. Leukemia

10. Acute Lymphoblastic Leukemia Proliferation of lymphoblasts anemia, thrombocytopenia, increased WBC lymphadenopathy/splenomegaly B- or T-cell flow cytometry TdT+ Most common leukemia of childhood

11. Acute Lymphoblastic Leukemia

13. Acute Myelogenous Leukemia Proliferation of myeloblasts anemia, thrombocytopenia, increased WBC Myeloid, monocytic, RBC, or megakaryocytic flow cytometry myeloperoxidase +, TdT- Auer rod Over age of 20

14. Acute Myelogenous Leukemia

15. Chronic Myelogenous Leukemia 1 of myeloproliferative diseases (PV, ET) Proliferation of more mature granulocytes normal to increased platelet count anemia Splenomegaly t(9;22) (bcr-abl) (Philadelphia chromosome)

16. Chronic Myelogenous Leukemia Long chronic phase Blast crisis Hydroxyurea, interferons Bone marrow transplantation

17. Chronic Myelogenous Leukemia

18. Myelofibrosis Marrow becomes fibrotic extramedullary hematopoiesis dry tap Teardrop RBC Myeloproliferative, toxin, infection

19. Chronic Lymphocytic Leukemia Proliferation of small mature B-lymphocytes flow cytometry (monoclonal Kappa or lambda) Lymphadenopathy relationship to small lymphocytic lymphoma May have Ab production and AIHA 50% 5-year survival

20. Chronic Lymphocytic Leukemia

21. Multiple Myeloma Neoplasm of plasma cells monoclonal protein in serum (SPEP) Proteinuria (Bence-Jones) (UPEP) Lytic lesions in bones fractures Anemia, increased globulin Rouleaux formation Renal failure/ amyloidosis

22. Multiple Myeloma

23. Infectious Mononucleosis Acute infection with EBV Adolescent/Young Adult Fever, sore throat, splenomegaly, fatigue Heterophile antibodies Usually self limited

24. Lymphomas Nodal based malignant proliferations of lymphoid cells Hodgkin’s disease Non-Hodgkin’s lymphoma follicular vs. diffuse small vs. large cell Staging

25. Diffuse vs. Follicular Lymphoma

26. Low grade NHL Small lymphocytic lymphoma nodal counterpart for CLL Follicular lymphomas B-cell t(14;18) failure of apoptosis

27. Small Lymphocytic Lymphoma

28. Follicular Lymphoma

29. Follicular Lymphoma

30. High Grade NHL May be nodal or extranodal May be T- or B-cell Adults or pediatric Large cell lymphoma Burkitt’s lymphoma t(8;14) related to EBV Lymphoblastic lymphoma

31. Large Cell Lymphoma

32. Burkitt’s Lymphoma

33. Burkitt’s Lymphoma

34. Extranodal Marginal Zone B-cell Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) Proliferation of mucosal associated lymphoid tissue Small lymphoid cells, with/out abundant cytoplasm May transform to large cell lymphoma Median survival of 8 years

35. Extranodal Marginal Zone B-cell Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT)

36. Hodgkin Lymphoma Bimodal age distribution Related to EBV Reed Sternberg cell other background inflammatory cells Radiation, chemotherapy, or BMT

37. Hodgkin Lymphoma Nodular Lymphocyte Predominant Nodular Sclerosis Mixed Cellularity Lymphocyte Depleted

38. Hodgkin Lymphoma

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