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Disorders of White Blood Cells and Lymphoid Tissues

The document discusses disorders of white blood cells and lymphoid tissues, focusing on neoplastic disorders including leukemias, lymphomas, and multiple myeloma. It describes the four main types of leukemia (acute lymphocytic, chronic lymphocytic, acute myeloid, chronic myeloid), their characteristics and causes. It also outlines the main types of lymphomas - Hodgkin's lymphoma, non-Hodgkin's lymphomas, and Burkitt's lymphoma, providing details on diagnosis, symptoms and treatment.

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205 views30 pages

Disorders of White Blood Cells and Lymphoid Tissues

The document discusses disorders of white blood cells and lymphoid tissues, focusing on neoplastic disorders including leukemias, lymphomas, and multiple myeloma. It describes the four main types of leukemia (acute lymphocytic, chronic lymphocytic, acute myeloid, chronic myeloid), their characteristics and causes. It also outlines the main types of lymphomas - Hodgkin's lymphoma, non-Hodgkin's lymphomas, and Burkitt's lymphoma, providing details on diagnosis, symptoms and treatment.

Uploaded by

ammar amer
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Disorders of White Blood Cells and

Lymphoid Tissues
Neoplastic Disorders of Haemopoitic System and Lymphoid Tissues

The Neoplastic disorders include:

• Leukemias
• Lymphomas
• Multiple Myeloma
Leukemias

• Leukemias are malignant tumors of the haemopoitic


stem cells characterized by diffuse replacement of
bone marrow by neoplastic cells.

• The leukemic cells proliferate mainly in bone marrow,


circulate in the blood and infiltrate in the spleen,
lymph nodes, and other organs.
Classification:

Leukemias are classified according to the:

1). Type of malignant cells i.e. the precursor of the


malignant cells are either lymphogenic or myelogenic.

2). Their incidence i.e. either acute or chronic. In acute


cases are characterized by replacement of the bone
marrow with immature cells and rapidly fetal.
So there are four types or classes of leukemia these are:
1). Acute Lymphocytic Leukemia
(ALL):
This type of leukemia characterized by:

• Accumulation of lymphoblasts.

• It occurs mostly in childhood with peak incidence


between 2-7 years.

• Etiology of ALL is unknown, but cytogenetic studies


reveal some abnormality of chromosome number and
structure may lead to produce ALL.
The pathogenesis of clinical disease in all relates to the
progressive accumulation in the bone marrow of
lymphoblasts.
2). Chronic Lymphocytic Leukemia
(CLL):
• It is the most indolent of all leukemia, most often seen
in old people "older than 50 years". The leukemic
cells are B cells in 95% of cases, but in rare cases 5%
the leukemic cells are T cells. The T cell leukemias
are much more aggressive than the B cell CLL.

• The leukemic B cells fail to respond to antigenic


stimulation i.e. unfunctional B lymphocytes.
• -About 50% of patients have chromosomal
abnormality.
Clinical Features:
• CLL is often asymptomatic. When symptoms are
present, they are nonspecific and include;
easy fatigability, weight loss, and anorexia, increase
susceptibility to bacterial infection. Total leukocyte
count may be increased only slightly or may reach
200000 per microliter. Many patients live more than
10 years after diagnosis.
3). Acute Myeloid Leukemia
(AML):
• The leukemic cell is myeloid multipotential haemopoitic stem cell.

• AML primarily affect adult. Its incidence increases steadily with age, with
the median age being 50 years.

• The etiology of AML is not known.

• The risk factors include the following: toxic agents, radiation, genetic
abnormalities, and hematologic disorders. Exposure to benzene for a long
period is a known risk factor.  This carcinogen is a solvent used in
industries that create drugs, rubber, dyes, plastics and other things.  People
working in these industries have a higher risk of developing AML
4). Chronic Myeloid Leukemia
(CML):
• CML affects adults between 25-60 years of age and
accounts for 15% to 20% of all cases of leukemia.

• Clinical features:
• Splenomegaly , the laboratory finding, there is marked
elevation of the leukocyte count commonly exceeding
100000 cell per microliter, the circulating cells are
predominantly neutrophils and myelocytes, but basophils
and eosinophils are prominent, about 50% of patients
have thrombocytosis. The course of CML is one of slow
progression. Median survival is 3 years.
Chronic Myeloid Leukemia
Lymphomas

Types of Lymphomas
• Hodgkin's Lymphomas = Hodgkin's Disease
• Non Hodgkin's Lymphomas (NHL)
• Burkitt's Lymphoma
Hodgkin’s Lymphomas = Hodgkin’s Disease

• It is a malignant neoplasm of lymphatic structures


characterized by painless and progressive
enlargement of single lymph node or group of
lymph nodes. More often localized to a single axial
group of nodes (cervical, mediastinal, para-aortic).
• Hodgkin's disease is somewhat more common in men
than in women and in the white than in blacks. The
peak incidence in the late 20 years of age , a decrease
in frequency during the 4th and 5th decades, and a
gradually increasing incidence after age of 50 years.
• Young adults who have experienced Epstein- Bar virus
infection (infectious mononucleosis) have a threefold
increased risk of developing Hodgkin's lymphoma.

• -Genetic factors may play a role in developing.

• There is an increased incidence of HD in patients with


immunodeficiency and autoimmune diseases such as
rheumatoid arthritis
• -Hodgkin's lymphoma originate within one area of the
lymphatic system and if unchecked will spread
throughout the lymphatic network (disseminate).
• -Hodgkin's lymphoma is characterized by the presence of
distinctive neoplastic giant cells called Reed- Sternberg
(SR) cells admixed with a variable inflammatory
infiltrate.
• The Reed- Sternberg (RS) cell has abundant, slightly
eosinophillic cytoplasm. Particularly characteristic are
two mirror image nuclei, each containing a large
(inclusion-like) acidophilic nucleolus surrounded by a
distinctive clear zone: together they impart an owl-eyed
appearance.
Signs and Symptoms:

• In early stages there is no systemic complication but the


advanced stages there is systemic complication like:
fever, night sweat, loss weight, fatigue, pruritis, and
anemia. In the advanced stages the liver, lungs, GIT, and
CNS may be affected.
Diagnosis:

• -Biopsy for histopathologic examination.


• -CT scan.
• -Radiologic visualization of abdominal and pelvic
lymph nodes.

• -Treatment: Radiation and chemotherapy are used in


treating the disease.
Non Hodgkin's Lymphomas (NHL)

• NHLs are malignant tumors originated in lymphoid


tissue usually in the lymph nodes (65%of cases) or in
the lymphoid tissue of parenchymal organs (35%). It
characterized by multicentric in origin and spread
early to various tissues throughout the body specially
the liver, spleen and bone marrow.
•NHLs are tumors of immune cells so it may origin in
T, B cells or histiocytes (macrophages of lymphoid
tissues). Most NHLs (80-85) % are of B cell origin;
the remainders are in large T cell tumor. Tumors of
histiocytes are quite uncommon.
•The neoplastic cells of B cell origin may either aggregate
as nodule or spread diffusely in lymphoid tissue.
Aggregation as nodule is called nodular lymphoma, while
diffusely spread called
diffuse lymphoma………………………………..

•All T cell lymphomas are diffuse.

•Nodular lymphomas are indolent tumors with


long survival but not curable.

•Diffuse lymphomas are aggressive tumors that


are rapidly fatal unless treated, but with
appropriate therapy, many can be cured.
Burkitt's Lymphoma

• This is a high grad tumor of B lymphocytes,


clinically aggressive. In fact this tumor is the most
rapidly proliferative of all human tumors. Mostly
affect children.
• Currently Burkett's lymphoma can be occurs as
endemic, the sporadic and the
immunodeficiency which are associated HIV
and AIDS.
• The children with impaired immunity can
infected with Epstein-Barr virus (the causative
agent of Burkitt's disease), the disease involves
the jaw or other facial bone, distal ileum,
cecum, overies, kidney or the breast.

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