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WBC Absolute counts in disease:Penia PhiliaNeutroPenia PhiliaEosinoPenia cytosisMonoPenia cytosisLympho
Leukopenia: Neutropenia Reduction in granulocytes:• Decreased Production – Marrow.• Increased destruction – drugs, immune When severe – Agranulocytosis. Clinical features:• Infections – chills, fever, fatigue, ulcers.
Leukocytosis: Neutrophilia Increased granulocytes:• Acute inflammation, Bacterial infections. When severe – Leukemoid reaction. Clinical features:• Infections or Trauma - fever, fatigue.
Lymphocytosis: Infectious Mononucleosis Increased Lymphocytes:• Chronic Inflam, Viral, fungal, TB etc. Large lymphocytes, more cytoplasm. Irregular,indented by RBC – also known as virocyte Clinical features: Chronic fever, lymphadenopathy.
Hemato-oncology: Blood Cancer Cancer of blood forming – stem cells (Blasts). Leukemia – ‘White’ ‘blood’ – excess WBC. Starts in bone marrow or lymphatic tissue. Spread to blood & other ‘RES’ tissues only.(Liver, Spleen & lymphnodes) Two Major types: Myeloid & Lymphoid. Two clinical presentaiton: Acute / Chronic. Many subtypes* – due to several differentmutations – personalized medicine *
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LymphoblastLeukemia: Cancer of Blast cells.AcuteMyeloidLeukemiaAcute Lymphatic LeukemiaChronic LeukemiaChronic Leukemia
Hodgkins LymphomaBig binucleate cancer cells known asReed Sternberg Cells (RS cells)
Non-Hodgkins Lymphoma: Large group of lymphatic neoplasms. Clinical: Fever, anemia, infections,Lymphadenopathy. Spleen+/-. No RS cells or eosinophilia Complex names and classification.• Cell type – B, T & Histiocytic “B commonest”• Clinical – low, intermediate & high grade.• Histology – Follicular & diffuse.• Special types: Burkitts lymphoma, Myeloma,Waldenstroms macroglobulinemia, lennert‟s,
Non Hodgkins LymphomaLow, Intermediate & High grade.
Burkitt‟s lymphoma: large B cell NHL Endemic in Africa Epstein Barr Virus(EBV) B Cell Lymphoma. Dark large Blymphocytes (malignant)with plenty of palemacrophages. (Starrysky pattern).
Multiple Myeloma: Malignancy of Plasma cells(Mature B lymph, Ab) Old age, males common. Marrow, LN, Blood. Multiple, punched out Lytic bonelesions (Osteolysis) Hyper gammaglobulinemia Monoclonal antibody peak –serum protein electrophoresis. Immunodeficiency infections.
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Myeloproliferative Disorders.Myelodysplastic Syndromes.(Precanceraous stage of blood cancers)
Polycythemia Rubra Vera (PV)Hypercellular Marrow,Red skin & Hepatosplenomegaly
ET - Blood Film & clinical.Plenty ofPlateletsMegakaryocyte
Myelo Dysplastic Syndromes: Dysplastic Proliferation (abnormal cells) Neoplastic, old age, unexplained anemia. Abnormal cells destroyed in bone marrow. Hypercellular BM & Leukopenia, anemia. Commonly known as Refractory Anemia. Many subtypes, Mild to severe dysplasia. Increasing blasts – poor prognosis. Transforms to acute leukemia.