Patho Chapter 12: Disorders of White Blood Cells

Hodgkin's Lymphoma

-B-cell abnormality -Solid tumor in lymphoid tissue -Reed-Sternberg cells in lymph tissue -Leukopenia -Anemia The presence of Reed-Sternberg cells in microscopic examination is a hallmark of Hodgkin's lymphoma, as are solid tumors in lymph tissue. Production of white and red blood cells is often suppressed, leading to anemia and leukopenia. Unlike NHL, Hodgkin's lymphoma is due to a B-cell abnormality and does not involve T cells or natural killer cells.

Acute Lymphocytic Leukemia (ALL)

-Bone marrow > 20% lymphoblasts -B or T cells do not function or mature -More common in children than adults "Acute" indicates the presence of immature cells, or blasts. Lymphocytic indicates the cell lines affected are B or T cells. Although, ALL is much more common in children than adults, it is not the most common form of cancer in the United States. M-proteins are associated with multiple myeloma.

Acute Myelogenous Leukemia (AML)

-Bone marrow more than 20% blast cells of myeloid origin -Blast cells may invade other tissues -Anemia In AML, the myelogenous line is affected. "Acute" indicates the presence of immature or blast cells. These cells may invade other tissues. Immunoglobulin (Ig) formation is not affected, as immunoglobulins are produced by lymphocytic cells. Anemia may be present as production of red blood cells is suppressed by overproduction of cancer cells.

Chronic Lymphocytic Leukemia (CLL)

-Bone marrow reveals small lymphocytes and lymphocytes >30% -Elderly individuals affected -Most common type of leukemia in U.S. -B cells do not produce Igs Unlike ALL, which more commonly affects children, CLL most commonly affects the elderly. CLL is the most common form of leukemia in the United States. "Chronic" refers to the presence of mature cells, not immature or blast cells. Lymphocytes are elevated as the lymphocytic line is affected. Although lymphocyte number is elevated, lymphocyte function is not normal, as B cells do not produce normal immunoglobulins.

Multiple Myeloma

-Can lead to bone destruction -B cell malignancy -Proliferation of abnormal plasma cells Multiple myeloma is due to abnormal B cells. B cells, which produce antibodies, are known as plasma cells. Plasma cells produce immunoglobulins, or Igs. In multiple myeloma, abnormal Ig fragments are produced. The excess production of B cells can lead to destruction of the bone tissue and cause bone pain.

Which of the following statements are true? Select all that apply. -Multiple myeloma is a condition of T cells. -Hodgkin's lymphoma presents with Reed-Sternberg cells. -Hodgkin's lymphoma is a malignancy of B cells. -Non-Hodgkin's lymphoma is a malignancy of T, B, or natural killer cells. -Acute lymphocytic leukemia is more common in children.

-Hodgkin's lymphoma presents with Reed-Sternberg cells. -Hodgkin's lymphoma is a malignancy of B cells. -Non-Hodgkin's lymphoma is a malignancy of T, B, or natural killer cells. -Acute lymphocytic leukemia is more common in children.

Chronic Myelogenous Leukemia (CML)

-Overproduction of mature myeloid cells -Progressive phases with loss in neutrophil differentiation -Total WBC count may elevate to 100,000 cells/μL Chronic myelogenous leukemia indicates an abnormality in mature cells of myeloid lineage, which includes granulocytes, such as neutrophils. Significant elevation in white blood cell number (>100,000) may be present. CML is not related to the lymphocytic line. Reed-Sternberg cells are present in Hodgkin's lymphoma.

Non-Hodgkin's Lymphoma (NHL)

-T, B or NK cells involvement -Over 20 different forms -Lymph node enlargement -Thrombocytopenia Non-Hodgkin's lymphoma actually refers to a collection of several forms of lymphoma. Often one of the first signs of NHL is enlarged lymph nodes. This form of lymphoma may arise from several cells types, but invasion of blast cells into other tissues does not occur. Like many forms of leukemia, thrombocytopenia may be present as excess white blood cell levels suppress platelet formation.

What are some symptoms associated with white blood cell neoplasms? Select all that apply. anemia splenomegaly bone pain increased risk of infection thrombocytopenia

-anemia -splenomegaly -bone pain -thrombocytopenia -increased risk for infection

Which form of leukemia presents with immature T or B cells? Acute lymphocytic leukemia Chronic lymphocytic leukemia Acute myelogenous leukemia Chronic myelogenous leukemia

Acute lymphocytic leukemia

A 65-year-old patient reports night sweats and weight loss. The complete blood count report shows that she has lymphocytosis. The total white blood cell count is 23,000 microliters. On diagnosis, the bone marrow of the patient is infiltrated with small lymphocytes. What should the nurse suspect based on the information? Acute lymphocytic leukemia Chronic lymphocytic leukemia Acute myelogenous leukemia Chronic myelogenous leukemia

Chronic lymphocytic leukemia

Which of the following are examples of lymphomas? Select all that apply. Acute myelogenous Hodgkin's Non-Hodgkin's Chronic lymphocytic leukemia Multiple myeloma

Hodgkin's Non-Hodgkin's

If Reed-Sternberg cells are noted on a biopsy sample, which of the following is the most likely diagnosis? Hodgkin's lymphoma Non-Hodgkin's lymphoma Multiple myeloma Acute lymphocytic leukemia Acute myelogenous leukemia

Hodgkin's lymphoma

A patient is being tested for a hematological neoplasm. Which finding(s) would be present in the patient if he tests positive for the neoplasm? Select all that apply. Increased number of red blood cells Increased oxygen carrying capacity Increased number of platelets Increased proliferation of abnormal lymphocytes Increased clotting time

Increased proliferation of abnormal lymphocytes Increased clotting time

A patient comes to the hospital and reports night sweats as a result of acute myelogenous leukemia. Which other effect does the condition have on the patient? Select all that apply. It increases the production of blood cells. It decreases the number of myeloid cells to below 10%. It increases levels of immature lymphocytes. It increases the incidence of anemia. It increases immature myeloid cells.

It increases the incidence of anemia. It increases immature myeloid cells.

A patient who has an infection was brought to the hospital. The result of the complete blood count with differential report shows a white blood cell count of 12,000 cells/microliter. Normal is 5,000 to 10,000 cells/microliter. Which condition has the patient developed? Leukopenia Leukocytosis Thrombocytopenia Neutropenia

Leukocytosis

In which condition are abnormal plasma cells, immunoglobulins, or immunoglobulin fragments present? Acute lymphocytic leukemia Non-Hodgkin's lymphoma Multiple myeloma Hodgkin's lymphoma Chronic myelogenous leukemia

Multiple myeloma