复旦大学：《病理学 Pathology》课程英文PPT课件_Chapter XI The Disease of Hematopoietic and Lymphoid Systems

The Disease of Hematopoietic and Lymphoid Systems

The Disease of Hematopoietic and Lymphoid Systems

Hematopoietic and Lymphoid Systems a Myeloid tissue Bone marrow RBC, platelets, granulocytes, monocytes lymphoid tissue mph nodes lymus spl oleen

Hematopoietic and Lymphoid Systems ◼ Myeloid tissue ◼ Bone marrow ◼ RBC, platelets, granulocytes, monocytes ◼ Lymphoid tissue ◼ lymph nodes ◼ thymus ◼ spleen

Disorders a encompass a wide range of diseases, involving its any organs or tissues ■RBC: usually anemia WBC: overgrowth, usually malignant common and lethal

Disorders ◼ encompass a wide range of diseases, involving its any organs or tissues. ◼ RBC: usually anemia ◼ WBC: overgrowth, usually malignant common and lethal

Neoplastic proliferations of white cells Be defined briefly as follows Myeloid neoplasms髓样组织肿瘤 ymphoid neoplasms淋巴样组织肿瘤 3. Histiocytosis an-made classification The distinction in some cases may be blurred

Neoplastic proliferations of white cells Be defined briefly as follows: 1. Myeloid neoplasms 髓样组织肿瘤 2. Lymphoid neoplasms 淋巴样组织肿瘤 3. Histiocytosis Man-made classification The distinction in some cases may be blurred

Myeloid neoplasms Arise within hematopoietic stem cells Three general categories Acute myelogenous leukemia(AML急性髓性白血病 8 types: FAB classification MI-8 Chronic myeloproliferative disorders(慢性骨髓增生性疾病) Chronic myelogenous leukemia慢性髓性白血病 Polycythemia vera真性红细胞增生症 Myeloid metaplasia with myelofibrosis伴骨髓纤维化的髓样增生 Essential thrombocythemia真性血小板增生症 Myelodysplastic syndromes(骨髓增生异常综合症) Myeloid neoplasms: CD13, CD14, CD15CD64

Myeloid neoplasms ◼ Arise within hematopoietic stem cells ◼ Three general categories: ◼ Acute myelogenous leukemia (AML 急性髓性白血病) ◼ Chronic myeloproliferative disorders （慢性骨髓增生性疾病） ◼ Chronic myelogenous leukemia 慢性髓性白血病 ◼ Polycythemia vera 真性红细胞增生症 ◼ Myeloid metaplasia with myelofibrosis 伴骨髓纤维化的髓样增生 ◼ Essential thrombocythemia 真性血小板增生症 ◼ Myelodysplastic syndromes（骨髓增生异常综合症） Myeloid neoplasms: CD13,CD14,CD15,CD64 8 types: FAB classification M1~8

Lymphoid neoplasms A group of entities that vary widely in terms of their clinical presentation and behavior e Classification scheme that relies on a combination of clinical morphologic, phenotypic and genotypic features the relationship between lymphoma and lymphocytic leukemia Certain important relevant principles most: B Cell origin neoplasms are often composed of cells that arrest at specific stages

Lymphoid neoplasms A group of entities that vary widely in terms of their clinical presentation and behavior Classification scheme that relies on a combination of clinical, morphologic, phenotypic and genotypic features the relationship between lymphoma and lymphocytic leukemia Certain important relevant principles most: B Cell origin neoplasms are often composed of cells that arrest at specific stages

Lymphoid neoplasms I A. Precursor B-cell neoplasms I B. Peripheral B-cell neoplasms NHL IA Precursor T-cell neoplasms IIB. Peripheral T-/NK-cell neoplasms ll. Hodgkin lymphoma

ⅠA. Precursor B-cell neoplasms ⅠB. Peripheral B-cell neoplasms ⅡA. Precursor T-cell neoplasms ⅡB. Peripheral T-/NK-cell neoplasms Ⅲ. Hodgkin lymphoma Lymphoid neoplasms NHL

I A. Precursor B-cell neoplasms 1. Precursor B-cell leukemia/lymphoma IA. Precursor T-cell neoplasms Precursor T-cell leukemia/lymphoma pre-B-lymphoblastic tumor: first leukemia lymphoma pre-T-lymphoblastic tumor: mediastinal masses involved the thymus leukemia Both tumors usually have the clinical appearance of an acute lymphoblastic leukemia (ALL)

ⅠA. Precursor B-cell neoplasms 1. Precursor B-cell leukemia/lymphoma ⅡA. Precursor T-cell neoplasms 1. Precursor T-cell leukemia/lymphoma pre-B-lymphoblastic tumor: first leukemia lymphoma pre-T-lymphoblastic tumor: mediastinal masses involved the thymus leukemia Both tumors usually have the clinical appearance of an acute lymphoblastic leukemia (ALL)

Common features of acute leukemias ALL +AML ■ Clinical features 1. Abrupt stormy onset--within 3 months 2. Symptoms related to depression of normal marrow function Pathophysiology Block in differentiation blasts accumulate in marrow normal hematopoietic stem cells Anemia Mature leukocytes Thrombocytopenia fatigue infection bleeding

Common features of acute leukemias ALL +AML ◼ Clinical features 1. Abrupt stormy onset—within 3 months 2. Symptoms related to depression of normal marrow function Pathophysiology Block in differentiation blasts accumulate in marrow normal hematopoietic stem cells Anemia fatigue Mature leukocytes infection Thromobocytopenia bleeding

Common features of acute leukemias ■ Clinical features 3. Bone pain and tenderness 4. Generalized lymphadenopathy splenomegaly, and hepatomegaly More common in alL 5. Central nervous system manifestations Headache, vomiting, and nerve palsies children adults ALL>AML

◼ Clinical features 3. Bone pain and tenderness 4. Generalized lymphadenopathy splenomegaly, and hepatomegaly More common in ALL 5.Central nervous system manifestations Headache, vomiting, and nerve palsies children ＞adults, ALL＞AML Common features of acute leukemias