33 concise topics with breakdowns: definitions, key facts, and class questions.
This section covers the morphological substrates of hematopoietic and hemostatic disorders. Everything is analyzed here: from "red blood" (erythrocytosis, posthemorrhagic, iron-deficiency, and aplastic anemias) to reactive leukocyte changes, leukemoid reactions, and splenic pathology.
The most extensive and complex section is hemoblastoses. You will find clear criteria for acute myeloid and chronic leukemias, myelodysplastic syndromes, and myeloproliferative neoplasms. Special attention is given to lymphoproliferative disorders: Hodgkin lymphoma, chronic lymphocytic leukemia, multiple myeloma, Waldenström macroglobulinemia, and Castleman disease. Hemorrhagic diatheses, coagulopathies, and thrombocytopathies are also described in detail.
What is most frequently asked in class? Instructors love to focus on the differential diagnosis of acute and chronic leukemias, the cellular composition of granulomas in Hodgkin lymphoma (Reed-Sternberg and Berezovsky-Reed-Sternberg cells), and, of course, the fatal complications of leukemias seen at autopsy.
How does absolute erythrocytosis differ from relative erythrocytosis?
In absolute erythrocytosis, the mass of circulating red blood cells genuinely increases due to reactive enhancement of erythropoiesis. In relative erythrocytosis, the cell mass is unchanged, but plasma volume decreases, leading to hemoconcentration.
What forms of posthemorrhagic anemia exist?
The disease is subdivided into two main forms: acute and chronic.
What is autosplenectomy?
This is a complete functional shutdown of the spleen. It is frequently seen in sickle cell anemia, where impaired blood flow causes multiple infarctions of the organ, leading to eventual atrophy.
What is the main difference between B12-deficiency anemia and folate-deficiency anemia?
In vitamin B12 deficiency, in addition to typical hematological and gastroenterological changes, specific neurological symptoms develop (funicular myelosis) due to impaired myelin synthesis.
How does anemia of chronic disease differ from iron-deficiency anemia?
In anemia of chronic disease, ferritin levels are normal or elevated, and iron is sequestered in macrophages, whereas in iron-deficiency anemia, iron stores are depleted.
What happens to the bone marrow in aplastic anemia?
A dramatic suppression of hematopoiesis occurs. Trephine biopsy reveals that active hematopoietic tissue is replaced by adipose tissue, with only isolated islands of myeloid cells remaining.
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