Transcript Hemopoietic System - El Camino College

Hemopoietic System
Spring 2013
Hemopoietic System
• Consists of blood
• Lymphatic tissue
• Bone marrow
• Spleen
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Three Types of Blood Cells
• Erythrocytes
– Red blood cells
– Responsible for transferring oxygen and CO2 to &
from various organs in the body
• Leukocytes
– White blood cells
– Formed within bone marrow
– Play an important role in body’s defense system
• Thrombocytes
– Platelets
– Necessary for blood to clot properly
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Erythrocytes
• Very small cells in relation to
other blood cells
• Don’t contain a nucleus
– Live approx 120 days
• Individuals with less than 12g
per 100ml of blood have
anemia
• Contain various antigens or
lack of which determines blood
type
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Blood Types
i.This rebuttal has been covered in point number 2 above.
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Agglutination
• Rejection of cells due to antigens
– Can cause immediate shock
– Delayed symptoms
• Blood type “O”
– Universal donor (does not have antigens)
• Blood type “AB”
– Universal recipient
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RH factor
http://www.youtube.com/watch?v=7OWp8d
8WKkg
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Pathologies of RBC’s
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Erythrocytes
• http://coursewareobjects.elsevier.com/obje
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Leukocytes
• May be classified as granular and non-granular
– Granular has cytoplasmic granules and irregular
nuclei
– Non-granular does not contain granules & has a
regular nucleus
• Mainly formed in lymphatic tissue and spleen
• Able to move out of capillaries and attack foreign
substances
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Leukocytes
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Leukocytes
• http://coursewareobjects.elsevier.com/obje
cts/mroradpath_v1/mod11/media/11s04l01
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• Necessary for blood to clot
and coagulate in seconds
Thrombocytes
• Formed in bone marrow
• Live for 10 days
• Critical for preventing
hemorrhage
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Thrombocytes
• http://coursewareobjects.elsevier.com/obje
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Lymphatic System
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Lymphocytes
• Most radiosensitive blood cells
• Most important in the development of immunity
• Derived from lymphatic tissue (T) and bone
marrow (B)
– Both work together to ingest foreign substances and
process the specific foreign antigens
– With transplants- these cells along with macrophages
see it as a foreign substance
• Try to destroy the foreign antigens resulting in rejection of
graft or organ
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Spleen
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Spleen
• Largest lymphoid
organ
• Produces
lymphocytes and
plasma cells
• Cleanses blood &
lymphocytes to fight
infectious blood-borne
microorganisms
– Removes old or
defective blood cells
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Anemia
• Decrease in the amount of oxygen carrying
hemoglobin in blood
– Results in improper formation of new RBC’s
– Increased rate of RBC destruction
– Or a loss of RBC as a result of prolonged bleeding
• Person appears pale
• Has muscle weakness, fatigue, & SOB
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Types of Anemia
• Iron Deficiency
• Hemolytic
• Megoblastic
• Aplastic
• Myelophthisic
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Iron Deficiency Anemia
• Most common type
• Results from chronic blood loss
– From an ulcer, malignant tumor, or menorrhagia
– Inadequate iron intake
– Pregnancy
• Treatment
– Dietary change
– Ferrous sulfate supplements with vitamin C
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Hemolytic Anemia
• Shortened life span of the red blood cells
with resulting hemolysis and the release of
hemoglobin into the plasma
• 3 hereditary defects
– Spherocytosis
– Sickle cell anemia
– Thalassemia
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Sickle Cell Anemia
• Hemoglobin molecule is
abnormal and RBC’s are
crensentic
– Tend to rupture
• X-ray demonstrates
biconcave indentations
on both the superior &
inferior margins
– Softened vertebral bodies
– Appear like fish vertebrae
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Thalassemia
• Defect in hemoglobin
formation
• Occurs in persons living
near Mediterranean Sea
• Jaundiced
• Extensive hyperplasia
• X-ray demonstrates
widening of medullary
spaces and thinning of
the cortices
– Localized radiolucency
simulating osteolytic
lesions
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• A deficiency of
Vitamin B12 and folic
acid
Megaloblastic
– Can be from
malnutrition, strict
vegetarianism &
alcoholism
– Leads to defective
DNA synthesis
– Decreased number if
RBC’s (normal
hemoglobin)
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Aplastic Anemia
• Failure of bone marrow to function
• Results in a decrease in RBC’s,
leukocytes, and platelets
– Cannot fight infection and have a bleeding
tendency
• Causes include exposure to chemical
agents, drugs, infections and invasion of
bone marrow by cancer
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Myelophthisic Anemia
• Infiltration of bone marrow by cancer,
metastases, and carcinomas
• Causes cortical thickening and can cause
a severe decrease in red and white blood
cells and platelets in the bone marrow
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AIDS
• It is caused by HIV 1 and HIV 2
• HIV 1 more virulent
– Paralyzes the normal immune mechanisms
resulting in severe immunosuppression
– In the majority of cases in western hemisphere
• HIV 2
– Converts viral RNA to a DNA copy
– Each time cell divides retroviral DNA is
duplicated
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HIV and Tissues
• One major sign in the
presence of unusual
opportunistic
infections
• Symptoms include
fever,
lymphadenopathy,
malaise, joint pain
w/in 1-4 weeks of
infection
http://www.youtube.com/watch?v=RO8MP
3wMvqg&feature=related
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Encephalitis :
AIDS
Contrast enhanced lesions
Will be shown via CT and MRI
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Kaposi’s
Sarcoma
Most common malignanancy
In AIDS pts
Especially in homosexual males
Co-infected with herpes
Present in 25-30% of AIDS pts
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AIDS
X-rays demonstrate hilar
Adenopathy
Nodular pulmonary
Infiltrates
Pleural effusion
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• Pneumocystitis
carinii pneumonia
Case Study
REVIEW
• Chest radiograph
of patient with
dyspnea, hypoxia,
and HIV infection.
• The pattern of
diffuse interstitial
infiltrates as seen
suggests a
diagnosis of PCP.
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Neoplastic Diseases
Multiple
Myeloma
X-ray plays an important role as
90% of cases has bone involvement
X-ray demonstrates osteoporosis with
Discrete punched out osteolytic lesions
MRI can be useful in early stage 35
Multiple Myeloma
• Disease of plasma
cells that results in
cell proliferation
• Usually confined to
bone marrow
• Forms tumors with
weakened bone
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Leukemia
• Neoplastic disease of leukocytes
• May lead to anemia, bleeding & infection
• All forms require destruction of cells through
radiation therapy or chemotherapy
– Leaves pt severely immunosuppressed
– Survival rates depends on complete remission
– May bone marrow transplant
• Radiography plays limited role
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Leukemia
Acute
• Quick onset
Chronic
• Slow onset
• May have hemorrhage
• Non specific signs
– Fatigue & weakness
• Children primarily
– 33% of all cancer deaths
in children under 15
• Without treatment die
in 6 months
• Poor differentiated cells
• Over age 60 years
• Mature differentiated
cells
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Non-Hodgkin’s Lymphoma
• CT of abdomen &
pelvis is used to
stage disease
• Treatment consists of
chemo and/or Rad
therapy
• Symptoms vary
– Lymphadenopathy
and anemia
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Case study:
Hodgkin’s Disease
• CT exams show
enlarged
retroperitoneal
nodes
• NM and MRI can be
useful in staring of
this disease as well
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Hodgkin’s Disease
Treatment includes RAD therapy
And chemotherapy
Symptoms include malaise, fever,
Anorexia, enlarged lymph nodes
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Infectious Mononucleosis
• Viral
disease
• Often
associated
with
Epstein
Barr
syndrome
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Infectious
Mononucleosis
X-rays can demonstrate this by
Demonstrating lymphadenopathy and
Splenomegaly
Hilar lymph node enlargement bilateral
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Hemophilia
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Hemophilia
• Inherited anomaly of blood coagulation that only
affects males
• X-ray demonstrates recurrent bleeding in joints
–
–
–
–
Most commonly knee, elbows and ankles
Soft tissue prominence
Synovial hypertrophy
Causes destruction of bone leading to segments of
severe osteoporosis
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Hemophilia
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Imaging Considerations
• X-ray plays a limited role
– Except in cases of multiple myeloma, some types of
leukemia and AIDS
• CT is valuable in determining lymph node
involvement of neoplastic disease
• CT and MRI of brain can assist in diagnosis and
treatment of CNS problems associated with HIV
• MRI useful in diseases of the blood marrow
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