Hematopoietic and Lymphoid Systems, UTHSC
Fall 2022 D2 Pathology
Anemia
• General term, indicating a decrease in red blood cell volume (hematocrit) or
concentration of hemoglobin
• Usually an indication of underlying systemic disease
Anemia - Clinical Features
• Pallor of the skin or mucosa
• Brittle, spoon-shaped nails (koilonychia)
• Fatigue, dyspnea
Iron Deficiency Anemia
• Very common condition, especially in women
• Secondary to chronic blood loss, decreased dietary intake of iron (Fe), decreased
absorption of Fe
• Decreased serum Fe
• Microcytic, hypochromic anemia
Iron Deficiency Anemia - Treatment
• Iron supplementation
• Determine and treat underlying cause
• Response to treatment is usually rapid
Plummer-Vinson Syndrome
• Iron deficiency anemia in conjunction with glossitis and dysphagia
• Associated with a high incidence of oral and esophageal squamous cell carcinoma
what cancer is Plummer-Vinson Syndrome associated with?
oral and esophageal squamous cell carcinoma
Koilonychia
Spoon nails
Plummer-Vinson Syndrome - Clinical Features
• Females, 30-50
• Burning sensation of the tongue and oral mucosa
• Angular cheilitis
• Dysphagia (esophageal webs)
• Brittle nails and koilonychia
• Fatigue
Plummer-Vinson Syndrome - Treatment
• Iron supplementation
• Esophageal dilation may be necessary
• Periodic oral cancer screening
Pernicious Anemia
• Condition caused by poor absorption of cobalamin (vitamin B12, extrinsic factor),
which is necessary for normal maturation of rbc's and other cells.
• Most patients lack intrinsic factor, which is necessary for the absorption of extrinsic
factor
Pernicious Anemia - Clinical Features
, • Fatigue, weakness, headache
• Paresthesia, tingling, or numbness of the extremities
Pernicious Anemia - Oral Clinical Features
- Burning sensations of the tongue, lips, buccal mucosa
- Erythema or atrophy
Pernicious Anemia - Treatment
• Intramuscular injection of cyanocobalamin
• Rapid resolution is usually expected
• Pernicious anemia is associated with an increased risk of stomach cancer
Aplastic Anemia
• Complete failure of hematopoietic precursor (stem) cells to differentiate into all
elements of the circulation
• Most cases appear to be an immune-mediated disease caused by cytotoxic T
lymphocytes
• Unknown etiology, but environmental toxins, viruses, and drugs have been implicated
Aplastic Anemia - Clinical Features
• Fatigue, lightheadedness (secondary to erythrocyte deficiency)
• Bleeding disorders (secondary to thrombocytopenia)
• Infections (secondary to leukocytic deficiency)
Aplastic Anemia - Oral Clinical Features
- Hemorrhage, petechiae
- Pallor
- Ulcerations
- Gingival hyperplasia
Aplastic Anemia - Histology
• Acellular marrow
• Fatty infiltration
• Little inflammation associated with ulcerations
Aplastic Anemia - Diagnosis
Pancytopenia
Aplastic Anemia - Treatment
• Supportive and symptomatic
- Antibiotics
- Transfusions
- Bone marrow transplantation
why does Aplastic Anemia have a guarded prognosis?
Recurrence is common and patients are at increased risk of developing acute leukemia
Myelophthisic Anemia
• Replacement of normal marrow elements
• Secondary to malignancies, fibrosis, osteopetrosis
• Pancytopenia
• Treatment dependent upon the underlying condition
what are some extrinsic diseases that can cause Anemia Secondary to Decreased
Red Cell Survival?
Fall 2022 D2 Pathology
Anemia
• General term, indicating a decrease in red blood cell volume (hematocrit) or
concentration of hemoglobin
• Usually an indication of underlying systemic disease
Anemia - Clinical Features
• Pallor of the skin or mucosa
• Brittle, spoon-shaped nails (koilonychia)
• Fatigue, dyspnea
Iron Deficiency Anemia
• Very common condition, especially in women
• Secondary to chronic blood loss, decreased dietary intake of iron (Fe), decreased
absorption of Fe
• Decreased serum Fe
• Microcytic, hypochromic anemia
Iron Deficiency Anemia - Treatment
• Iron supplementation
• Determine and treat underlying cause
• Response to treatment is usually rapid
Plummer-Vinson Syndrome
• Iron deficiency anemia in conjunction with glossitis and dysphagia
• Associated with a high incidence of oral and esophageal squamous cell carcinoma
what cancer is Plummer-Vinson Syndrome associated with?
oral and esophageal squamous cell carcinoma
Koilonychia
Spoon nails
Plummer-Vinson Syndrome - Clinical Features
• Females, 30-50
• Burning sensation of the tongue and oral mucosa
• Angular cheilitis
• Dysphagia (esophageal webs)
• Brittle nails and koilonychia
• Fatigue
Plummer-Vinson Syndrome - Treatment
• Iron supplementation
• Esophageal dilation may be necessary
• Periodic oral cancer screening
Pernicious Anemia
• Condition caused by poor absorption of cobalamin (vitamin B12, extrinsic factor),
which is necessary for normal maturation of rbc's and other cells.
• Most patients lack intrinsic factor, which is necessary for the absorption of extrinsic
factor
Pernicious Anemia - Clinical Features
, • Fatigue, weakness, headache
• Paresthesia, tingling, or numbness of the extremities
Pernicious Anemia - Oral Clinical Features
- Burning sensations of the tongue, lips, buccal mucosa
- Erythema or atrophy
Pernicious Anemia - Treatment
• Intramuscular injection of cyanocobalamin
• Rapid resolution is usually expected
• Pernicious anemia is associated with an increased risk of stomach cancer
Aplastic Anemia
• Complete failure of hematopoietic precursor (stem) cells to differentiate into all
elements of the circulation
• Most cases appear to be an immune-mediated disease caused by cytotoxic T
lymphocytes
• Unknown etiology, but environmental toxins, viruses, and drugs have been implicated
Aplastic Anemia - Clinical Features
• Fatigue, lightheadedness (secondary to erythrocyte deficiency)
• Bleeding disorders (secondary to thrombocytopenia)
• Infections (secondary to leukocytic deficiency)
Aplastic Anemia - Oral Clinical Features
- Hemorrhage, petechiae
- Pallor
- Ulcerations
- Gingival hyperplasia
Aplastic Anemia - Histology
• Acellular marrow
• Fatty infiltration
• Little inflammation associated with ulcerations
Aplastic Anemia - Diagnosis
Pancytopenia
Aplastic Anemia - Treatment
• Supportive and symptomatic
- Antibiotics
- Transfusions
- Bone marrow transplantation
why does Aplastic Anemia have a guarded prognosis?
Recurrence is common and patients are at increased risk of developing acute leukemia
Myelophthisic Anemia
• Replacement of normal marrow elements
• Secondary to malignancies, fibrosis, osteopetrosis
• Pancytopenia
• Treatment dependent upon the underlying condition
what are some extrinsic diseases that can cause Anemia Secondary to Decreased
Red Cell Survival?
