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Pathology 2 Chapter 9: Hematopoietic System Hematopoietic System Goals Acquaint the student radiographer with the pathophysiology and radiographic manifestation off all common and some unusual disorders of the hematopoietic system. Objectives Understand, define and describe terms of the chapter. Describe the physiology of the hematopoietic system. Describe conditions affecting the system as well as their radiographic manifestations. Physiology of the Blood An adequate blood supply to all body tissues is necessary to bring oxygen, nutrients, salts, and hormones to the cells and to carry away the waste products of cellular metabolism. The components of blood are also a major defense against infection, toxic substances, and foreign antigens. Blood cont…. Red bone marrow (found in vertebrae and flat bones such as the sternum, ribs, skull, and proximal femur) and lymph nodes are the blood-forming tissues of the body. Red blood cells (erythrocytes) and platelets (thrombocytes) are made in red bone marrow. White blood cells (leukocytes) are produced in red marrow and lymphoid tissue. Diseases of RBC’s Hemolytic anemias Sickle Cell anemia Megaloblastic Anemia Polycythemia (primary and secondary) Anemia Anemia refers to the decrease in the amount of oxygen carrying hemoglobin in the peripheral flow. Can be contributed to Improper formation of new red blood cells Increased rate of red blood cell destruction Loss of red blood cells from prolonged bleeding Patient may suffer from Paleness Fatigue, muscular weakness Shortness of breath w/ increased respiratory rate Hemolytic anemia Destruction of RBC’s Underlying abnormality is a shortened life span of the red blood cells with resulting hemolysis and the release of hemoglobin into the plasma. Most common cause is hereditary defect that may produce abnormal red cells or abnormal hemoglobin. Radiographic appearance Osteoporosis in the long bones, widened medullary spaces with thinning of the cortex. Skull shows thinning of cortex with hair-onend appearance Sickle Cell Anemia Hemoglobin is abnormal; RBC’s have crescent-shape. When red blood cells are shaped like sickles or moons, they can get stuck and die, especially inside smaller blood vessels. This keeps blood from flowing properly in the body and it also causes a lot of pain. Important organs like the brain, heart, and kidneys need constant blood flow to work properly. A person's body knows that the sickle cells aren't good, so it attacks and destroys them. But the body can't make new blood cells fast enough to replace the old ones. Radiographic appearance Bi-concave indentations on both the superior and inferior margins of the softened vertebral bodies giving appearance of “fish vertebrae.” Another typical appearance localized steplike central depressions vertebral end plates. Megaloblastic Anemia Occurs as a result of deficiency of vitamin B12 and or folic acid. Results in an overall decrease of RBC’s. Stomach appears tubular with a decrease or absence of rugae. Polycythemia primary (neoplastic) results from hyperplasia of bone marrow, resulting in increased amounts of erythrocytes, granulocytes and platelets. Chest films show prominent vascular markings without cardiomegaly. Secondary (non-neoplastic) elevated hemoglobin concentration. Normal chest film, but skull radiographs show hair-on-end appearance on children with cyanotic heart disease. Diseases of WBC’s Leukemia Lymphoma Infectious Mononucleosis Leukemia Neoplastic proliferation of WBC’s. The term leukemia refers to cancers of the white blood cells, which are also referred to as leukocytes or WBCs. When a child has leukemia, large numbers of abnormal white blood cells are produced in the bone marrow. These abnormal white cells crowd the bone marrow and flood the bloodstream, but they cannot perform their proper role of protecting the body against disease because they are defective. Radiographic appearnace Skeletal radiographs display radiolucent bands at metaphyses on long bones of children (moth-eaten appearance). Commonly shows displacement or obstruction of GI. Lymphoma neoplasm of lymph system The term lymphoma refers to cancers that originate in the body's lymphatic tissues. Lymphatic tissues include the lymph nodes (also called lymph glands), thymus, spleen, tonsils, adenoids, and bone marrow, as well as the channels (called lymphatics or lymph vessels) that connect them. Although many types of cancer eventually spread to parts of the lymphatic system, lymphomas are distinct because they actually originate there. Radiographic appearance enlargement of mediastinal lymph nodes produces asymmetry on chest films, polypoid masses in the stomach, thickening of rugae, as well as erosion of thoracolumbar spine. Infectious Mononucleosis viral infection of the lymph system that produces lymphadenopathy and splenomegaly. commonly see enlarged hilar lymph nodes on chest radiographs Bleeding Disorders Hemophilia Purpura Hemophilia inability of proper blood coagulation. Increased cloudy densities displayed over soft tissues. Chronic cartilage destruction with joint narrowing. Purpura deficiency of number of platelets. Small bowel shows thickening of mucosal folds splenomegaly