Plasma cell Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Plasma cell and links to relevant pages within the course.
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| Clinical Significance cont'd Proteinuria related to kidney impairment may be due to glomerular membrane damage caused by toxic agents, immune complexes found in lupus erythematosus, or streptococcal glomerulonephritis. The amount of protein present in urine samples from patients with glomerular damage usually ranges from 10-40 mg/dl. If the urinary protein is due to a disorder that affects tubular reabsorption, the urine protein quantities will be much greater. In patients with multiple myeloma, proteinuria is due to the excretion of the Bence Jones protein. This low molecular weight protein produced by a malignant clone of plasma cells circulates in the blood and is filtered in the kidneys in quantities exceeding the tubular capacity. This excess protein is excreted in the urine. | View Page |
| Which of the following statement about synovial fluid is true: | View Page |
| What is the cell indicated by the arrow in this illustration: | View Page |
| Identify the cell in this illustration indicated by the arrow: | View Page |
| The cell indicated by the arrow in the illustration is occasionally seen in the bone marrow and can be mistaken for a plasma cell - what is this cell called: | View Page |
| What is another name used to designate a fully committed B-lymphocyte: | View Page |
| Which of the following cell types would be considered a rare finding in a direct bone marrow smear? | View Page |
| Lymphocytes Lymphocytes are often located in nodules and these nodules are unevenly distributed throughout the marrow so the lymphocyte count may vary in bone marrow samples from different sites. Plasma cells are often found clustered around blood vessels. Monocytes seem to congregate about arterioles in the center of the cord. | View Page |
| The young cells that can be found surrounding a macrophage are: | View Page |
| Osteoblast Another example of a cell rarely seen in the bone marrow is an osteoblast. Osteoblasts are cells which are similar in appearance but somewhat larger than plasma cells or tumor cells. The nucleus is eccentric and the "hoff" area is sometimes located away from the nucleus. The cytoplasm appears rather foamy when compared to a plasma cell. The size of an osteoblast is 20-25 microns. Osteoblast produce bone. | View Page |
| Normal M:E Ratio The normal M:E ratio in adults varies from 1.2:1 to 5:1 myeloid cells to nucleated erythroid cells. An increased M:E ratio (6:1) may be seen in infection, chronic myelogenous leukemia or erythroid hypoplasia. A decreased M:E ratio (<1.2-1) may mean a decrease in granulocytes or an increase in erythroid cells. M:E ratios are somewhat higher in newborns and infancy than in later childhood and in adults. It is important to note that lymphocytes, monocytes and plasma cells are not included in the M:E ratio. | View Page |
| Plasma Cells An occasional plasma cell is a normal finding in the bone marrow. The nuclear chromatin pattern is coarse, the cytoplasm is varying shades of blue with a "hoff" or light staining area adjacent to the nucleus. | View Page |
| Increased Plasma Cells Although an occasional plasma cell is normal in the marrow, the presence of sheets of plasma cells, as seen here, is consistent with multiple myeloma. | View Page |
| Flame Cells A rare abnormal variant of a plasma cell called a flame cell is shown here. Not the red tinged area at the periphery. These cells contain more immunoglobulin than normal plasma cells. | View Page |
| Mott Cell Another rare but abnormal type of plasma cell is the Mott cell (morula cell). The compartments visible in the cytoplasm are immunoglobulins which have not been released. Mott cells may be seen in parasitic infections and malignant tumors. | View Page |
| Match the following. | View Page |
| Humoral Immunity Humoral immunity involves the production of antibodies (immunoglobulins), and is brought about by lymphocytes which we call B-cells. B-cells are bone-marrow derived lymphocytes. After B-cells are stimulated by an antigen, they proliferate and transform into plasma cells which produce specific antibodies. | View Page |
| Cause of Delayed HTR Delayed HTR result from a secondary (anamnestic) immune response causing a weak, undetectable antibody to become stronger.Upon re-stimulation by donor RBC positive for the antigen corresponding to the patient's antibody:* Patient's memory B cells differentiate into antibody-producing plasma cells.* As new IgG antibody is produced, it sensitizes antigen-positive transfused donor red blood cells.* The IgG-sensitized donor red blood cells are then removed by extravascular hemolysis (EVH) mainly in the spleen. | View Page |
| The upper image of a peripheral blood smear reveals RBC Rouleaux formation. Several blood cells that are similar in appearance to the one indicated by the arrow in the bottom image are also seen on the smear. Which of the following conditions is associated with both of these findings? | View Page |
| The cell photographed here is known as a MOTT cell. The condition in which these cells are associated is: | View Page |
| Approximately 10% of the circulating white cells were similar to the one seen in the photograph. The patient was 42 years old and visited his physician because of recent bruising. Note the absence of platelets on the smear. Possible associated conditions include: | View Page |
| Multiple myeloma Plasma cells are uncommonly observed in the peripheral blood smear.They are normal constituents of lymph nodes, spleen, connective tissue and bone marrow. The presence of plasma cells in the peripheral blood is indicative of a large number of conditions mostly related to infections , immune disorders, malignancies, toxic exposures, hypersensitivity reactions and their responses.Although mature plasma cells have a distinct appearance, they still may be confused morphologically with immature plasma cells and other cells with inclusions, reactive changes or nucleated red bloods cell with altered identities.In the upper and lower photographs are plasma cells with features mindful of myeloma cellsThe large myeloma cell in the upper photograph has an eccentric immature nucleus with a muddy chromatin pattern.Note also clumping and stacking of the erythrocytes, bordering on rouleaux formation ,implicating an increase in plasma gamma globulin.The plasma cell with the double nucleus in the lower photograph is particularly suggestive of myeloma.Further studies are in order including a bone marrow examination where at least 30% of bone marrow cells should be variations of mature and immature plasma cells.Serum electrophoresis will reveal a monoclonal globulin spike, and light chains in excess of 1.0 gm/24 hours may be seen in the urine.The presence of lytic bone lesions is a convincing clinical clue.With these findings in combination, a diagnosis of myeloma can be made with assurance. | View Page |