Approach to Investigating Lymphadenopathy Flashcards
What are causes of lumps?
Infection
Lymphoma
Metastatic cancer
Connective tissue disease e.g. SLE or sarcoidosis
What are general symptoms associated with lump?
Night sweats - infection, lymphoma, menopause, too thick a duvet / central heating
Weight loss - lymphoma, other malignancy, infections
How can we differentiate between the various diagnoses for lymphadenopathy?
Bacteria infection - regional
Viral infection - generalised
Metastatic malignancy
Lymphoma
In viral causes of lump - is it tender, consistency, surface, skin inflamed, tethered?
Tender - yes
Consistency - hard
Surface - smooth
Skin inflamed - no
Tethered - no
In bacterial causes of lump - is it tender, consistency, surface, skin inflamed, tethered?
Tender - yes
Consistency - hard
Surface - smooth
Skin inflamed - yes
Tethered - maybe
In a lymphoma cause of lump - is it tender, consistency, surface, skin inflamed, tethered?
Tender - no
Consistency - rubber / soft
Surface - smooth
Skin inflamed - no
Tethered - no
In a metastatic carcinoma cause of lump - is it tender, consistency, surface, skin inflamed, tethered?
Tender - no
Consistency - hard
surface - irregular
Skin inflamed - no
Tethered - yes
What biopsy is often needed for lymphoma?
Fine needle aspirate or core biopsy often insufficient
Need a larger lesion biopsy
Why can immunohistochemistry be helpful in lymphoma?
Confirming it is a lymphoma and helping sub classify
How does immunophenotyping work?
Use cells in liquid phase (blood or bone marrow)
Cells tagged with antibodies attached to a fluorochrome emits a specific colour of light when a laser is shone on it
How does cytogenetic analysis work?
Specific patterns of chromosome abnormality in certain lymphomas
G banding - aspirate node, grow cells in culture and look at spread of chromosomes
FISH - look for specific abnormalities in chromosomes using probs that emit a specific light colour
How can we classify lymphoma?
