Approach to the Investigation of Lymphadenopathy

Question 1

non-lymphoma causes of lymphadenopathy

Answer 1

infection
mets eg breast/ovarian
connective tissue disease eg sarcoid/SLE

Question 2

symptoms of lymphadenopathy

Answer 2

night sweats eg drenching clothing
weight loss
itch
fatigue
alcohol induced pain

Question 3

Ix suspicious lymphadenopathy

Answer 3

LN biopsy
immunohistochemistry

(can do immunophenotyping of blood/marrow instead of biopsy)

Question 4

lymphadenopathy is regional/generalised in bacterial infection

Answer 4

regional

Question 5

lymphadenopathy is regional/generalised in viral infection

Answer 5

generalised

Question 6

large glands = infection T or F

Answer 6

F, cant tell from the size

Question 7

there are enlarged lymph nodes where in lung cancer?

Answer 7

cervical

Question 8

consistency of viral LNs

Answer 8

hard

Question 9

consistency of bacterial LNs

Answer 9

hard

Question 10

consistency of LNs in lymphoma

Answer 10

rubbery/soft

Question 11

what causes viral lymphadenopathy

Answer 11

follicular hyperplasia in response to inc lymphocytes

Question 12

why is there pain in viral lymphadenopathy

Answer 12

capsule of the lymph node enlarges

Question 13

consistency of metastatic lymphadenoathy

Answer 13

hard

Question 14

lymph nodes are tender/nontender in infection

Answer 14

tender

Question 15

lymph nodes are tender/nontender in cancer

Answer 15

non tender

Question 16

what will make lymph nodes feel irregular on the surface

Answer 16

mets (growing outwith the LN)

Question 17

if the skin is inflamed over the area of lymphadenopathy what is the likely cause?

Answer 17

bacterial infection

Question 18

best way to biopsy a lymph node?

Answer 18

take the whole thing out

Question 19

you can diagnose lymphoma on a CT T or F

Answer 19

F, need a biopsy

Question 20

follicular hyperplasia is normal T or F

Answer 20

T, it is a physiological immune response by lymph nodes

Question 21

sclerosed tissue surrounding nodules…

Answer 21

hodgkins lymphoma

Question 22

reed-sternberg cells on histology…

Answer 22

hodgkins lymphoma

Question 23

low grade lymphomas contain mature/immature cells

Answer 23

mature

Question 24

what does immunohistochemistry measure?

Answer 24

pattern of proteins on the surface of lymphoma cells

Question 25

positive areas will stain ___ on immunohistochemistry

Answer 25

brown

Question 26

immunophenotyping uses liquid/solid

Answer 26

liquid

Question 27

give examples of cytogenic analysis techniques for lymphoma

Answer 27

G banding

FISH

Question 28

the most aggressive forms of lymphoma result from progenitor cells/mature cells

Answer 28

progenitor cells

Question 29

if you have a B cell NHL what should be found out?

Answer 29

whether its low or high grade

Question 30

which is more common - hodgkins or non-hodgkins lymphoma?

Answer 30

NHL

Question 31

NHL is a problem with B/T cells

Answer 31

B AND T (mainly B)

Question 32

HL is a problem with B/T cells

Answer 32

B

Question 33

burkitt’s lymphoma is low/fast growing

Answer 33

very fast and aggressive

Question 34

a mantle cell lymphoma can mask as….

Answer 34

a non-hodgkins low grade lymphoma

Question 35

what is the prognosis of a marginal zone NHL?

Answer 35

very good

Question 36

main difference between leukaemia and lymphoma

Answer 36

lymphomas arise in the lymph nodes and tissues

leukaemias arise in the blood