Benign Lymph Node Enlargement, Spleen & Thymus

Question 1

What causes paracortical hyperplasia in a lymph node?

Answer 1

T cell-mediated immune response that causes activation of T cells and shrinking of B cell follicles

Question 2

What is the cause of sinus histiocytosis in lymph nodes?

Answer 2

Expansion of macrophages in nodal subcapsular and trabecular sinuses

Question 3

Thymic hyperplasia is most frequently seen with what autoimmune disorder?

Answer 3

Myasthenia gravis

Question 4

What are possible causes of congestive splenomegaly?

Answer 4

Systemic venous congestive, liver cirrhosis, portal vein thrombosis

Question 5

What are potential causes of non-caseating granulomatous lymphadenitis?

Answer 5

Sarcoidosis, toxoplasmosis

Question 6

What are common viral causes of paracortical hyperplasia?

Answer 6

Mononucleosis, varicella-herpes zoster, measles, HSV

Question 7

What are potential causes of caseating granulomatous lymphadenitis?

Answer 7

TB, leprosy, cat scratch disease, fungal infections

Question 8

Infection with this parasite may cause chronic splenitis and give the spleen a gray to black color.

Answer 8

Malaria

Question 9

Where are B cells located in a lymph node?

Answer 9

Follicle/Germinal centers

Question 10

What is functional asplenia?

Answer 10

Loss of spleen function often due to multiple infarcts. Sickle cell disease is the most common cause

Question 11

What histologic findings are characteristic of sarcoid granulomas in lymph nodes?

Answer 11

Non-caseating granulomas with Asteroid bodies & Schaumann bodies

Question 12

Caseating granulomas with Langhan’s multinucleated giant cells are associated with what pathology?

Answer 12

Tuberculosis

Question 13

What histologic findings are characteristic in a patient with asplenia?

Answer 13

Howell-Jolly Bodies & Target Cells

Question 14

Thymic hypoplasia is often associated with what congenital disorder?

Answer 14

DiGeorge Syndrome (22q11 deletion

Question 15

Thymomas are neoplasms of what cell type?

Answer 15

Epithelial cells

Question 16

True/False. In cases of HIV lymph node hyperplasia, follicle boundaries are blurred.

Answer 16

True - this is due to extraversion of RBCs into the germinal centers and depletion of lymphocytes

Question 17

True/False. The spleen is rarely impacted by infarcts due to extensive collateral blood supply.

Answer 17

False - the spleen is one of the most common sites where emboli lodge. Splenic infracts are common due to poor collateral blood supply

Question 18

What is the histologic presentation of acute nonspecific lymphadenitis?

Answer 18

Germinal centers with numerous mitotic figures, macrophages with debris, increased neutrophils

Question 19

This type of granulomatous lymphadenitis involves central areas of necrosis within a granuloma.

Answer 19

Caseating granulomatous lymphadenitis

Question 20

What histologic findings are seen in necrotizing lymphadenitis and with what disease are they associated?

Answer 20

Stellate necrotizing granulomas due to Cat-Scratch Disease

Question 21

Where do most thymomas arise?

Answer 21

Anterior superior mediastinum - symptoms are due to impingement on mediastinal structures

Question 22

What is the pathophysiology of acute splenomegaly?

Answer 22

Acute congestion of the red pulp. Infiltration with neutrophils and plasma cells may cause acute splenitis

Question 23

True/False. The spleen may take over RBC production when the bone marrow is not producing enough RBCs.

Answer 23

True - this is called extramedullary hematopoiesis

Question 24

“Onion skin” thickening of splenic arteries is associated with what condition?

Answer 24

SLE

Question 25

Hyperplasia of B cells in lymph nodes is with what pattern of reactive lymphadenopathy?

Answer 25

Reactive follicular hyperplasia

Question 26

A Virchow node, or lymphadenopathy of the supraclavicular nodes, is suggestive of what pathology?

Answer 26

Left - gastric cancer
Right - lung cancer

Question 27

Where are T cells located in a lymph node?

Answer 27

Paracotex

Question 28

What are hematoxylin bodies?

Answer 28

These are clumps of necrotic material present in cases of SLE lymphadenopathy

Question 29

Reactive follicular hyperplasia is associated with what conditions?

Answer 29

Viral infection, rheumatoid arthritis, SLE, early HIV, syphilis

Question 30

The spleen is rarely involved by metastatic solid tumors. What is the most common primary malignant tumor of the spleen.

Answer 30

Angiosarcomas - malignant cancer of blood vessels

Question 31

Sinus histiocytosis in lymph nodes is associated with what pathology?

Answer 31

Carcinoma

Question 32

These are fibrotic nodules of persistent splenic hemorrhage that disrupt local architecture.

Answer 32

Gamna-Gandy Bodies