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Haematology Year 3 > Function of lymph nodes + spleen > Flashcards

Function of lymph nodes + spleen Flashcards

1
Q

Function of the lymphatic system

A

filter lymph + return lymph to the circulation (prevents oedema)

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2
Q

primary lymphoid tissues

A

bone marrow

thymus

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3
Q

secondary lymphoid tissues

A

lymph nodes
spleen
tonsils

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4
Q

what in lymph nodes ensures unidirectional lymph flow

A

valves

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5
Q

what cells are seen in lymph nodes

A

Lymphocytes: B cells, T cells, NK cells
Macrophage
Dendritic cells
Endothelial cells

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6
Q

where do B cells mature

A

bone marrow

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7
Q

where do T cells mature

A

Thymus

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8
Q

where in the lymph node is lymph filtered

A

node parenchyma

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9
Q

marker for B cell

A

CD20

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10
Q

marker for T cell

A

CD3

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11
Q

causes of lymphadenopathy

A

local inflammation
systemic inflammation
malignancy (haematological/metastatic)
other conditions e.g. sarcoidosis

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12
Q

what is lymphangitis

A

superficial infection may see red lines extending up lymph tract from an inflamed lesion

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13
Q

what would a lymphadenopathy of predominant B cells mean

A

autoimmune conditions

infections

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14
Q

what would a lymphadenopathy of predominant phagocytic response mean

A

draining a tumour site

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15
Q

what would a lymphadenopathy of predominant T cells mean

A

viral infections

drugs e.g. phenytoin

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16
Q

what is a malignant lymphadenopathy called

A

lymphoma

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17
Q

what does a generalised lymphadenopathy suggest

A

systemic inflammatory process or widespread malignancy

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18
Q

where is the spleen located

is it palpable?

A

left upper quadrant

not usually palpable unless substantially enlgarged

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19
Q

blood supply to the spleen

A

splenic artery

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20
Q

what is the splenic artery a branch of

A

coeliac axis

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21
Q

what vessel drains the spleen

A

splenic vein

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22
Q

what two vessels form the portal vein

A

splenic vein

superior mesenteric vein

23
Q

what does the parenchyma of the spleen include

A

red pulp

white pulp

24
Q

contents of the red pulp of the spleen

A

sinusoids + cords (contain macrophage + some fibroblasts)

25
Q

what does the white pulp in the spleen do

A

comprises the peri-arteriolar lymphoid sheath (PALS)

Contains CD4+ cells and lymphoid cells

26
Q

how does PALS work

A

antigen reaches white pulp via the blood

antigen presenting cells in the white pulp present antigen to immune reactive cells

when stimulated by antigen, T and B cell responses may occur

27
Q

features of splenomegaly

A

dragging sensation in LUQ
discomfort with eating
pain if infarction
hypersplenism

28
Q

triad of hypersplenism

A

splenomegaly
fall in one or more cellular components of blood
correction of cytopenias by splenectomy

29
Q

infective causes of splenomegaly

A

EBV, malaria, TB, typhoid

30
Q

congestive causes of splenomegaly

A

hepatic cirrhosis
portal/splenic vein thrombosis
cardiac failure

31
Q

haematological causes of splenomegaly

A

lymphoma/leukaemia
haemolytic anaemia
myeloproliferative disorders

32
Q

inflammatory conditions that can cause splenomegaly

A

rheumatoid arthritis

SLE

33
Q

causes of hyposplenism

A

splenectomy
coeliac disease
sickle cell
sarcoidosis

34
Q

feature of hyposplenism

A

Howell-jolly bodies

35
Q

what do people need to be immunised against after a splenectomy

A

pneumococcus

36
Q

what is lymphoma

A

malignant lymphocytes that accumulate in the lymph node

37
Q

subdivisions of lymphoma

A

Hodgkin lymphoma

Non-Hodgkin lymphoma

38
Q

symptoms of lymphoma

A

painless, non-tender, rubbery/soft, asymmetrical lump
NOT TETHERED

fever, night sweats, weight loss, itch, pain, fatigue

39
Q

presentation of a viral lymphadenopathy

A

tender, hard and smooth lymph node

40
Q

presentation of a bacterial lymphadenopathy

A

tender, hard and smooth lymph node with skin inflamed

41
Q

how would a metastatic lymphadenopathy present

A

non-tender, hard lymph node with an irregular surface

TETHERED

42
Q

how is a lymphadenopathy investigated

A

FNA or core biopsy

43
Q

what investigation can be done to sub classify a confirmed lymphoma

A

immunohistochemistry

44
Q

4 types of Hodgkin disease

A

nodular sclerosis
lymphocyte rich
mixed cellularity
lymphocyte depleted

45
Q

what cell type is associated with Hodgkin disease

A

reed Sternberg cells

46
Q

what immunomarker is +ve in non-hodgkin lymphoma

A

CD20

47
Q

what immunomarker is +ve in reed Sternberg cells (Hodgkin lymphoma)

A

CD30 and CD15

48
Q

two types of non-hodgkin lymphoma

A

T cell

B cell

49
Q

which type of non-hodgkin lymphoma is most common

A

B cell

50
Q

what is a B cell non-hodgkin lymphoma divided into

A

low grade B cell

high grade B cell

51
Q

how is a lymphoma staged

A
  1. one group of glands above diaphragm
  2. more than one group of glands either above or below diaphragm
  3. both above and below the diaphragm
  4. extra nodal disease
52
Q

what tissue is the spleen derived from

A

mesoderm

53
Q

weight of average spleen

A

150g

Haematology Year 3 (21 decks)

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