imaging the lymphatic sysytem Flashcards

1
Q

what is the difference between PET scans and other types of imagine

A

it is functional imaging - can be used to assess metabolic function, while other imaging is anatomical only

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2
Q

on a CXR what shape do the hilar lymphnodes classically have (non-diseases)

A

> shape (sideways V); if not then this is indication that hilar lymph nodes are involved

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3
Q

what is special about lymphomas that invade the CNS

A

they can cross the midline of the brain

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4
Q

grade vs stage

A

grade - histological, the tissue itself;
stage - anatomical (e.g. TNM)

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5
Q

3 fucntions of the lymphatic system

A
  1. maintenance of fluid balance within the tissues;
  2. absorption and carriage of water/insoluble fats from the intestine;
  3. protection of the body through the generation of an immune response
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6
Q

what causes bilateral leg swelling

A

systemic causes e.g. Heart failure, pulmonary hypertension

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7
Q

what causes lymphoedema (7)

A
  1. disruption/damage to the lymphatic system e.g. cancer surgery, RT;
  2. infection e.g. Filariasis, cellulitis;
  3. inflammation;
  4. venous disease e.g. DVT, varicose veins;
  5. obesity;
  6. trauma/injury
  7. immobility
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8
Q

4 components to the lymphatic system

A

lymphatic vessels; lymph nodes; spleen; thymus

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9
Q

what do deep and superficial lymphatic vessels follow

A

deep - follow arteries;
superficial - follow veins

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10
Q

what is the cicterna chyli

A

abdominal origin of the thoracic duct, and it receives the bilateral lumbar lymphatic trunks - valuable landmark

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11
Q

where is the cisterna chyli located

A

right side of L1/2

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12
Q

what does the cisterna chyli drain into

A

thoracic ducts

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13
Q

where is the thoracic duct located

A

enters the throax through the aortic hiatus in the diaphragm; located in the posterior mediastinum

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14
Q

what do lymph nodes allow for (in immune response)

A

interaction of antigen, APC and lymphoid cells

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15
Q

at what size doe splenomegaly occur

A

> 14cm

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16
Q

role of the spleen

A

trapping and presenting antigens in the circulating blood; culling old red blood cells

17
Q

how does splenomegaly appear on an abdominal X ray

A

big area of opacification -> pushing transverse colon out of the way

18
Q

6 categories of causes for splenomegaly

A
  1. infective
  2. vascular e.g. portal hypertension
  3. neoplastic e.g. lymphoma
  4. haematological e.g. hemolytic anaemia
  5. immunological e.g. RA, sarcoidosis
  6. metabolic e.g. gaucher’s
19
Q

3 most common causes for splenomegaly

A

TB, lymphoma, sarcoidosis

20
Q

bacterial, viral and protozoal causes of splenomegaly

A

bacterial - TB, endocarditis;
viral - infective mononucleosis (EBV);
protozoal - malaria, leishmaniasis

21
Q

what is felty’s syndrome

A

a rare disorder characterised by RA, splenomegaly and nuetropenia

22
Q

examples of aggressive NHL

A

diffuse large B-cell lymphoma; anaplastic large-cell lymphoma; Burkitt lymphoma

23
Q

examples of indolent NHL

A

follicular lymphoma; cutaneous t-cell lymphoma; MALT lymphoma

24
Q

which lymphoma is extra-nodal disease more common in

A

NHL

25
Q

what must be done prior to obstaining a lymph node biopsy

A

INR must be checked, anticoagulants must be stopped (2-4 days)