Inflammatory disease Of Lymoh nodes Flashcards
What are the causes of Lymphadenopathy
M- Malignancy I - Infection A- Autoimmune M- Miscellaneous I. - Iatrogenic
What are two types of Reactive Hyperplasia Lymphadenopathy
Acute & Chronic
Local & Generalized
Describe the morphology seen in follicular hyperplasia
germinal centres surrounded by mantle zone of small resting B cells
The Histology of Reactive Hyperplasia depends on what five factors
Patient’s age Immune capability Inciting factor Past Exposure Time/ Duration
Reactive Hyperplasia Lymphadenopathy Histology taken before 8days of progression shows what type of cell Hyperplasia
Para cortical/Diffuse Hyperplasia (T cell)
Reactive Hyperplasia Lymphadenopathy Histology taken after 15days of progression shows what type of cell Hyperplasia
Follicular Hyperplasia (B cell)
List three types of Chronic Reactive Hyperplasia Lymphadenopathy
Follicular (B Cell)
Paracortical/ diffuse (T cell)
Sinus histiocytosis (macrophages)
What are six diseases that cause Follicular Hyperplasia
SCRATCH
Syphilis
Cat Scratch
Arthritis
Toxoplasmosis
Castleman’s Disease
HIV
What are the three patterns of Hyperplasia seen in HIV associated Lymphadenopathy
Pattern A - Acute: Explosive Follicular Hyperplasia
Pattern B - Chronic : Mixed
Pattern C - Burn out : Follicular Involution
What is the aetiology of Castleman’s Disease (Giant Lymoh node hyperplasia)
Unknown Aetiology
What are three histological types found in Castleman’s Disease (Giant lymph node Hyperplasia)
Hyaline vascular
Plasma cell
Overlap
Describe the Histology “Hyaline Vascular” type of Castleman’s Disease (Giant lymph node Hyperplasia)
Localized
Mediastinal
Self limiting
Describe the Histology “Plasma cell” type of Castleman’s Disease (Giant lymph node Hyperplasia)
Generalized Systemic Symptoms (fever, ^ ESR , ^ y-globulins, anaemia)
List six causes of Diffuse Hyperplasia (Paracorticol) Lymphadenopathy - Tcell
Postvaccinial lymphadenitis
Infectious mononucleosis (EBV)
Angioimmunoblastic Lymphadenopathy
Herpes Zoster
CMV
Drugs (dilatin, penicillin, atenolol, allopurinol, gold)
What are the prototypes for Postvaccinial Lympadenitis
Diffuse
Follicular
Combined
Describe the Histology of Postvaccinial Lymphadenitis
A type of Diffuse Hyperplasia Lymphadenopathy
Increase in immunoblasts - mottled appearance
Vascular proliferation
Sinusoidal congestion
Plasma cells, eosinophils, mast cells
Which virus causes Infectious Mononucleosis
Epstein-Barr Virus (EBV)
What is the Histology seen in Infectious Mononucleosis (cause of Diffuse Hyperplasia )
Transformed cells
Reed Sternberg like giant cells
Capsular and pericapsular infiltration
Which age group is more susceptible to Angioimmunoblastic Lymphadenopathy
Elderly
What usually causes dermatopathic lymphadenitis
it is usually found in lymph nodes draining chronic inflammation
What are the clinical features of Sinus Histiocytosis with massive Lymphadenopathy (SHML)
Massive Lymphadenopathy (bull neck)
Fever, ^ y- globulins
SHML (Sinus Histiocytosis with massive Lymphadenopathy) is most susceptible in which group of people
Black children
What is the Histology of SHML (Sinus Histiocytosis with massive Lymphadenopathy)
EMPERIPOLESIS (Histiocytic engulfment of lymphocytes)
Sinusoidal distention with histocytes
Medullary plasma cell infiltration
Capsular fibrosis
What is the toxoplasmosis triad
Reactive follicular hyperplasia
Monocytoid B-cell reaction
Epithelioid histiocytic aggregates
What is the name of the protozoan that causes Toxoplasmosis
Toxoplasma gondii
Which animal is the definitive host of Toxoplasma gondii
Cats
What are three major clinical Syndromes associated with Toxoplasmosis
Toxoplasma lymphadenitis
Systemic Toxoplasmosis in immunodeficient pt
Fetal Toxoplasmosis -(transplacental infection)
Which nodes would you commonly see paracortical hyperplasia?
Axillary and Inguinal lymph nodes
What is differential diagnosis for Dermatopathic Lymphadenopathy
Mycosis Fungodes
What is the Histology of Dermatopathic Lymphadenopathy
Paracortical pallor
paracortical Hyperplasia
What is the aetiology of Histiocytic Necrotizing Lymphadenitis ( Kikuchi Fujimoto)
Unknown proposed to be viral
Which ethnicity is more susceptible to Histiocytic Necrotizing Lymphadenitis
Asian females
What is the Histology of Histiocytic Necrotizing Lymphadenitis
Histiocytic cells
Atypical lymphoid cells
What type of granuloma is Cat scratch disease
Necrotizing / Supprative Granuloma
What organism causes Cat scratch disease
Gram neg bacteria
Bartonella Henselae
WHat organism causes Toxoplasmosis
Protozoan (parasite) Toxoplasma Gondii
CAT host
What type of granuloma is Cat scratch disease
Necrotizing / Supprative Granuloma
What organism causes Cat scratch disease
Gram neg bacteria
Bartonella Henselae
WHat organism causes Toxoplasmosis
Protozoan (parasite) Toxoplasma Gondii
CAT host
What type of granuloma is Cat scratch disease
Necrotizing / Supprative Granuloma
What organism causes Cat scratch disease
Gram neg bacteria
Bartonella Henselae
WHat organism causes Toxoplasmosis
Protozoan (parasite) Toxoplasma Gondii
CAT host
Which cells can be seen in Dermatopathic lymphadenitis
Langerhans cells
Interdigitting reticulum cells
What is another name for Sinus Histiocytosis with massive lymphadenopathy
Rosai- Dorfman disease
What generally causes Sinus histiocytosis
Malignancy drainage
Infectious Mononucleosis (EBV) affects which lymph nodes?
Cervical
Toxoplasmosis affects which lymph nodes ?
Post cervical
Cat scratch disease affects which lymph nodes?
Axillary & Cervical
STIs affect which lymph nodes
Inguinal
HIV affects which lymph nodes?
Parotid, Sub-mandibular, epitrochlear
Pathologies of the lungs and oesophagus drain to which lymph nodes
Right supraclavicular
Pathologies of the stomach, pancreas and gall bladder drain to which lymph nodes?
Left supraclavicular (aka Virchow’s sign)
Acute Appendicitis would affect which lymph nodes
Mesenteric
A lymphadenopathy in a pt less than 30 is likely to be benign or malignant and what percent
80% benign
What type of granuloma is Cat scratch disease
Necrotizing / Supprative Granuloma
What organism causes Cat scratch disease
Gram neg bacteria
Bartonella Henselae
A lymphadenopathy in a pt over 50 is likely to be benign or malignant and what percent
malignant 60%
What generally causes Sinus histiocytosis
Malignancy drainage
WHat organism causes Toxoplasmosis
Protozoan (parasite) Toxoplasma Gondii
CAT host
Which cells can be seen in Dermatopathic lymphadenitis
Langerhans cells
Interdigitting reticulum cells
What is another name for Sinus Histiocytosis with massive lymphadenopathy
Rosai- Dorfman disease
What is another name for Sinus Histiocytosis with massive lymphadenopathy
Rosai- Dorfman disease
What generally causes Sinus histiocytosis
Malignancy drainage
What type of granuloma is Cat scratch disease
Necrotizing / Supprative Granuloma
WHat organism causes Toxoplasmosis
Protozoan (parasite) Toxoplasma Gondii
CAT host
What organism causes Cat scratch disease
Gram neg bacteria
Bartonella Henselae
Which cells can be seen in Dermatopathic lymphadenitis
Langerhans cells
Interdigitting reticulum cells