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Essential Haematology > Inflammatory disease Of Lymoh nodes > Flashcards

Inflammatory disease Of Lymoh nodes Flashcards

1
Q

What are the causes of Lymphadenopathy

A 
M- Malignancy
I  - Infection 
A- Autoimmune 
M- Miscellaneous 
I.  - Iatrogenic
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2
Q

What are two types of Reactive Hyperplasia Lymphadenopathy

A

Acute & Chronic
Local & Generalized

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3
Q

Describe the morphology seen in follicular hyperplasia

A

germinal centres surrounded by mantle zone of small resting B cells

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4
Q

The Histology of Reactive Hyperplasia depends on what five factors

A 
Patient’s age
Immune capability 
Inciting factor
Past Exposure
Time/ Duration
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5
Q

Reactive Hyperplasia Lymphadenopathy Histology taken before 8days of progression shows what type of cell Hyperplasia

A

Para cortical/Diffuse Hyperplasia (T cell)

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6
Q

Reactive Hyperplasia Lymphadenopathy Histology taken after 15days of progression shows what type of cell Hyperplasia

A

Follicular Hyperplasia (B cell)

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7
Q

List three types of Chronic Reactive Hyperplasia Lymphadenopathy

A

Follicular (B Cell)
Paracortical/ diffuse (T cell)
Sinus histiocytosis (macrophages)

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8
Q

What are six diseases that cause Follicular Hyperplasia

A

SCRATCH
Syphilis
Cat Scratch
Arthritis
Toxoplasmosis
Castleman’s Disease
HIV

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9
Q

What are the three patterns of Hyperplasia seen in HIV associated Lymphadenopathy

A

Pattern A - Acute: Explosive Follicular Hyperplasia
Pattern B - Chronic : Mixed
Pattern C - Burn out : Follicular Involution

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10
Q

What is the aetiology of Castleman’s Disease (Giant Lymoh node hyperplasia)

A

Unknown Aetiology

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11
Q

What are three histological types found in Castleman’s Disease (Giant lymph node Hyperplasia)

A

Hyaline vascular
Plasma cell
Overlap

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12
Q

Describe the Histology “Hyaline Vascular” type of Castleman’s Disease (Giant lymph node Hyperplasia)

A

Localized
Mediastinal
Self limiting

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13
Q

Describe the Histology “Plasma cell” type of Castleman’s Disease (Giant lymph node Hyperplasia)

A 
Generalized 
Systemic Symptoms (fever, ^ ESR , ^ y-globulins, anaemia)
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14
Q

List six causes of Diffuse Hyperplasia (Paracorticol) Lymphadenopathy - Tcell

A

Postvaccinial lymphadenitis
Infectious mononucleosis (EBV)
Angioimmunoblastic Lymphadenopathy
Herpes Zoster
CMV
Drugs (dilatin, penicillin, atenolol, allopurinol, gold)

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15
Q

What are the prototypes for Postvaccinial Lympadenitis

A

Diffuse
Follicular
Combined

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16
Q

Describe the Histology of Postvaccinial Lymphadenitis

A type of Diffuse Hyperplasia Lymphadenopathy

A

Increase in immunoblasts - mottled appearance

Vascular proliferation

Sinusoidal congestion

Plasma cells, eosinophils, mast cells

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17
Q

Which virus causes Infectious Mononucleosis

A

Epstein-Barr Virus (EBV)

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18
Q

What is the Histology seen in Infectious Mononucleosis (cause of Diffuse Hyperplasia )

A

Transformed cells
Reed Sternberg like giant cells
Capsular and pericapsular infiltration

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19
Q

Which age group is more susceptible to Angioimmunoblastic Lymphadenopathy

A

Elderly

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20
Q

What usually causes dermatopathic lymphadenitis

A

it is usually found in lymph nodes draining chronic inflammation

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21
Q

What are the clinical features of Sinus Histiocytosis with massive Lymphadenopathy (SHML)

A

Massive Lymphadenopathy (bull neck)
Fever, ^ y- globulins

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22
Q

SHML (Sinus Histiocytosis with massive Lymphadenopathy) is most susceptible in which group of people

A

Black children

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23
Q

What is the Histology of SHML (Sinus Histiocytosis with massive Lymphadenopathy)

A

EMPERIPOLESIS (Histiocytic engulfment of lymphocytes)

Sinusoidal distention with histocytes

Medullary plasma cell infiltration

Capsular fibrosis

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24
Q

What is the toxoplasmosis triad

A

Reactive follicular hyperplasia

Monocytoid B-cell reaction

Epithelioid histiocytic aggregates

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25
Q

What is the name of the protozoan that causes Toxoplasmosis

A

Toxoplasma gondii

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26
Q

Which animal is the definitive host of Toxoplasma gondii

A

Cats

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27
Q

What are three major clinical Syndromes associated with Toxoplasmosis

A

Toxoplasma lymphadenitis

Systemic Toxoplasmosis in immunodeficient pt

Fetal Toxoplasmosis -(transplacental infection)

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28
Q

Which nodes would you commonly see paracortical hyperplasia?

A

Axillary and Inguinal lymph nodes

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29
Q

What is differential diagnosis for Dermatopathic Lymphadenopathy

A

Mycosis Fungodes

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30
Q

What is the Histology of Dermatopathic Lymphadenopathy

A

Paracortical pallor

paracortical Hyperplasia

31
Q

What is the aetiology of Histiocytic Necrotizing Lymphadenitis ( Kikuchi Fujimoto)

A

Unknown proposed to be viral

32
Q

Which ethnicity is more susceptible to Histiocytic Necrotizing Lymphadenitis

A

Asian females

33
Q

What is the Histology of Histiocytic Necrotizing Lymphadenitis

A

Histiocytic cells

Atypical lymphoid cells

34
Q

What type of granuloma is Cat scratch disease

A

Necrotizing / Supprative Granuloma

35
Q

What organism causes Cat scratch disease

A

Gram neg bacteria
Bartonella Henselae

36
Q

WHat organism causes Toxoplasmosis

A

Protozoan (parasite) Toxoplasma Gondii

CAT host

37
Q

What type of granuloma is Cat scratch disease

A

Necrotizing / Supprative Granuloma

38
Q

What organism causes Cat scratch disease

A

Gram neg bacteria
Bartonella Henselae

39
Q

WHat organism causes Toxoplasmosis

A

Protozoan (parasite) Toxoplasma Gondii

CAT host

39
Q

What type of granuloma is Cat scratch disease

A

Necrotizing / Supprative Granuloma

40
Q

What organism causes Cat scratch disease

A

Gram neg bacteria
Bartonella Henselae

41
Q

WHat organism causes Toxoplasmosis

A

Protozoan (parasite) Toxoplasma Gondii

CAT host

42
Q

Which cells can be seen in Dermatopathic lymphadenitis

A

Langerhans cells
Interdigitting reticulum cells

43
Q

What is another name for Sinus Histiocytosis with massive lymphadenopathy

A

Rosai- Dorfman disease

44
Q

What generally causes Sinus histiocytosis

A

Malignancy drainage

45
Q

Infectious Mononucleosis (EBV) affects which lymph nodes?

A

Cervical

46
Q

Toxoplasmosis affects which lymph nodes ?

A

Post cervical

47
Q

Cat scratch disease affects which lymph nodes?

A

Axillary & Cervical

48
Q

STIs affect which lymph nodes

A

Inguinal

49
Q

HIV affects which lymph nodes?

A

Parotid, Sub-mandibular, epitrochlear

50
Q

Pathologies of the lungs and oesophagus drain to which lymph nodes

A

Right supraclavicular

51
Q

Pathologies of the stomach, pancreas and gall bladder drain to which lymph nodes?

A

Left supraclavicular (aka Virchow’s sign)

52
Q

Acute Appendicitis would affect which lymph nodes

A

Mesenteric

53
Q

A lymphadenopathy in a pt less than 30 is likely to be benign or malignant and what percent

A

80% benign

54
Q

What type of granuloma is Cat scratch disease

A

Necrotizing / Supprative Granuloma

54
Q

What organism causes Cat scratch disease

A

Gram neg bacteria
Bartonella Henselae

55
Q

A lymphadenopathy in a pt over 50 is likely to be benign or malignant and what percent

A

malignant 60%

55
Q

What generally causes Sinus histiocytosis

A

Malignancy drainage

56
Q

WHat organism causes Toxoplasmosis

A

Protozoan (parasite) Toxoplasma Gondii

CAT host

56
Q

Which cells can be seen in Dermatopathic lymphadenitis

A

Langerhans cells
Interdigitting reticulum cells

56
Q

What is another name for Sinus Histiocytosis with massive lymphadenopathy

A

Rosai- Dorfman disease

57
Q

What is another name for Sinus Histiocytosis with massive lymphadenopathy

A

Rosai- Dorfman disease

57
Q

What generally causes Sinus histiocytosis

A

Malignancy drainage

58
Q

What type of granuloma is Cat scratch disease

A

Necrotizing / Supprative Granuloma

58
Q

WHat organism causes Toxoplasmosis

A

Protozoan (parasite) Toxoplasma Gondii

CAT host

58
Q

What organism causes Cat scratch disease

A

Gram neg bacteria
Bartonella Henselae

58
Q

Which cells can be seen in Dermatopathic lymphadenitis

A

Langerhans cells
Interdigitting reticulum cells

59
Q
A
60
Q
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Q
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Q
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63
Q
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Essential Haematology (14 decks)

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