Investigating lymphadenopathy and diagnosing lymphoma

Question 1

What are symptoms of lymphadenopathy?

Answer 1

Lump
Lympoma
Infection
Met cancer
Connective tissue disease
Night sweats
Weight loss
Itch without rash
fatigue
Alcohol induced pain

Question 2

What would be differentials for lymphadenopathy?

Answer 2

Reactive
Bacterial infection (regional)
Fungal infection (generalised)
Met malignancy
Lymphoma

Question 3

What should you do if lymphoma or another cancer is suspected?

Answer 3

Biopsy
FNA or core biopsy
Need a big sample

Question 4

Can lymphoma be diagnosed via CT scan?

Answer 4

Nope

Question 5

What can you do to assess lymph node pathology?

Answer 5

Histological-microscopic appearances
Immunohistochemistry solid node
Immunophenotyping blood/marrow
Genetic analysis
Molecular analysis

Question 6

What is immunohistochemostry?

Answer 6

Look at pattern of proteins on surface of lymphoma cells

Question 7

Describe immunophenotyping?

Answer 7

Use cells in a liquid phase

Cells tagged with antibodies attached to flourochrome

Question 8

What can immunophenotyping determine?

Answer 8

Pattern of CD numbers

Question 9

Describe cytogenetic analysis?

Answer 9

Specific patterns of chromosome abnormality in certain lymphomas
G banding
FISH

Question 10

What are Reed Sternberg cells?

Answer 10

Seen in Hodgkin’s disease, they are very abnormal B cells that had lost normal protins associated with B cells e.g. CD 20.