L1: Pathology of lymphatic system

Question 1

What are the diseases of lymphatic vessels?

Answer 1

1- Acute lymphangitis
2- Erysipelas
3- Chronic lymphangitis
4- Hamartomas
5- tumours

Question 2

What is the definition of acute lymphangitis?

Answer 2

• acute inflammation of lymphatic vessels and the peri lymphatic blood vessels.

Question 3

What causes acute lymphangitis?

Answer 3

streptococcus pyogenes infection

Question 4

What are the complications of acute lymphaginitis?

Answer 4

Chronic lymphangitis

Question 5

What is the definition of erysipelas?

Answer 5

• Spreading acute lymphangitis of dermis usually of the face due streptococcus pyogenes infection

Question 6

What is the Pathology of erysipelas?

Answer 6

 The area is raised, painful, red with well-defined and indurated margin and Spreads rapidly

 Cervical lymphadenitis

Question 7

What is the course of erysipelas?

Answer 7

Disease lasts 1-3 weeks and heals with no disfigurement.

Question 8

What are the types of chronic lymphaginitis?

Answer 8

Non specific: Following acute lymphangitis

Specific: T.B, Syphilis, Filariasis.

Question 9

What are the types of hamartomas?

Answer 9

• Capillary lymphangioma

- Cavernous lymphangioma

Question 10

What are tumors of lymphatic vessels?

Answer 10

Malignant: Lymphangiosarcoma

Question 11

What are the diseases of lymph nodes?

Answer 11

Acute and chronic lymphadenitis

Question 12

What are types of acute lymphadenitis?

Answer 12

Bacterial and viral

Question 13

What is the source of bacterial acute lymphadenitis?

Answer 13

• Acute inflammation of regional lymph nodes draining an acute bacterial infection (usually pyogenic mainly face and hand)

Question 14

What is the N/E of bacterial acute Lymphadenitis?

Answer 14

• The Lymph nodes are discrete enlarged and soft.

- The cut surface bulges out and is pink grey.

Question 15

What is the M/E of acute bacterial lymphadenitis?

Answer 15

• L.N show large germinal centers containing numerous mitotic figures, sometimes a neutrophilic infiltrate & necrosis resulting in the formation of an abscess.

Question 16

What is the clinical examination of bacterial acute lymphadenitis?

Answer 16

• They are discrete, enlarged, soft, painful and tender.

Question 17

What are the complications of bacterial acute lymphadenitis?

Answer 17

 Acute suppurative lymphadenitis

 Chronic non specific lymphadenitis

Question 18

What is example of viral acute lymphadenitis?

Answer 18

• As in glandular fever which is presented by fever, sore throat, enlarged cervical lymph nodes.

Question 19

What is viral acute lymphadenitis misdiagnosed with?

Answer 19

lymphoma

Question 20

What are the types of chronic lymphadenitis?

Answer 20

A- Chronic non specific lymphadenitis

B- Chronic specific (granulomatous) lymphadenitis

Question 21

How does chronic non-specific lymphadenitis occur?

Answer 21

• Occurs in lymph nodes draining foci of chronic non specific inflammation.

Question 22

What is the N/E of chronic non specific lymphadenitis?

Answer 22

 Affected nodes are matted, moderately enlarged and firm.

 Cut surface has a red tinge and is hemogenous.

Question 23

How does the reaction heal in chronic nonspecific lymphadenitis?

Answer 23

fibrosis

Question 24

Give an example for chronic specific granulomatous lymphadenitis.

Answer 24

infective granulomas

Question 25

What are the causes of lymph node enlargement?

Answer 25

1) Acute lymphadenitis
2) Chronic lymphadenitis

3) Hyperplastic lymphadenopathy:
 Follicular hyperplasia 
 Sinus histiocytosis.
 Nodes draining tumour
4) Histocytosis X: Due to proliferation of langerhan’s cells.

5) Lymphomas: either
 Hodgkin’s lymphoma
 Non Hodgkin's lymphoma
6) Secondaries: either from
 Carcinomatous 
 Sarcomatous

Question 26

What is the definition of splenomegaly?

Answer 26

enlargement of the spleen

Question 27

What is splenomegaly classified according to?

Answer 27

1- According to the rate of enlargement

2- According to the size

Question 28

What is splenomegaly classified into according to the rate of enlargement?

Answer 28

Acute and chronic

Question 29

What are the causes of acute splenomegaly?

Answer 29

Septicemia, Pyemia, Typhoid fever, Glandular fever (infectious mononucleosis).

Question 30

What are the causes of chronic splenomegaly?

Answer 30

Divided according to the etiology into:

1) Bacterial: Brucellosis, T.B., Syphilis.
2) Parasitic: Bilharziasis, Malaria, Hydatid, Leishmaniasis (kalazar)

3) Circulatory disturbances as Congestive splenomegaly, Infarction.
4) Hematological disorders as Extra medullery hemopoeisis, Hemolytic anemia, Polycythemia, Leukemia, Purpura, Hypersplenism

5) Lipid storage disorders as Gaucher’s disease, Niemenn pick disease, Hyper lipidemias.
6) Histocytosis X.
7) Amyloidosis and sarcoidosis

8) Tumors mostly lymphoma

Question 31

What are the types of splenomegaly according to size?

Answer 31

Massive splenomegaly (weight more than 1000 gm)

Moderate splenomegaly (weight 500-1000 gm)

Mild splenomegaly (weight <500 gm)

Question 32

What are the causes of massive splenomegaly?

Answer 32

 Chronic myeloproliferative disorders & chronic leukemia 
 Hairy cell leukemia
 Lymphomas
 Malaria & Gaucher disease
 Primary tumors of the spleen (rare)

Question 33

What are the causes of Moderate splenomegaly?

Answer 33

 Congestive splenomegaly
 Leukemias
 Autoimmune hemolytic anemia 
 Amyloidosis
 Niemann-Pick disease 
 Langerhans histiocytosis 
 Chronic splenitis
 Tuberculosis, sarcoidosis

Question 34

What are the causes of mild splenomegaly?

Answer 34

 Acute splenitis
 Acute splenic congestion
 Infectious mononucleosis
 Acute febrile disorders e.g. septicemia & SLE