L1: Pathology of lymphatic system Flashcards
What are the diseases of lymphatic vessels?
1- Acute lymphangitis 2- Erysipelas 3- Chronic lymphangitis 4- Hamartomas 5- tumours
What is the definition of acute lymphangitis?
- acute inflammation of lymphatic vessels and the peri lymphatic blood vessels.
What causes acute lymphangitis?
streptococcus pyogenes infection
What are the complications of acute lymphaginitis?
Chronic lymphangitis
What is the definition of erysipelas?
- Spreading acute lymphangitis of dermis usually of the face due streptococcus pyogenes infection
What is the Pathology of erysipelas?
The area is raised, painful, red with well-defined and indurated margin and Spreads rapidly
Cervical lymphadenitis
What is the course of erysipelas?
Disease lasts 1-3 weeks and heals with no disfigurement.
What are the types of chronic lymphaginitis?
Non specific: Following acute lymphangitis
Specific: T.B, Syphilis, Filariasis.
What are the types of hamartomas?
- Capillary lymphangioma
- Cavernous lymphangioma
What are tumors of lymphatic vessels?
Malignant: Lymphangiosarcoma
What are the diseases of lymph nodes?
Acute and chronic lymphadenitis
What are types of acute lymphadenitis?
Bacterial and viral
What is the source of bacterial acute lymphadenitis?
- Acute inflammation of regional lymph nodes draining an acute bacterial infection (usually pyogenic mainly face and hand)
What is the N/E of bacterial acute Lymphadenitis?
- The Lymph nodes are discrete enlarged and soft.
- The cut surface bulges out and is pink grey.
What is the M/E of acute bacterial lymphadenitis?
- L.N show large germinal centers containing numerous mitotic figures, sometimes a neutrophilic infiltrate & necrosis resulting in the formation of an abscess.
What is the clinical examination of bacterial acute lymphadenitis?
- They are discrete, enlarged, soft, painful and tender.
What are the complications of bacterial acute lymphadenitis?
Acute suppurative lymphadenitis
Chronic non specific lymphadenitis
What is example of viral acute lymphadenitis?
- As in glandular fever which is presented by fever, sore throat, enlarged cervical lymph nodes.
What is viral acute lymphadenitis misdiagnosed with?
lymphoma
What are the types of chronic lymphadenitis?
A- Chronic non specific lymphadenitis
B- Chronic specific (granulomatous) lymphadenitis
How does chronic non-specific lymphadenitis occur?
- Occurs in lymph nodes draining foci of chronic non specific inflammation.
What is the N/E of chronic non specific lymphadenitis?
Affected nodes are matted, moderately enlarged and firm.
Cut surface has a red tinge and is hemogenous.
How does the reaction heal in chronic nonspecific lymphadenitis?
fibrosis
Give an example for chronic specific granulomatous lymphadenitis.
infective granulomas
What are the causes of lymph node enlargement?
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
What is the definition of splenomegaly?
enlargement of the spleen
What is splenomegaly classified according to?
1- According to the rate of enlargement
2- According to the size
What is splenomegaly classified into according to the rate of enlargement?
Acute and chronic
What are the causes of acute splenomegaly?
Septicemia, Pyemia, Typhoid fever, Glandular fever (infectious mononucleosis).
What are the causes of chronic splenomegaly?
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
What are the types of splenomegaly according to size?
Massive splenomegaly (weight more than 1000 gm)
Moderate splenomegaly (weight 500-1000 gm)
Mild splenomegaly (weight <500 gm)
What are the causes of massive splenomegaly?
Chronic myeloproliferative disorders & chronic leukemia Hairy cell leukemia Lymphomas Malaria & Gaucher disease Primary tumors of the spleen (rare)
What are the causes of Moderate splenomegaly?
Congestive splenomegaly Leukemias Autoimmune hemolytic anemia Amyloidosis Niemann-Pick disease Langerhans histiocytosis Chronic splenitis Tuberculosis, sarcoidosis
What are the causes of mild splenomegaly?
Acute splenitis
Acute splenic congestion
Infectious mononucleosis
Acute febrile disorders e.g. septicemia & SLE
