Lec 03: Morphology of Non-Neoplastic Lymph Nodes Flashcards by The Amazing Penisman

Which lymph node region corresponds to humoral response?

a. Cortex
b. Paracortex
c. Capsule
d. Medulla

a. Cortex

For humoral response.

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Correct lymphatic flow:

a. Medulla -> Paracortex -> Cortex
b. Cortex -> Paracortex -> Medulla
c. Cortex -> Medulla -> Paracortex
d. Paracortex -> Medulla -> Paracortex

b. Cortex -> Paracortex -> Medulla

* Traced from afferent lymphatics going into the node to efferent lymphatics going outside.

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Lymph node part which predominates most of the cortex.

Follicles.

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PRIMARY or SECONDARY lymphoid follicle: composed of inactive lymphocytes.

PRIMARY lymphoid follicle.

They appear homogenous because it is composed of INACTIVE LYMPHOCYTES which have not encountered an antigen yet.

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PRIMARY or SECONDARY lymphoid follicle: heterogenous in appearance.

SECONDARY lymphoid follicle.

Appear heterogenous because it is composed of stimulated lymphocytes.

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PRIMARY or SECONDARY lymphoid follicle: found mostly in adults.

SECONDARY lymphoid follicle.

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TRUE or FALSE: The mantle zone of the lymph node cortex contains B cells ONLY.

TRUE.

The B cells also “fence around the follicle.”

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CENTROBLAST or CENTROCYTE?

: Immature

CENTROBLAST

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CENTROBLAST or CENTROCYTE?

: Darker & smaller because they haven’t encountered antigens yet.

CENTROBLAST

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CENTROBLAST or CENTROCYTE?

: Contain macrophages

CENTROCYTE

They have encountered antigens/

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CENTROBLAST or CENTROCYTE?

: More cytoplasm

CENTROCYTE

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These cells form a meshwork of follicles.

Follicular Dendritic Cells (FDC)

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AKA interfollicular region/area:

a. Cortex
b. Paracortex
c. Capsule
d. Medulla

b. Paracortex

It is located beneath the cortex and BETWEEN the lymphoid follicles.

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Contains the mobile pool of T-cells.

a. Cortex
b. Paracortex
c. Capsule
d. Medulla

b. Paracortex

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Presence of post-capillary venules (to enter central circulation) lined by endothelial cells (also active in immune response) and characterized by presence of lymphocytes in
the wall.

a. Cortex
b. Paracortex
c. Capsule
d. Medulla

b. Paracortex

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Contains plasma cells (where all plasma cells go), lymphocytes, macrophages.

a. Cortex
b. Paracortex
c. Capsule
d. Medulla

d. Medulla

The medulla contains different sets of cellular populations. It is also rich in lymph sinuses, arteries and veins.

Located closes to the hilum:

a. Cortex
b. Paracortex
c. Capsule
d. Medulla

d. Medulla

Usually avoided for lymph node biopsy due to fibrotic changes commonly present:

a. Axillary lymph node
b. Inguinal lymph node
c. Cervical lymph node
d. NOTA
e. a&c only
f. AOTA

b. Inguinal lymph node

* Brought about by trauma, and (for practical reasons) the area being prone to infection.

Usually preferred for lymph node biopsy due to easy accessibility and they show the morphologies better.

a. Axillary lymph node
b. Inguinal lymph node
c. Cervical lymph node
d. NOTA
e. a&c only
f. AOTA

e. a&c only

Lymph node evaluation method used to demonstrate morphologic features and alterations in the cellular population;

a. biopsy
b. electron microscopy
c. cytogenetics
d. bacteriologic examination

a. biopsy

Lymph node evaluation method used to identify specific organism if there is an infection.

a. biopsy
b. electron microscopy
c. cytogenetics
d. bacteriologic examination

d. bacteriologic examination

Lymph node evaluation method used to see chromosomal changes within the cell especially under suspicion of neoplastic malignancy.

a. biopsy
b. electron microscopy
c. cytogenetics
d. bacteriologic examination

c. cytogenetics

Lymph node evaluation method used to view specific areas and cells.

a. biopsy
b. electron microscopy
c. cytogenetics
d. bacteriologic examination

b. electron microscopy

Which of the following lymph node evaluation is/are used if under suspicion of neoplastic malignancy?

a. immunophenotyping
b. cytogenetics
c. molecular genetics
d. AOTA

d. AOTA

The following are patterns of reactive lymph nodes, EXCEPT: a. follicular b. paracortical c. sinusoidal d. mixed e. NOTA

e. NOTA * Reactive lymph nodes are BENIGN enlargements due to hyperplasia (expansion of lymphocytes – polyclonal) of cellular components reflecting stimulation of lymphoid cells by a variety of antigens.

Identify the pattern of the reactive lymph node described: Prominent germinal centers where immune response takes place: a. follicular b. paracortical c. sinusoidal d. mixed e. NOTA

a. follicular | * There is also an increase in size and number of follicles.

Identify the pattern of the reactive lymph node described: Follicles are intact, paracortical area is expanded and there are sheets of lymphocytes and immunoblasts. a. follicular b. paracortical c. sinusoidal d. mixed e. NOTA

b. paracortical | * In the paracortical pattern, cortex is still intact because the expansion happened in the paracortical area.

Identify the pattern of the reactive lymph node described: AKA sinus histiocytosis: a. follicular b. paracortical c. sinusoidal d. mixed e. NOTA

c. sinusoidal | * Distended sinuses compress the nodal parenchyma and sinuses contain numerous histiocytes.

The following describes morphology of lymph nodes in SLE Lymphadenopathy: a. effaced architecture b. Foci of necrosis – compromised (highly necrosed) areas due to destroyed B-cells c. Vasculitis with fibrinoid necrosis (pink granular deposition on the wall with apoptotic cells; karyorrhectic debris and neutrophils) d. NOTA e. AOTA

e. AOTA

The following describes morphology of lymph nodes in Drug-induced Lymphadenopathy, EXCEPT: a. effaced follicles b. proliferation of immunoblasts c. eosinophilia d. purely regionalized lymphadenopathy

d. purely regionalized lymphadenopathy | * It may have general or regionalized lymphadenopathy

The following describes the morphology of lymph nodes in Tumor-reactive Lymphadenopathy, EXCEPT: a. sinus histiocytosis b. occasionaly germinal center hyperplasia or paracortical hyperplasia c. lots of histiocytes/macrophages in sinuses d. NOTA e. AOTA

d. NOTA

A special stain for glycoproteins expressed on macrophages with histiocytes used to highlight histiocytes.

CD68

Identify the pattern of the HIV lymphadenitis described: acute infection.

Pattern A ``` Morphology o Hyperplastic follicles o Numerous macrophages o Widespread apoptosis o Folliculysis, disruption of dendritic network o Focal hemorrhages ```

Identify the pattern of the HIV lymphadenitis described: effaced follicles with vascular hyperplasia.

Pattern B (subacute or chronic AIDS) Morphology o Effaced follicles – disappear because these were disrupted early on o Involution of germinal centers o Depletion of lymphocytes o Vascular hyperplasia – to compensate for lost areas

Identify the pattern of the HIV lymphadenitis described: enlarged and coalescing lymphoid follicles

Pattern A In pattern A, there are numerous hyperplastic follicles with disruption of dendritic network.

Identify the pattern of the HIV lymphadenitis described: Sclerosing follicles, hyalinazed germinal centers, full of collagen and extensive angiogenesis within lymph node.

Pattern C (full-blown AIDS) Morphology o Small or absent follicles; sclerosing o Hyalinized germinal centers; pink (full of collagen) o Extensive angiogenesis (Arise since the node is trying to catch up due to lost areas.)

TRUE or FALSE: Early Tuberculous lymphadenitis is granulomatous.

FALSE. Early tuberculous lymphadenitis is exudative.

TRUE or FALSE: Epithelioid histiocytes are activated macrophages.

TRUE.

In 1'TB, after the bacteria is inhaled, transported to the lungs and entrapped in bronchial lymph nodes, these complexes may form:

Ghon complex (peripheral granuloma + lymphadenopathy) and Ranke's complex (if with calcification)