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Lymphatic System > LN > Flashcards

LN Flashcards

1
Q

Function of LN

A

-Drain protein containing fluid that escapes from blood capillaries.
-Transport fats from GI tract to the blood
Produce lymphocytes
-Develop immunity

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2
Q

Lymph flows into LN through the?

A

Afferent vessels

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3
Q

Lymph flows out of LN through?

A

Efferent Vessels

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4
Q

What are small bean shaped structures lying along the course of lymphatics?

A

Lymph Nodes

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5
Q

Where can the primary LN follicle be found?

A

Germinal Center

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6
Q

What are the 3 components that makes up the node?

A

-lymphatic sinuses
-blood vessels
-parenchyma

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7
Q

What is the thin capsule around node made up of?

A

Fibroblast & collagen

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8
Q

Space under capsule is called?

A

Subcapsular sinuses

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9
Q

Should a LN have epithelium? If so, explain what it’s presence means

A

No, if it is present then sus mets ca

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10
Q

—- is known as the T cell house

A

Paracortex

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11
Q

Where are plasma cells & macrophages plentiful?

A

Medulla

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12
Q

Primary & secondary follicles are found here

A

Cortex

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13
Q

B cells enter the LN through?

A

High Endothelial Venules (HEVs)

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14
Q

Activated B cells within lymphoid follicles are known as?

A

Follicular Center Cells

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15
Q

B cells that have cleaved nuclei are called?

A

Centrocytes

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16
Q

Non-cleaved cells with larger more open nuclei & several nucleoli?

A

Centroblasts

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17
Q

Stimulated mature B cells responding to an antigen change into — & then —- which then leave follicle & pass to —- & —-

A

Centroblasts, centrocytes, paracortex, medullary sinuses

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18
Q

After leaving follicles, B cells become —- which divide to give rise to plasma cells or memory B cells.

A

Immunoblasts

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19
Q

Where does B cell maturation occur?

A

Germinal Center

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20
Q

B cells undergo their development in —- while T cells in the —-

A

Bone marrow, Thymus

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21
Q

If something went wrong during phase at bone marrow – abnormal cells are being made there (primary lymphoid organ), it results in —-?

A

Leukemia

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22
Q

If there is something that goes wrong in secondary lymphoid organ —?

A

Lymphoma

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23
Q

What cells are numerous in paracortex & acts as APCs?

A

Dendritic Cells

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24
Q

Paracortical T-cells, mostly —- are key players in the recognition of antigen.

A

CD4(+) T-helper cells

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25
Q

The B-cells that survive the tumultuous, Darwinian struggle within the germinal center eventually differentiate into —-

A

Plasma Cells

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26
Q

What cells can be found in cortex?

A

B Cells
Macrophages
Follicular Dendritic Cells**

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27
Q

Paracortex has what kind of cells present?

A

T Cells
Immunoblasts
Langerhans’s Cells

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28
Q

Plasma cells
Immunoblasts
Plasmacytoid Lymphocytes
Rare macrophages
can be found where?

A

Medulla

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29
Q

Resting or mature
65-90% of cell population
Round nucleus (generally)
Smooth membrane
Hyperchromatic, coarse, even chromatin
Thin rim of cytoplasm
Nucleoli- absent to inconspicuous

A

Small Lyc

30
Q

10 to 12 microns in size
Round with a cleaved membrane
Thin rim of cytoplasm
Absent to inconspicuous nucleoli

A

small cleaved centrocytes

31
Q

20 to 40 microns
Cleaved angulated nuclei
Coarse chromatin, even distribution
Inconspicuous nucleoli

A

Large Cleaved Lyc

32
Q

First sign of antigenic stimulation
20 to 40 microns
Round vesicular nuclei
1-3 prominent peripheral nucleoli
Moderate, basophilic cytoplasm

A

Small/large centroblast

33
Q

Before B cells become plasma cells, they are —?

A

Immunoblasts

34
Q

Large nuclei
Prominent central macronucleolus or:
2 or more nucleoli (T Type)
Plasmacytoid cytoplasm
Irregular membrane
Occasional plasmacytoid cytoplasm and perinuclear

A

Immunoblasts (B or T cell)

35
Q

Specialized histiocytes
Antigen presenting
Stromal
Long Cytoplasmic processes
Non phagocytic
Part of reticular network of lymph node

A

Follicular Dendritic Cells

36
Q

Contain bits of B-cells (failure to bind antibody to antigen)
Seen mostly in benign conditions**
CAN be seen in aggressive (high grade) lymphomas

A

Tingible Body Macrophages (TBM)

37
Q

Represent reticulum cells in follicles & germinal centers.
In aspirates, these form large structures that can be in flat, loose sheets or cohesive 3-D cell clusters.
Cytoplasm is abundant, pale, ill-defined and delicate

A

Lympho-histiocytic Aggregate in LN FNA

38
Q

Enlarged nodes(<3 cm in diameter), usually NOT tender
Common in the inguinal, axillary, and cervical regions because these lymph nodes drain large areas
The FNA is quite cellular
MOST COMMON DIAGNOSIS IN FNA

A

CHR Lymphadenitis (Rx LN)

39
Q

Polymorphous
Small lymphoid cells
May see plasma cells and immunoblasts
Tingible body macrophages
- High range of maturation
- Lymphohistiocytic aggregates
Key: POLYMORPHOUS

A

Rx LN

40
Q

What is the dx for:
Polymorphic population,
Morphologic Diversity
Lymphoglandular bodies in the bkg

A

Rx LN

41
Q

These aggregates create the appearance of an epithelioid group of cells.

A

Lymphoid Tangles in LN FNA

42
Q

Lymphoid globules or hyaline bodies that are detached blebs of lymphocyte cytoplasm

A

Lymphoglandular Bodies

43
Q

Cat Scratch is caused by — and can be stained with —?

A

Bartonella hensalae, silver stain

44
Q

Lump that develops at the collar bone

A

Branchial Cleft Cyst

45
Q

Freely movable beneath the skin
Tender
Less firm
Arising and subsiding over weeks or months
PAIN

A

Rx Adenopathy

46
Q

Matted
Non-tender
Stony hard if fibrosis is present
Slowly, inexorably growing

A

Malignant Adenopathy

47
Q

—– are clonal, uncontrollably expanding, destructive proliferations of lymphoid cells.

A

Lymphoma

48
Q

Lymphoid neoplasms that predominantly involve the bone marrow and peripheral blood are considered

A

Leukemia

49
Q

CD34, TdT, CD117

A

Markers for Immature Cells

50
Q

CD3, CD5, CD4, CD8, CD7

A

T cell Markers

51
Q

CD19, CD20, CD79a, PAX-5

A

B cell markers

52
Q

CD38, CD138, CD79a

A

Plasma Cell markers

53
Q

Dx for a mixed population of small lyc + large cells

A

Rx Node, Follicular Lymphoma

54
Q

Dx of small cell pattern of lyc

A

SLL/CLL, Mantle Cell Lymphoma

55
Q

What cells have large bright red nucleolus surrounded by clear zone & what condition are the found in?

A

Reed Sternberg Cells, Hodgkin’s Lymphoma

56
Q

Much less common than classical type incidence
Usually, males between 30-50
Malignant cells are monoclonal B cells: L & H cells, large cells w/ one large multilobate, folded nucleus. Their contorted nuclear shape gives the name “popcorn cells”
Smaller than typical RS cells w/ smaller nucleoli
(-) for CD30, CD15
(+) for CD20 & CD45 and 50% show + EMA

A

Nodular Lymphocyte predominant HL

57
Q

Reed Sternberg stains (+) for which markers but doesn’t stain the lyc in the bkg

A

CD15 & CD30

58
Q

What dx is:
-Seen mostly in young adult male
Abundant cellularity:
-RS cells
- Hodgkin’s cells
-Lymphs
-Eosinophils
-Plasma cells
-Macrophages

A

HL; mixed cellularity

59
Q

Seen in more young females
Fibrous tissue (fibroblasts)
Few RS & Hodgkin’s cells
Few Lymphs
Popcorn cells
May be confused w/ granulomatous lymphadentitis
=> Nodular bands of tissue are filled w/ fibroblasts – hard lymph nodes

A

HL - Nodular Sclerosing Type

60
Q

Lymph flows into LN through —- vessels & out through —-

A

narrow, wider

61
Q

Most of the fluid collects in main channel for lymphatic drainage called —?

A

Thoracic duct

62
Q

2 very important streams for lymphatic flow; contributes about 40% of fluid that gets into thoracic duct

A

Liver & intestine

63
Q

T cells either release —- to kill invaders or activate the —– to do the killing

A

cytokines, APCs (macrophages)

64
Q

Maturity of B cells:

A

Centroblasts => centrocyte => Immunoblasts (paracortex & medullary sinus) => plasma cells

65
Q

Paracortical T-cells, mostly ——- cells, are key players in the recognition of antigen.

A

CD4(+) T-helper

66
Q

—— have larger and more empty-appearing nuclei, the germinal centers show up as pale disks in the cortex on H&E stained slides.

A

Activated B-cells

67
Q

They are thought to represent the reticulum cells in follicles and germinal centers.

A

Lympho-histiocytic aggregate

68
Q

It is characterized by a t(11;14) translocation involving the cyclin D1 gene (cell cycle).

A

Mantle Cell Lymphoma

69
Q

Immunophenotype (CD10+), cytogenetic (t(14;18)), and constitutively over-express the Bcl-2 gene (B-Cell Lymphoma ) that blocks apoptosis.
40% progress to Diffuse Large B-Cell Lymphoma (TP53 gene mutation)
-½ can transform into large B cell lymphoma

A

Follicular Lymphoma

70
Q

Activates c-myc oncogene
Has an endemic form found in Africa (EBV); sporadic form found in US (both in children)
CD19, CD20 positive, CD10 also may be positive
Characteristics t(8:14) translocation

A

Burkitt’s Lymphoma

71
Q

— stains the Epstein’s Barr Body in — lymphoma

A

EBER, Burkitt’s Lymphoma

72
Q
A

Lymphatic System (1 decks)

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