Lymph Node Pathology Flashcards

0
Q

3 secondary lymphoid organs?

A

lymph node
spleen
MALT

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1
Q

2 primary lymphoid organs?

A

bone marrow

thymus

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2
Q

3 places with MALT? mucosa associated lymphoid tissue

A

tonsils
GIT
airways

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3
Q

what is in paracortex of lymph nodes?

A

naive T-cells

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4
Q

what is in mantle zone of lymph nodes?

A

Naive B cells

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5
Q

what are in primary follicles? 3 things:

A
  1. naive B cells
  2. follicular dendritic cells
  3. T-cells
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6
Q

medullary cords in lymph nodes contain?

A

plasma cells

immunoblasts

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7
Q

sinuses in lymph nodes contain 4 things

A
  1. lymph
  2. macrophages
  3. eosinophils
  4. B&T lymphocytes
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8
Q

CD 20 belongs to?

A

B-cells

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10
Q

CD3 belongs to?

A

T-cells

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11
Q

BLC2 anti-apoptosis protein is due to what translocation?

A

14;18

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12
Q

what do CLL and SLL (small lymphocytic lymphoma) cells look like?

A

mature looking B-cells of naive/memory cell type

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13
Q

what happens in GC?

A

Naive B in mantle zone»centroblasts»centrocytes»immunoblasts»hypermutation/switching»medullary cord» plasma cell

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14
Q

where are follicular dendritic cells/CD4 helper T-cells located in the lymph node?

A

Germinal Centre

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15
Q

3 reactive lymphadenopathies?

A
  1. localised:TB
  2. systemic: viral: EBV, HIV, Measles, rubella
  3. non-infective: autoimmune
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16
Q

2 main causes of lymphadenopathy?

A

Reactive

Neoplastic

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17
Q

what causes large painful lymph nodes?

A

lymphadenitis from infection due to rapid expansion, stretching of capsule

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18
Q

when are lymph nodes not tender?

A

chronic non-specific lymphadenitis

19
Q

3 causes of chronic non-specific lymphadenitis

A
  1. follicular hyperplasia
  2. paracortical
  3. sinus histiocytosis
20
Q

what are the 2 primary tumours of lymphadenopathy?

A
  1. Hodgkin lymphoma

2. non-Hodgkin’s lymphoma

21
Q

what is more common cause of neoplastic lymphadenopathy?

A

secondary metastases

22
Q

what neoplasias metastasizes to lymph nodes? 3 kinds

A
  1. carcinomas
  2. melanomas
  3. germ cells
23
Q

what type of neoplasia doesn’t as readily metastasise to nodes?

A

sarcoma

24
Q

3 big classes causes of neoplastic lymphadenopathy

A
  1. primary tumour
  2. secondary tumour
  3. leukaemic infiltration
25
Q

how to diagnose lymphoma gold standard? aspirate or biopsy?

A

biopsy

26
Q

hodgkin lymphoma look like what cels?

A

Reed Sternberg cells resemble mature B-cell neoplasms

27
Q

lymphoma cells are generally at what stage of development?

A

mature/post-bone marrow stage (peripheral)

28
Q

blood involvement in lymphomas?

A

minimal peripheral blood involvement

29
Q

2 kinds of non-Hodgkin lymphomas?

A
  1. nodal

2. extranodal

30
Q

4 big lymphoma risk factors?

A
  1. immunosuppression
  2. autoimmune
  3. EBV/H. pylori
  4. environmental: chemo, rad
31
Q

most follicular lymphoma translocations?

A

t(14-18) (over expression of BCL2)

32
Q

what is Burkitt’s lymphoma chromosomal translocation?

A

chromosome 8

MYC oncogene: ovegrowth

33
Q

role of EBV in lymphoma?

A

infects B cells
need T-cells to induce latency
loss of T-cell immunity»increase viral proteins»polyclonal Bcells»lymphoma

34
Q

clinical features of focal/generalised nodal lymphoma: B symptoms:

A
  1. fever
  2. night sweats
  3. weight loss >10% from baseline in 6/12
35
Q

when does hodgkin’s lymphoma happen?

A

young adult, second peak in later life

36
Q

hodgkin’s lymphoma what characteristic cells

A

Reed-Sternberg cells

37
Q

what is predominant type of hodgkin’s lymphoma ?

A

nodular lymphocyte

38
Q

what do Reed-Sternberg cells look like?

A

large cell, +++cytoplasm
large bilobate nucleus
prominent eosinophilic nucleoli

39
Q

Non-hodgkin’s lymphomas tend to be B-cell or T-cell?

A

B-cell (85%)

40
Q

where are ‘extranodal’ Non-hodgkin’s lymphoma happen?

A

Thyroid: hashimoto’s
Stomach: H.pylori
other: brain, breast, lung, intestine

41
Q

what are diffuse large B cell lymphoma cell types?

A

post-germinal centre B-cells: (no nodules)

  1. centroblasts
  2. immunoblasts
42
Q

follicular lymphomas predominant cell type? architecture?

A
  1. centrocyte-like

2. nodular

43
Q

follicular lymphomas immunophenotype?

A

CD19-20

BCL2+