Lymph Node Pathology Flashcards
3 secondary lymphoid organs?
lymph node
spleen
MALT
2 primary lymphoid organs?
bone marrow
thymus
3 places with MALT? mucosa associated lymphoid tissue
tonsils
GIT
airways
what is in paracortex of lymph nodes?
naive T-cells
what is in mantle zone of lymph nodes?
Naive B cells
what are in primary follicles? 3 things:
- naive B cells
- follicular dendritic cells
- T-cells
medullary cords in lymph nodes contain?
plasma cells
immunoblasts
sinuses in lymph nodes contain 4 things
- lymph
- macrophages
- eosinophils
- B&T lymphocytes
CD 20 belongs to?
B-cells
CD3 belongs to?
T-cells
BLC2 anti-apoptosis protein is due to what translocation?
14;18
what do CLL and SLL (small lymphocytic lymphoma) cells look like?
mature looking B-cells of naive/memory cell type
what happens in GC?
Naive B in mantle zone»centroblasts»centrocytes»immunoblasts»hypermutation/switching»medullary cord» plasma cell
where are follicular dendritic cells/CD4 helper T-cells located in the lymph node?
Germinal Centre
3 reactive lymphadenopathies?
- localised:TB
- systemic: viral: EBV, HIV, Measles, rubella
- non-infective: autoimmune
2 main causes of lymphadenopathy?
Reactive
Neoplastic
what causes large painful lymph nodes?
lymphadenitis from infection due to rapid expansion, stretching of capsule
when are lymph nodes not tender?
chronic non-specific lymphadenitis
3 causes of chronic non-specific lymphadenitis
- follicular hyperplasia
- paracortical
- sinus histiocytosis
what are the 2 primary tumours of lymphadenopathy?
- Hodgkin lymphoma
2. non-Hodgkin’s lymphoma
what is more common cause of neoplastic lymphadenopathy?
secondary metastases
what neoplasias metastasizes to lymph nodes? 3 kinds
- carcinomas
- melanomas
- germ cells
what type of neoplasia doesn’t as readily metastasise to nodes?
sarcoma
3 big classes causes of neoplastic lymphadenopathy
- primary tumour
- secondary tumour
- leukaemic infiltration
how to diagnose lymphoma gold standard? aspirate or biopsy?
biopsy
hodgkin lymphoma look like what cels?
Reed Sternberg cells resemble mature B-cell neoplasms
lymphoma cells are generally at what stage of development?
mature/post-bone marrow stage (peripheral)
blood involvement in lymphomas?
minimal peripheral blood involvement
2 kinds of non-Hodgkin lymphomas?
- nodal
2. extranodal
4 big lymphoma risk factors?
- immunosuppression
- autoimmune
- EBV/H. pylori
- environmental: chemo, rad
most follicular lymphoma translocations?
t(14-18) (over expression of BCL2)
what is Burkitt’s lymphoma chromosomal translocation?
chromosome 8
MYC oncogene: ovegrowth
role of EBV in lymphoma?
infects B cells
need T-cells to induce latency
loss of T-cell immunity»increase viral proteins»polyclonal Bcells»lymphoma
clinical features of focal/generalised nodal lymphoma: B symptoms:
- fever
- night sweats
- weight loss >10% from baseline in 6/12
when does hodgkin’s lymphoma happen?
young adult, second peak in later life
hodgkin’s lymphoma what characteristic cells
Reed-Sternberg cells
what is predominant type of hodgkin’s lymphoma ?
nodular lymphocyte
what do Reed-Sternberg cells look like?
large cell, +++cytoplasm
large bilobate nucleus
prominent eosinophilic nucleoli
Non-hodgkin’s lymphomas tend to be B-cell or T-cell?
B-cell (85%)
where are ‘extranodal’ Non-hodgkin’s lymphoma happen?
Thyroid: hashimoto’s
Stomach: H.pylori
other: brain, breast, lung, intestine
what are diffuse large B cell lymphoma cell types?
post-germinal centre B-cells: (no nodules)
- centroblasts
- immunoblasts
follicular lymphomas predominant cell type? architecture?
- centrocyte-like
2. nodular
follicular lymphomas immunophenotype?
CD19-20
BCL2+