Lymph Nodes

Question 1

Importance of lymph nodes .

Answer 1

Involved in humoral and cellular immunity + deals with foreign bodies .

Question 2

What are the various layers of a lymph node ?

Answer 2

Capsule
Subcapsular sinus
Cortex - superficial cortex
paracortex
Medulla
Hilum

Question 3

Lymph node cortex constitutes …

Answer 3

Superficial cortex : Rich in B cells.

Contains lymphoid follicles - germinal centers where B cells proliferate and differentiate.

Paracortex : Lacks follicles + T-cell dominant.

Question 4

The medulla of lymph node constitutes….

Answer 4

B cells + plasma cells + macrophages

Question 5

What is the difference between primary follicle and mature follicle in a lymph node cortex ….. ?

Answer 5

Primary follicle - no / small germinal centre - fully dark purple in histology - surrounded by similar mantle zone

Mature follicle - germinal centre that is pale in colour surrounded by dark mantle zone .

Question 6

Site affected in follicular hyperplasia in a lymph node .

Answer 6

Cortex - superficial cortex- primary follicle - germinal centre .

Question 7

Conditions in which follicular hyperplasia is noted in a lymph node …

Answer 7

Bacterial infection
EARLY HIV
Autoimmune disease

Question 8

Morphology changes seen in follicular hyperplasia in a lymph node …

Answer 8

Expanded germinal centre
Thin mantle zone

Question 9

Cells involved in paracortex region of lymph node …

Answer 9

T cells .

Question 10

Condition that is involved with the paracortex region of the lymph node ?

Answer 10

Paracortical hyperplasia.

Question 11

Conditions that involve paracortical hyperplasia of the lymph node ?

Answer 11

Drugs
Vaccine
VIRUS

Question 12

What is the first region of the lymph node u look into in case of pathology abnormalities…?

Answer 12

Subcapsular sinus - for infiltration.

Question 13

What are the Ann Arbor staging criteria used for?

Answer 13

Staging of Hodgkin and Non-Hodgkin lymphomas.

Question 14

Which disease presents with Langerhans cells with Birbeck granules?

Answer 14

Langerhans cell histiocytosis

Question 15

Which lymphoma presents with cyclin D1 overexpression and t(11;14)?

Answer 15

Mantle cell lymphoma

Question 17

Which lymphoma is associated with BCL2 overexpression and t(14;18)?

Answer 17

Follicular lymphoma

Question 18

Starry sky appearance on lymph node biopsy is characteristic of which lymphoma?

Answer 18

Burkitt lymphoma
t(8;14)
c-MYC activation

Question 19

Name one lymphoma that is extranodal and associated with H. pylori infection

Answer 19

MALT lymphoma (marginal zone lymphoma)

Question 20

Reed-Sternberg cells are characteristic of which lymphoma?

Answer 20

Hodgkin lymphoma

Question 21

What is the classic histological finding in cat scratch disease?

Answer 21

Stellate granulomas with central necrosis

Question 22

Which part of the lymph node undergoes hyperplasia in viral infections?

Answer 22

Paracortex (due to T-cell proliferation)

Question 23

A 6-year-old boy presents with lytic bone lesions, rash, and diabetes insipidus. A biopsy of the lesion shows Birbeck granules on electron microscopy.

Answer 23

Langerhans Cell Histiocytosis

CD1a and S100 positive

Question 24

A 35-year-old African-American woman presents with bilateral hilar lymphadenopathy, cough, and hypercalcemia. Lymph node biopsy reveals non-caseating granulomas.

Answer 24

CD4+ T cells - Sarcoidosis

(Th1-mediated granulomatous response)

Question 25

A 68-year-old male presents with painless lymphadenopathy, fatigue, and frequent infections. A blood smear shows smudge cells.

Answer 25

CD5+, CD19+, CD23+ B cells

Question 26

A 40-year-old female presents with massive mediastinal lymphadenopathy and systemic symptoms. Biopsy shows hyaline vascular proliferation.

Answer 26

Castleman Disease — Human herpesvirus-8 (HHV-8)

Question 27

A 35-year-old male from India presents with painless, matted cervical lymphadenopathy. A biopsy shows caseating granulomas with Langhans giant cells

Answer 27

Tuberculous Lymphadenitis (Scrofula)

Question 28

22-year-old female presents with tender cervical lymphadenopathy, fever, and night sweats. A biopsy shows necrotizing lymphadenitis without neutrophils.

Answer 28

Kikuchi disease

Question 29

A 12-year-old boy develops a tender, swollen axillary lymph node two weeks after being scratched by a stray cat. Lymph node biopsy shows stellate granulomas with central necrosis.

Answer 29

Cat Scratch Disease

Question 30

A 60-year-old male presents with painless, generalized lymphadenopathy for several months. A lymph node biopsy shows nodular proliferation of small B cells and BCL2 overexpression.

Answer 30

Follicular lymphoma

Question 31

A 10-year-old boy from Africa presents with a rapidly growing jaw mass. Histopathology shows a starry sky appearance, and FISH reveals t(8;14) translocation.

Answer 31

Burkitt Lymphoma

Question 33

How is lymphadenitis classified ?

Answer 33

Acute lymph adenitis . Chronic lymph adenitis.

Question 34

Causes of acute lymph adenitis

Answer 34

FB Microbial infection.

Question 35

Chronic lymph adenitis

Answer 35

Persistent acute lymph adenitis Malignancy

Question 36

Histopath finding of TB

Answer 36

Giant cell - horse shoe shaped .

Question 37

Lymphoma

Answer 37

Malignant inspite of OMA

Question 38

Cells involved in lymphoma

Answer 38

Proliferation of Histiocytes Lymphocytes Their precursors

Question 39

Lymphocytes Proliferation in organ ? Proliferation in peripheral ?

Answer 39

Lymphoma - organ Lymphocytosis - peripheral blood

Question 40

Histiocytosis

Answer 40

Macrophages

Question 41

Layer of lymph node involved in sinus histiocytosis …

Answer 41

Subcapsular sinus

Question 42

Conditions involving sinus histiocytosis ….

Answer 42

Carcinoma Reactive conditions Rosai-Dorfman Disease

Question 43

Rosai-Dorfman Disease

Answer 43

Sinus Histiocytosis with Massive Lymphadenopathy

Question 44

Type of spread in Hodgkin lymphoma.

Answer 44

Orderly spread .

Question 45

What is the key marker for Hodgkin lymphoma?

Answer 45

CD15 and CD30 positive (Reed-Sternberg cells).