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Haematology > Lymph nodes and spleen > Flashcards

Lymph nodes and spleen Flashcards

1
Q

what are the sites of primary lymphoid tissue

A

bone marrow and thymus

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2
Q

what are the sites of secondary lymphoid tissue

A 
lymph nodes 
spleen 
tonsils 
epitheliolymphoid tissue 
bone marrow
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3
Q

what are the functions of the lymphatic system

A

returns lymph to circulation in fluid homeostasis - prevents oedema
permits cell traffic and trapping
protective function

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4
Q

how can lymph node groups be examined

A

palpated in examination

radiologically

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5
Q

what are lymph nodes

A

small oval bodies located along the course of lymphatic vessels

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6
Q

what are lymphatic vessels

A

blind ending vascular channels that collect fluid and drain it to circulation
allow for passive movement of fluid
have valves to ensure unidirectional flow

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7
Q

afferent/efferent channels enter the lymph node

A

afferent channels bring lymph fluid into lymph nodes

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8
Q

afferent/efferent channels exit the lymph node

A

efferent

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9
Q

where do efferent channels drain

A

cisterna chyli / thoracic duct

Left or Right: jugular/subclavian/bronchomediastinal trunks

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10
Q

where does all lymph eventually drain to

A

left venous angle - thoracic duct (3/4 of body)

right venous angle - right lymphatic duct

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11
Q

what is contained at the hilum of lymph nodes

A

arterial and venous vessels

efferent channel

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12
Q

lymph is filtered through node parenchyma before entering the bloodstream true or false

A

true

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13
Q

the lymphoid system regulates the adaptive/innate immune system

A

adaptive immune system

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14
Q

which cells link the adaptive and innate immune systems

A

Antigen Presenting Cells APCs

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15
Q

which cells are found in lymph nodes

A 
B cells - cortex 
T cell - paracortex 
Plasma cells - medulla 
macrophages, APCs, DCs 
endothelial cells
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16
Q

what is the difference between primary and secondary follicles in lymph nodes

A

secondary follicles contain a germinal centre

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17
Q

what is lymphadenopathy

A

enlarged lymph nodes

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18
Q

what are causes of lymphadenopathy

A

localised inflammation
systemic inflammation
malignancy: haematological and metastases
others: sarcoidosis, Castlemans disease, IgG4 related

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19
Q

what are local inflammatory causes of lymphadenopathy

A

infection
vaccination
dermatopathic

20
Q

what are systemic inflammatory causes of lymphadenopathy

A

viral infection

autoimmune conditions

21
Q

what is sarcoidosis

A

granulomatous condition

NOT a histological diagnosis

22
Q

where do all lymph vessels of the head and neck drain to

A

deep cervical lymph nodes

23
Q

what does generalised lymphadenopathy suggest

A

systemic inflammation or widespread malignancy

24
Q

In autoimmune conditions, there is a predominant B cell/T cell/Phagocytic response

A

B cell response

25
Q

When draining a tumour site, there is a predominant B cell/T cell/Phagocytic response

A

Phagocytic response

26
Q

In viral infections or use of certain drugs (phenytoin), there is a predominant B cell/T cell/Phagocytic response

A

T cell response

27
Q

what is the spleen

A

2ndary lymphoid tissue located in the LUQ of the abdomen

28
Q

is the spleen usually palpable

A

no

only if significantly enlarged

29
Q

the spleen is a very vascular structure, true or false

A

true!

30
Q

describe the vasculature of the spleen

A

tortuous splenic artery from coeliac axis

splenic vein drains into superior mesenteric vein then portal vein

31
Q

what is the function of the spleen

A

acts as a filter for blood, eliminates damaged/foreign materials
responsible in immune response to blood borne antigens

32
Q

what 2 components make up the spleen’s parenchyma

A

red pulp

white pulp - mainly T cells

33
Q

what makes up the red pulp in the spleen

A

sinusoids

cords: macrophages, fibroblasts, cells in transit

34
Q

what is white pulp comprised of

A

Peri Arteriolar Lymphoid Sheath PALS

–> CD4+ T cells

35
Q

what are symptoms of splenomegaly

A

dragging sensation in LUQ
eating discomfort
pain

36
Q

what is the triad for hypersplenism

A

splenomegaly
decrease in >=1 cellular component of blood
correction of cytopaenias following splenectomy

37
Q

causes of splenomegaly

A 
infection 
congestion 
haematological 
inflammation 
storage diseases 
miscellaneous
38
Q

what are infectious causes of splenomegaly

A 
EBV
TB
Malaria 
Typhoid 
Brucellosis 
Leishmaniasis 
Trypanosomiasis
39
Q

what are congestive causes of splenomegaly

A

Portal venous hypertension from:
liver cirrhosis
portal vein thrombosis
cardiac failure

40
Q

what are haematological causes of splenomegaly

A 
lymphoma 
leukaemia 
haemolytic anaemia 
ITP
Myeloproliferative disorders
41
Q

what are inflammatory causes of splenomegaly

A

SLE

Rheumatoid arthritis

42
Q

What storage diseases can cause splenomegaly

A

Gaucher’s

Niemann Pick

43
Q

What are miscellaneous causes of splenomegaly

A

amyloidosis
tumour
cysts

44
Q

what can cause hypersplenism

A

conditions that cause splenomegaly

45
Q

what can cause hyposplenism

A

sickle cell disease
coeliac disease
sarcoidosis
non-surgical iatrogenic

46
Q

why is hyposplenism clinically important

A

reduced immune function and so patients need regular vaccinations/immunisations

47
Q

what feature can be seen in reduced red pulp function

A

Howell Jolly bodies = basophilic nuclear remnants seen in RBCs

Haematology (26 decks)

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