Lymph Nodes & Lymphatics Flashcards

1
Q

lymph nodes

A

Secondary lymphoid organ – site of production of antibody and cell- mediated immunity

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2
Q

anatomy of lymph node

A
  • cortex (outside)
  • paracortex
  • medulla
  • primary and secondary follicles
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3
Q

secondary follicle

A
  • Ag arrives in afferent lymph vessel into subcap sinus and captured and processed by macs and DC
  • B cell and APC interaction activate and migrate to secondary follicle and initiate germinal center reaction

B lymphocytes that recognize the antigen for which they are expressing receptors are activated and proliferate

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4
Q

what does the paracortex contain?

A

mainly T cells, fewer macs and DCs

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5
Q

what does the medulla contain?

A
  • macrophages! lymphs, plasma cells
    antibody secreting plasma cells
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6
Q

medulla contains:
paracortex contains:
cortex contains:

A

medulla: plasma cells and macrophages
paracortex: T cells
cortex: B cells

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7
Q

how do the majority of lymphocytes enter the lymph node?

A
  • through high endothelial venuses (HEV)
  • afferent lymphatic vessels in capsule and drain to sinuses
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8
Q

where do the lymphatics exit the lymph node?

A

hilus, efferent lymph vessels

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9
Q

all lymph nodes receive (afferent/efferent) lymphatic areas from specific areas of the body

A

afferent

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10
Q

what is a lymphocenter?

A

group of nodes present in the same location and drains from same region

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11
Q

what is lymphangiectasia?

A

rare digestive disorder that causes abnormal lymph vessels in the small intestine. This prevents the small intestine from absorbing nutrients properly.

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12
Q

what are common pathologies associated with the lymph system?

A
  • intestinal lymphagiectasia/lymphangitis
  • lymphangiosarcoma
  • chylothorax
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13
Q

intestinal lymphangiectasia

A
  • most common cause of PLE
  • yorkies and norwegian lundehunds
  • chronic D+, wasting, hypoproteinemia, lymphopenia, hypocalcemia, hypocholesterolemia
  • peripheral edema, ascites, hydrothorax
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14
Q

what is the most common cause of protein-losing enteropathy?

A

intestinal lymphangiectasia

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15
Q

what is another cause of intestinal lymphangiectasia?

A

lymphatic obstruction and increased lymphatic pressure due to inflammation, neoplasia and granulomatous infiltrates

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16
Q

intestinal lipogranulomatous lymphangitis?

A
  • discrete form of lymphangiectasia
  • can occur as a mass in the distal jejunum or ileum
  • transmural granulomatous inflammation reacting to lipid rich fluid
    MACROPHAGES REACTING TO FLUID: GRANULOMATOUS INFLAMMATION FORMS WHITE MASSES
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17
Q

what is lymphangiosarcoma?

A

neoplasia of lymphatic endothelium
pretty uncommon, not well-defined mass and thus hard to remove

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18
Q

a 3 y/o pittie mix presents for edema mass/swelling on the cervical trunk and hind limbs. what is your suspicion?

A

lymphangiosarcoma

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19
Q

chylothorax causes and clinical signs

A

causes: idiopathic, neoplasia, trauma, CHF
clinical signs: difficulty breathing, coughing, difficulty on ausculation, atelectasis

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20
Q

what clinical finding can be seen with chylothorax? why?

A

lymphopenia due to loss of lymphocytes in blood

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21
Q

MALT

A

mucosal-associated lymphoid tissue

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22
Q

BALT

A

bronchus associated lymphoid tissue

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23
Q

GALT

A

gut associated lymphoid tissue

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24
Q

what are other locations of lymph nodules other than mucosa, bronchi, gut?

A

tonsils, nasal cavity, conjunctiva, urinary bladder
lymph nodes in the cecum and colon (peyer’s patches) are overlaid by FAE w numerous M cells

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25
what is FAE?
follicle-associated epithelium: lines lymph nodes in the cecum and colon (peyer's patches) some bacteria like this route to gain access to gi: salmonella, listeria, mycobacterium, yersinia
26
what do M cells do?
deliver antigens to dendritic cells > PP/MALT
27
what are hemal nodes?
like mini spleens! similar to lymph nodes but sinuses are filled with blood can filter blood and remove senescent erythrocytes
28
A dog presents with chronic diarrhea with no response to treatment. The dog has been losing weight with hypoproteinemia and on exploratory surgery you see multiple, irregular, nodular, white lesions along the serosal surface of the small intestine. Given your concern, what is the pathogenesis of gross lesions?
inflammation secondary to lipid rich fluid
29
what species are hemal nodes prominent in?
ruminants, but also found in horses and primates
30
what can cause lymph nodes to atrophy?
- primary immunodeficiency disease - lack of antigenic stim - viral infx - cachexia and malnutrition - aging - radiation
31
what are viral diseases that injure lymphoid tissue?
- parvovirus: dogs/cats - canine distemper virus - FIV - equine herpes 1 - BVDV - porcine circovirus 2 : inflammation of thymus!
31
what lymph nodes are generally larger in size? why?
mesenteric and oral processing antigens and bacteria from the intestinal tract
32
lymphofollicular hyperplasia
numerous prominent secondary follicles
33
paracortical hyperplasia
expansion of the paracortex
34
sinus histiocytosis
increased histiocytes in the sinuses
35
sinus hemosiderosis
increased hemosiderin laden macrophages and erythrophagocytosis
36
sinus edema or erythrocytosis
expanded sinuses by edema or RBC
37
What is a cause of lymph node atrophy/injury * A) Equine infectious anemia * B) Ehrlichia * C) Parvo virus * D) Bovine Leukosis Virus
parvovirus
38
acute lymphadenitis
lymph nodes draining sites of infection - red and edematous can have capsule, necrosis and lymphangitis - culture for bacteria, examine impression smears for bacteria, histopathology
39
what is the main cause of lymphadenomegaly in cats?
YERSINIA PESTIS - THE PLAGUEEEE
40
yersinia pestis
- plague and lymphadenopathy in cats! * Gram neg coccobacillus * Natural cycle between rodents and their fleas * Squirrels, prairie dogs, rabbits, wood rats * Eating infected animal or bite by an infected flea * Fever, loss of appetite, lethargy, enlarged lymph nodes * Rapid progressing – start treatment early * Public health issues - zoonotic
41
is yersinia pestis gram - or +
negative
42
what are clinical signs of yersinia pestis?
fever, loss of appetitie, lethargy, enlarged lymph nodes
43
is yersinia pestis zoonotic?
yes
44
what are the 3 types of plague?
* Bubonic –fever, headache and swollen lymph nodes * flea/rodent transmission * Septicemic – fever, shock, hemorrhage * enter through break in skin * Pneumonic – fever, headache, pneumonia * air droplets
45
what bacteria can cause lymphadenitis?
* Yersinia Pestis * Mycobacterium avium ssp paratuberculosis * Rhodococcus Equi * Streptococcus Equi ssp. Equi
46
what fungus can cause lymphadenitis?
histoplasmosis
47
cause of strangles
streptococcus equi subsp equi
48
how does strangles affect the lymph nodes?
- retropharyngeal enlargement from LN abscesses and compressed pharynx - may spread blood or lymph to other organs: bastard strangles - purpura hemorrhagica is a type 3 hypersensitivity, may lead to necrotizing vasculitis with repeated exposure
49
what 2 equine diseases cause significant damage to the lymph system?
- strep equi subsp equi (strangles) - rhodococcus equi
50
rhodococcus equi
- foals up to 6 months - bronchopneumonia - 50% of foals develop pyogranulomatous ulcerative enteroptyphlocolitis of peyer's patches - pyogranulomatous lymphadenitis of mesenteric and colic lymph nodes - pyogranulomatous inflammation with phagocytized bacteria
51
A buffalo presents for necropsy * The animal showed chronic wasting * The intestine had a thickened mucosa (see below) * On histopathology there were aggregates of epithelioid macrophages and multinucleated giant cells * There are acid-fast staining bacilli within epithelioid macrophages Gross findings in GI: chronic, proliferative enteritis top differential?
Johne's disease! mycobacterium avium paratuberculosis
52
johne's disease
mycobacterium avium paratuberculosis - enteritis and granulomatous lymphadenitis - bacteria are acid fast and within macrophages - sheep and goats may have granulomas with necrotic caseous centers and mineralization
53
what is bovine tuberculosis?
- mycobacterium bovis - lymph nodes necrotic and suppurative/abscessed - chronic progressive disease - humans infected by consuming raw milk products
54
A sheep presents with an abscess in the neck * The sheep was sheared recently * The abscess appears encapsuled and contains greenish thick, opaque, fluid * Another sheep in the herd has had similar more long standing clinical signs * The mandibular lymph node is enlarged (4 cm in diameter) * Contents are thick and inspissated and tan to white morphologic diagnosis and possible cause?
- suppurative lymphadenitis - corynebacterium psuedotuberculosis
55
T/F: humans cannot get bovine tuberculosis
false- can get by consuming raw milk products
56
what bacteria causes lymphadenomegaly - specifically caseous lymphadenitis in ruminants?
corynebacterium pseudotuberculosis - gram + intracellular bacterium - horizontal transmission - enters thru skin wounds, drains to regional lymph nodes, then disseminates to lymph and blood - purulent to inspissated (thickened) - can cause internal abscessation and chronic wasting
57
what causes postweaning multisystemic wasting syndrome?
porcine circovirus 2
58
what does porcine circovirus 2 cause in pigs?
- postweaning multisystemic wasting syndrome - enlarged lymph nodes, interstitial pneumonia and poor body condition - lymphoid depletion with granulomatous inflammation with multinucleated giant cells and cytoplasmic inclusion bodies - thymus: atrophy: granulomatous inflammation, viral inclusions - severe wasting and stunted growth
59
what virus causes atrophy of the thymus?
porcine circovirus 2
60
what is PRRS?
porcine reproductive and respiratory syndrome virus - arterivirus with predilection for lymphoid tissues - virus replicates in macrophages of lymphoid tisues and lungs and may persist in tonsil and lung macrophages - interstitial pneumonia and generalized lymphadenopathy - tracheobronchial and mediastinal - lymph nodes can be hemorrhagic or enlarged pale tan