Lymph Nodes & Lymphoma Flashcards
Where is lymph returned to the circulation?
Subclavian / jugular V junction
What is primary lymphoid tissue?
Marrow for B cell maturation THOUGHT THEY MATURED IN LN?
Thymus for T cell maturation
What is the dilated lower end of the thoracic duct at the inferior aorta called?
Cisterna chyli
What sides of the body are the thoracic duct and lymphatic duct on?
Left thoracic duct
Right lymphatic duct
What is the normal LN shape?
Oval
COULD GO IN A LOT MORE DETAIL HERE
How does bacterial lymphadenopathy feel / appear?
Local Tender Hard Smooth Inflamed skin
How does viral lymphadenopathy feel / appear?
Systemic
Tender
Hard
Smooth
How does lymphoma lymphadenopathy feel / appear?
Not tender
Rubbery / soft
Smooth
Local / widespread
How does lymphadenopathy due to a met feel / appear?
Not tender
Hard
Craggy irregular
Tethered
What primaries could a LN met be due to?
Any but more likely
Leukaemia
Ovary
Breast
Other than a viral or bacterial infection, or a malignancy, what else can cause lymphadenopathy?
Sarcoidosis
Connective tissue disorder
Autoimmune condition eg RA
What test can diagnose lymphoma?
Immunohistochemistry
How is lymphoma classified?
Hodgkin’s and NHL
What is used to differentiate Hodgkin’s and NHL?
Hodgkin’s is Reed Sternberg CD30+ present on immunohistochemistry
The presentation is more likely to be Hodgkin’s than NHL if:
- the age range is
- gender
- above/below diaphragm
- B S+S present/absent
The presentation is more likely to be Hodgkin’s than NHL if:
- the age range is YOUNG
- FEMALEgender
- ABOVE diaphragm
- B S+S PRESENT
Is a biopsy always indicated for lymphoma?
Yes
Need a big sample
How is NHL sub-divided? Which type is more common?
90% B cell
10% T cell
What type of NHL is associated with a t(11:14) mutation?
Mantle cell (bad prognosis)
What type of NHL is associated with a t(14:18) mutation?
Follicular
What type of NHL is more common in Africans with EBV infection and involves the marrow? It has a bad prognosis
Burkitt
How does lymphoma present?
Lymphadenopathy
Weight loss
Bad night sweats
What tests are done to stage lymphoma?
PET + CT
What is stage 1, 2, 3 and 4 lymphoma?
1 = 1 group of LN 2 = 2+ groups of LN 3 = above and below diaphragm 4 = effects organ
