Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Blood > Lymph Nodes, Spleen & Thymus pathology > Flashcards

Lymph Nodes, Spleen & Thymus pathology Flashcards

1
Q

What are primary immune organs?

A

Sites of initial maturation -> immune competent cells
- bone marrow (for B cells)
- thymus (for T cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are secondary immune organs?

A

Sites of antigen driven replication and differentiation into committed effector cells
- lymph nodes
- spleen
- Mucosal Associated Lymphoid System (MALT) -> lymphoid cells lining the respiratory and GI tracts
- everywhere else

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which part of the lymph node does metastatic cancer usually go to?

A

Subcapsular sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Eg of non neoplastic lymph node pathology

A

Infective
- acute non-specific lymphadenitis -> staphylococcus
- granulomatous inflammation
- mycobacterium
- fungal infection
- cat-scratch
- lymphogranuloma venereum
- sarcoidosis
-viral
infectious mononucleosis

Necrotising lymphadenitis (Kikuchi’s lymphadenitis)

Drug related lymphadenopathy

Autoimmune
- SLE
- RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Histological findings of mycobacterial infection

A

“Cheesy” yellow appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Histological findings of granulomatous inflammation

A

Langhans giant cells

Caseating necrosis

Multi-nucleated giant cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Eg of non-neoplastic pathology of lymph nodes

A

Candida

PCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Histological findings if candida is the cause

A

Pseudohyphae

Spores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Trait seen in PCP

A

Boat-shaped cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Histological findings if CMV is the cause

A

Cytoplasmic inclusions

Nuclear inclusions

Owl’s eye inclusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Definition of lymphomas

A

Malignancies of the lymphoid system which primarily manifest themselves outside the bone marrow, at the sites of normal lymphoid homing
- lymph nodes
- spleen
- MALT
- anywhere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical presentation of lymphomas

A

Enlarging mass
- typically painless
- sites of nodal tissue
- lead to compression, infiltration of hollow organs -> pain, obstruction, perforation

Interference w/ normal organ fn
- solid organ infiltration -> kidneys, liver, bone marrow

Systemic symptoms
- fever
- night sweats
- weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to stage for lymphomas?

A

Stage 1
- involvement of single lymph node region/extralymphatic site

Stage 2
- involvement of 2/more lymph node regions on same side of diaphragm
- may include localised extralymphatic

Stage 3
- involvement of lymph node regions on both sides of the diaphragm
- may include spleen/localised

Stage 4
- everywhere
- diffuse extralymphatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the International Prognostic Index (IPI)?

A

Clinical tool to predict the prognosis of pts w/ aggressive NHL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is lymphomas classified?

A

Clinical behavior: aggressive vs indolent

Pathological diagnosis: WHO classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Traits of malignant lymphoma

A

High proliferation rate and cell death rate
- but proliferate&raquo_space;> death -> net proliferation
- large proliferation margin

More often localised at presentation

Shorter natural hist

Curable in some w/ aggressive therapy

All childhood lymphomas of this type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Traits of indolent lymphoma

A

Grow very slowly but cells don’t die
- small proliferation margin

Widespread at diagnosis

Prolonged natural hist

Currently incurable
- exceptions:
- localised disease
- marrow ablation w/ stem cell transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does clinical behaviour/natural hist of a disease mean?

A

It refers to usual course of development of a disease in the absence of treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Does pt with aggressive or indolent lymphoma have better response to treatment? Why?

A

Aggressive

Chemo targets rapidly dividing cells
- aggressive lymphoma divide very fast -> susceptible to chemo
- indolent -> slow-growing -> chemo don’t work very well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the principle of WHO classification of lymphomas?

A

Classification based on cell of origin: B, T, NK

3 major categories of lymphoid malignancies can be defined based on combination of morphology and cell lineage
- Non-Hodgkin lymphoma
- B cell neoplasms
- T/NK cell neoplasms
- Hodgkin lymphoma

Each disease is a distinct entity defined by a combination of
- clinical features
- morphology
- immunophenotype
- genetic/molecular features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is the pathological diagnosis of lymphomas made?

A

Multiparameter approach and integration of clinical features, histology, surface antigen expression and molecular features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the clinical features we look out for when diagnosing lymphomas?

A

Nodal vs extranodal

Primary site

Immune deficiency conditions
- eg: HIV+ pts -> Burkitt lymphoma

Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is morphology of a lymphoma?

A

Disruption of normal lymph node architecture
- growth pattern
- lymphoma cell size

Certain morphological features are characteristic of specific subtypes of lymphoma
- starry sky appearance in Burkitt’s lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is surface antigens expression?

A

Cluster of differentiation (CD) antigens/markers characteristic of specific subtypes of lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How is surface antigens expression detected?
Immunochemistry Flow cytometry
26
What are the diff markers of surface antigens expression?
Markers indicating cell of origin/lineage Markers characteristic of specific subtypes of lymphoma Markers of specific molecular abnormalities in specific subtypes
27
What are molecular signatures of lymphomas?
Certain DNA alterations characteristic of specific subtypes of lymphoma, usually translocations
28
Is diffuse large B cell lymphoma aggressive?
Yes
29
Clinical features of large B cell lymphoma
Most common non-hodgkin lymphoma (NHL) Disease of adults and children Presents w/ rapidly enlarging masses Curable w/ aggressive chemotherapy
30
Pathogenesis of large B cell lymphoma
No defining genetic abnormalities Several cytogenetic abnormalities associated w/ large cell lymphoma
31
Morphology of large B cell lymphoma
Diffuse infiltration of lymph node - cannot see follicles -> sheet of lymphoid cell -> diffuse growth pattern Large lymphoid cells
32
Surface antigens of diffuse large B cell lymphoma
B cell markers
33
Is Burkitt's lymphoma aggressive?
Yes
34
Clinical features of Burkitt's lymphoma
Disease of adults and children 3 subtypes - endemic (Africa) -> affect children, EBV+, jaw - sporadic (western countries) -> affect children and young adults, common site is ileocaecal region - immunodeficiency related -> HIV+ Very aggressive and rapidly fatal
35
Pathogenesis of Burkitt's lymphoma
t(8;14) -> upregulation of MYC oncogene (cell cycle regulation gene)
36
Morphology of Burkitt's lymphoma
Diffuse infiltration of lymph node High cell turnover -> attracts macrophages to phagocytose -> starry sky appearance
37
Surface antigens of Burkitt's lymphoma
Positive: - CD20 (B cell marker) - CD10 (follicle centre marker)
38
Molecular signature of Burkitt's lymphoma
t(8;14)
39
Is follicular lymphoma aggressive?
No
40
Clinical features of follicular lymphoma
Affects adults Usually widely disseminated at diagnosis, incl. bone marrow Will respond to gentle chemotherapy but will relapse - incurable short of bone marrow transplant, unless rare limited disease
41
Pathogenesis of follicular lymphoma
t(14;18)(q32, q21) - upregulates expression of anti-apoptotic protein Bcl2 -> immortalise lymphoma cells
42
Morphology of follicular lymphoma
Retain characteristic follicular (nodular) structure but monotonous accumulation of single cell type
43
Surface antigens of follicular lymphoma
Characteristic immunophenotype
44
Molecular signature of follicular lymphoma
Translocation detected by cytogenetics, FISH and/or polymerase chain rxn
45
Definition of classic Hodgkin lymphoma (CHL)
Lymphoid neoplasm composed of Reed-Sternberg cells (neoplastic) residing in an inflammatory (non-neoplastic) background, including lymphocytes, histiocytes, eosinophils and plasma cells
46
What is the basis of diagnosis of CHL?
Background rich in inflammatory cells, especially eosinophils Presence of Reed-Sternberg cells (lacunar cells)
47
What is the pattern of spread of CHL?
Contiguously via lymphatics
48
Treatment for CHL
Limited stage, low bulk (small tumor) disease treated w/ radiation therapy Higher stage, B symptoms treated w/ multi-agent chemotherapy +/- radiation therapy
49
Is CHL curable?
Yes
50
Why does CHL have a separate category in the classification sys?
Molecular studies indicate that the R-S cell in the majority of cases is an altered B cell -> HL is a type of B cell lymphoma but w/ a very diff biology from other types of B cell lymphoma
51
Tests to do if you suspect lymphoma
FNAC Biopsy - flow cytometry (fresh specimen) - histology - immunochemistry - cytogenetics (fresh specimen) - molecular tests
52
Tests to do if you suspect infection
FNAC Biopsy Culture Serology
53
What are the commonest organs where pri neoplasms metastasize?
Lymph nodes
54
What is the most impt prognostic indicator in cancer?
Lymph node metastasis
55
Pathologist role in LN metastases
Identify presence of tumor Microscopic type of tumor Identify source of metastatic tumor
56
What is the difference btw lymphomas and leukemia?
Lymphomas: - malignancies of the lymphoid sys which primarily manifest themselves outside the bone marrow, at sites of normal lymphoid homing - arise as discrete tumor masses Leukemias: - malignancies of hematopoietic sys which are primarily disorders of the bone marrow - present w/ widespread involvement of bone marrow - usually w/ large no. of tumor cells circulating in peripheral blood
57
Definitions of leukemia
Leukemic cells originate in bone marrow Leukemic cells usually spill from the bone marrow into the blood (may be seen in large no.) Leukemic cells may also infiltrate lymph nodes, liver, spleen and other tissues
58
What are the 3 main hematopoietic cell lines?
Erythroid series -> erythrocytes Myeloid series -> polymorphs Megakaryocytic series -> platelets
59
How is leukemia classified?
Acute leukemia -> aggressive Chronic leukemia -> slow growth, survival better in absence of treatment
60
Symptoms of acute leukemia
Result from suppression of normal marrow fn - anemia w/ accompanying fatigue - fever, usually reflecting an infection - bleeding, caused by thrombocytopenia - fatal within weeks if untreated
61
Symptoms of chronic leukemia
Non-specific symptoms - fatigue - weight loss - anemia - abnormal sensation in abdomen caused by splenomegaly - pts w/ untreated chronic leukemia usually survive much longer
62
Pathological characteristics of acute and chronic leukemias
Acute -> presence of immature, blast cells Chronic -> more mature and well-differentiated cells
63
Origins of lymphoid leukemia
Precursor of B/T lymphocyte
64
Origins of myeloid leukemia
Precursor of granulocytes, monocytes, erythrocytes/megakaryocytes
65
4 general classifications of leukemia
Acute lymphoblastic leukemia (ALL) Chronic lymphoid leukemia (CLL) Acute myeloblastic leukemia (AML) Chronic myeloid leukemia (CML)
66
How is the pathological diagnosis of leukemia made?
Clinical -> abnormal blood counts, symptoms and signs, sites of involvement Morphology -> indicate degree of differentiation/maturation; characteristic of specific subtypes of leukemia - not definitive Surface antigens -> certain Ab characteristic of specific subtypes of leukemia Molecular/genetic abnormalities -> certain DNA alterations are characteristic of specific subtypes of leukemia, usually translocations
67
Histological features of spleen
Red pulp - venous sinusoids - macrophages White pulp - arteries - T cells - B cells
68
Is spleen vascular or lymphoreticular?
Both
69
Fns of spleen
Filtration of unwanted elements of blood Major secondary organ in immune sys Source of lymphoreticular/hematopoietic cells Reserve pool and storage space
70
What is the key symptom in spleen diseases
Splenomegaly
71
Causes of splenomegaly
Infections - any infective agent that can cause blood-borne infection - transient, non-specific enlargements Congestion (portal hypertension) Lympho-hematogenous disorders - pri/sec lymphomas - splenic involvements by leukemias - anemias Immunologic-inflammatory conditions Storage diseases
72
What kind of tissue is the thymus?
Lymphoid tissue
73
What happens to the thymus as an individual ages?
Lymphoid tissue replaced by fat
74
Histological features of thymus
Lymphoid component Epithelial component Hassall corpuscles
75
What is the fn of the thymus?
T cell production
76
Pathology of thymus
Developmental disorders Thymic hyperplasias Myasthenia gravis Thymic (mediastinal) neoplsms

Blood (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions