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Lymphadenopathy Flashcards

1
Q

What is the definition of lymphadenomegaly

A

Lymph node enlargement

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2
Q

What is lymphadenopathy

A

Abnormality of lymph nodes (size, shape, structure, cellular compositon, necrosis)

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3
Q

What is the definition of lymphadenitis

A

Inflammation of the lymph nodes

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4
Q

When is a lymph node considered as large

A

When you can see it
When you can feel it
When the short axis is more then 10mm

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5
Q

How do we measure lymph node enlargement

A

Using a ruler or ultrasound

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6
Q

What ratio of the long axis to short axis will suggest malignancy

A

1:1

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7
Q

What are the types of lymphadenomegaly

A

Localised
Regional
Generalised

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8
Q

What is localised lymphadenomegaly

A

One lymph node or one lymph node group

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9
Q

What is regional lymphadenomegaly

A

2 or more contigous regions are involved

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10
Q

What is generalised lymphadenomegaly

A

2 or more contigous regions e.g right neck and right inguinal are involved

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11
Q

What are the causes of lymphadenomegaly

A 
In situ proliferation of leukocytes 
Influx of lymphocytes 
Infiltration by neoplastic cells
Accumulation of abnormal substances 
Swelling due to necrosis of the lymph node
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12
Q

How should a lymphadenomegaly be treated

A

Shouldnt be treated until the cause is known

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13
Q

When should lymphadenomegaly by treated if its unknown

A

When the patient is suffocating due to upper airway obstruction by pharyngeal nodes

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14
Q

If there is localised/regional lymph nodes what should you do

A

Focus on drainage area

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15
Q

What do you do if there is generalised lymphademegaly

A

Haemtological tests

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16
Q

What are the non malignant causes of generalised lymphomegaly

A 
Hiv 
Infectious mononuceleosis
SLE
TB
Sarcoidosis
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17
Q

What symptoms will prompt us to think the lymphadenopathy is malignant

A

B symptoms
Unexplained generakised pruritus (itching)
Immunosupression
Unexplained skin rash with oedema
Lymph node pain with alcohol consumption- hodgkin lymphoma
Lower neck nodes and intra abdominal nodes palpable
Lymph node fixed to surrouding tissue
Painless lymphnode
Hard and large lymph node
Increased age

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18
Q

What are the causes of cervical lymph node enlargement

A 
Viral nasopharyngeal infection 
Pharygitis
Dental abscess
Ear infection 
Infectious mononuceloosis 
Head and neck cancer
Thyroid cancer
Lymphoma 
Tb
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19
Q

What is non tuberculosis myobacteria infection in children

A

This occurs in chilren with no immunodeficiency that predipose them to mycobacterial infection

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20
Q

How many lymph nodes does myobacterial infection affect

A

One lymph node

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21
Q

What is the histological appearance of non tuberculsos mycobacteria infection

A

Looks like tb

22
Q

What does the supraclavicular node drain

A

Thorax
Git
IGU tract

23
Q

What are the malignant causes of supraclavicular lymph node

A

Hodgkins lymphoma
NHL
Bronchial cancer

24
Q

What is the left supraclavicular node called

A

Virchows node

25
What does the virchows node drain
Upper GIT
26
What are the causes of a large infraclavicular lmph node
Hodgkins lymphoma
27
Where are mediastinal lymph nodes located
In the mediastinum
28
Can you see the enlargement fo mediastinal lymph nodes
No becuase its in the mediastinum
29
Can you see the sings of large mediastinal lymph nodes
Yes
30
What are the signs of large mediastinal lymph nodes
Enlarged vessels on the chest which results in the obstruction of the superior vena cava
31
What are causes of large mediastinal lymph nodes
Sarcoidosis Lymphoma Tb
32
What structures do the axillary lymph nodes drain
Breast and skin
33
What are the causes of large axillary lymph nodes
``` Breast cancer Skin infection Cat scratch disease Melanoma Lymphoma Silicone leak Tattoo reaction ```
34
What structures do the inguinal lymph nodes drain
``` Penis Scrotum Vulva Anus Perineum Inner thigh External genitalia ```
35
What structure does the inguinal lymph nodes not drain
Testcile
36
What are the causes of increased inguinal lymph ndoe
``` Cellulitis Venereal disease Lymphoma Melanoma Scc ```
37
Whar are the dew conditions where lymphadenopathy is large
``` Dermatopathic lympahdenopathy Silicone reaction Progressive transformation of germinal centres HIV lymphadenitis Tb ```
38
What is dermatopathic lymphadenopathy
Lymph node reaction to cutaenous changes in the draining area , langerhan cells react to skin changes
39
What is progressive transformation of germinal centres
Abnormal immune reaction that is self resolving
40
What are the non neoplastic diseases with lymphoma like clinical presentation
Kikcuhis lymphadenitis Infectious mononucleosis SLE HIV
41
What is kikcuhis lymphadenitis
Necrotising histiocytic lymphadenitis due to an unkown autoimmune reaction
42
How do we investigate infectious mononucleosis
Monospot test
43
What is the most important test in investigation for lymphadenopathy
Full blood count with WBC differential
44
What radiological examination can be carried out
Ultrasound | Ct scan
45
What does ultrasound help to look at
``` Shape Measurement Blood flow of the lymph node Margins Contents (helium, necrosis) ```
46
If there is a localised regional lymph node with low risk of malignancy what should you do
Have a 3/4 week observation
47
For generalised lymphadenopathy what should you do
Not wait and carry out a biopsy
48
What is the gold standard biopsy
Excision biopsy
49
During biopsy which node should be targeted
Abnormal and largest
50
If excision biopsy is not possible what are the other types of biopsy that can be carried out
Core needle biopsy | Incision biopsy
51
What is a fine needle biopsy and what does it collect
Collects cells and not tissue
52
What do we do when we excise a tissue
1. Stain it 2. Apply immunohistochemistry- to detect an antigen 3. FISH 4. Other molecular studies

Cellular Pathology (19 decks)

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