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Cellular Pathology > Lymphadenopathy > Flashcards

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
Q

What does the virchows node drain

A

Upper GIT

26
Q

What are the causes of a large infraclavicular lmph node

A

Hodgkins lymphoma

27
Q

Where are mediastinal lymph nodes located

A

In the mediastinum

28
Q

Can you see the enlargement fo mediastinal lymph nodes

A

No becuase its in the mediastinum

29
Q

Can you see the sings of large mediastinal lymph nodes

A

Yes

30
Q

What are the signs of large mediastinal lymph nodes

A

Enlarged vessels on the chest which results in the obstruction of the superior vena cava

31
Q

What are causes of large mediastinal lymph nodes

A

Sarcoidosis
Lymphoma
Tb

32
Q

What structures do the axillary lymph nodes drain

A

Breast and skin

33
Q

What are the causes of large axillary lymph nodes

A 
Breast cancer
Skin infection 
Cat scratch disease
Melanoma 
Lymphoma 
Silicone leak 
Tattoo reaction
34
Q

What structures do the inguinal lymph nodes drain

A 
Penis 
Scrotum 
Vulva 
Anus 
Perineum 
Inner thigh
External genitalia
35
Q

What structure does the inguinal lymph nodes not drain

A

Testcile

36
Q

What are the causes of increased inguinal lymph ndoe

A 
Cellulitis 
Venereal disease
Lymphoma 
Melanoma 
Scc
37
Q

Whar are the dew conditions where lymphadenopathy is large

A 
Dermatopathic lympahdenopathy
Silicone reaction 
Progressive transformation of germinal centres
HIV lymphadenitis 
Tb
38
Q

What is dermatopathic lymphadenopathy

A

Lymph node reaction to cutaenous changes in the draining area , langerhan cells react to skin changes

39
Q

What is progressive transformation of germinal centres

A

Abnormal immune reaction that is self resolving

40
Q

What are the non neoplastic diseases with lymphoma like clinical presentation

A

Kikcuhis lymphadenitis
Infectious mononucleosis
SLE
HIV

41
Q

What is kikcuhis lymphadenitis

A

Necrotising histiocytic lymphadenitis due to an unkown autoimmune reaction

42
Q

How do we investigate infectious mononucleosis

A

Monospot test

43
Q

What is the most important test in investigation for lymphadenopathy

A

Full blood count with WBC differential

44
Q

What radiological examination can be carried out

A

Ultrasound

Ct scan

45
Q

What does ultrasound help to look at

A 
Shape
Measurement
Blood flow of the lymph node
Margins
Contents (helium, necrosis)
46
Q

If there is a localised regional lymph node with low risk of malignancy what should you do

A

Have a 3/4 week observation

47
Q

For generalised lymphadenopathy what should you do

A

Not wait and carry out a biopsy

48
Q

What is the gold standard biopsy

A

Excision biopsy

49
Q

During biopsy which node should be targeted

A

Abnormal and largest

50
Q

If excision biopsy is not possible what are the other types of biopsy that can be carried out

A

Core needle biopsy

Incision biopsy

51
Q

What is a fine needle biopsy and what does it collect

A

Collects cells and not tissue

52
Q

What do we do when we excise a tissue

A
  1. Stain it
  2. Apply immunohistochemistry- to detect an antigen
  3. FISH
  4. Other molecular studies

Cellular Pathology (19 decks)

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