lymphadenopathy Flashcards
presentation of viral lymph node
tender, hard, smooth
no inflamed skin
not tethered
presentation of bacterial lymph node
tender, hard, smooth
skin inflamed
might be tethered
presentation of lymphoma
non-tender, rubbery soft, smooth
no inflamed skin and not tethered
presentation of metastatic carcinoma
non-tender, hard, irregular surface
skin not inflamed
tethered
nodular sclerosing on histology
hodgkin’s lymphoma
Reed-Sternberg cells CD30+ve
hodgkin’s lymphoma
CD20+ cells in follicular B cell
non-hodgkins lymphoma
risk factors for hodgkin’s lymphoma
immunosuppression (HIV\, inherited immunodeficiency)
autoimmune disorders, RA, sarcoidosis
EBV
family history
burkitt lymphoma
non-hodgkin lymphoma
associated with EBV, malaria and HIV
MALT lymphoma
non-hodgkins lymphoma
affects the muscos-associated lymphoid tissuem usually around the stomach associated with H.pylori infection
diffuse large B cell lymphoma
non-hodgkin lymphoma often presents as a rapidly growing painless mass in over 65s
presentation of lymphoma
lymphadenopathy: rubbery and non-tender, sometimes pain when they drink alcohol
fever, night sweats and weight loss
itch without rash
breathlessness and cough if other symptoms involved
investigations for hodgkins lymphoma
LDH raised (not specific)
certain blood results: raised ESR and low HB > poor prognoses in HL
lymph node biopsy is the key diagnostic test
CT, MRI and PET scans can be used for diagnosis and staging
what is a reed-sternberg cell
abnormally large B cells that have multiple nuclei that have nucleoli inside them
management of Hodgkin lymphoma
multi-agent chemotherapy +/- radiotherapy
- ABVD: adriamycin, bleomycin, vinblastine, dacarbazine
immunotherapy/stem cell transplantation is an option for patients not responding to chemo
