Lymphadenopathy Flashcards
a ‘lump’: lymphadenopathy differentials
- infection (viral, bacterial)
- metastatic cancer e.g. breast, ovarian
- connective tissue disease (sarcoidosis); SLE
- lymphoma
lymphadenopathy general symptoms and causes
- night sweats: lymphoma, infection, menopause, too thick duvet
- weight loss: lymphoma, other malignancy, infections etc
would viral infection cause regional or widespread lymphadenopathy
widespread
approach to lymphadenopathy - questions to ask (6 points)
- is it regional or generalised?
- tender or not?
- hard or soft?
- surface smooth or irregular?
- is skin inflamed?
- is it tethered?
what is a lymphoma swollen node like
- surface smooth
- mobile
- soft
- rubbery
- non-tender
what investigation will we request if lymphoma or other malignancy is suspected in lymphadenopathy?
biopsy
- need a big sample, so fine needle aspirate or core biopsy is insufficient
can lymphoma be diagnosed by CT
no
how do we assess lymph node pathology (5 points)
- histology - microscopic appearances
- immunohistochemistry of solid node
- immunophenotyping of blood/marrow
- genetic analysis
- molecular analysis
some lymphoma diagnoses are apparent just on histology, true or false
true
what information does immunohistochemistry provide in the investigation of lymphoma
confirms is a lymphoma and helps to subclassify
immunohistochemistry - what cells are seen in follicular B cell Non Hodgkin’s Lymphoma?
CD20 +ve cells
immunohistochemistry - what cells are seen in Hodgkin’s Disease?
CD30 +ve Reed Sternberg cells
what is the purpose of molecular analysis in the investigation of lymphoma?
helps to further classify lymphoma and identify subtypes suitable for specific treatment
which is more common, B or T cell NHL
B
T cell NHL prognosis
bad, hard to treat
