Lymphadenopathy Investigations

Question 1

causes of lymphadenopathy

Answer 1

lymphoma 
infection 
-bacterial (regional)
-viral (generalised) 
metastatic cancer 
connective tissue disease

Question 2

what are the general symptoms of lymphoma

Answer 2

night sweats 
weight loss
fatigue 
and itch without rash 
alcohol induced pain

Question 3

what are the characteristics of viral lymphadenopathy

Answer 3

tender
hard
smooth 
no inflammation 
not tethered 

generalised

Question 4

what are the characteristics of bacterial lymphadenopathy

Answer 4

tender 
hard 
smooth 
skin inflammation 
maybe tethered 

localised

Question 5

characteristics of lymphoma lymphadenopathy

Answer 5

non-tender
rubbery/soft 
smooth 
no skin inflammation 
no tethering

Question 6

characteristics of metastatic carcinoma lymphadenopathy

Answer 6

non-tender
hard
irregular surface 
no skin inflammation 
tethered

Question 7

investigation for suspected lymphoma or other malignancy

Answer 7

surgical biopsy

fine needle aspirate or core biopsy is often insufficient

Question 8

reasons for lymph node biopsy

Answer 8

exclude other cause

classification of lymphoma

Question 9

what is immunohistochemistry used for

Answer 9

confirms it is a lymphoma and helps to sub-classify

looks at antigens on the surface of lymphoma cells

Question 10

how is Hodgkin’s disease classified by immunohistochemistry

Answer 10

CD30 +ve Reed Sternberg Cells

Question 11

what is cytogenic analysis

Answer 11

specific pattern of chromosome abnormality in certain lymphomas

Question 12

how are lymphomas classified

Answer 12

Hodgkin’s lymphoma
-malignant proliferations of B cells

Non-hodgkin’s lymphoma

• any lymphoma which isn’t Hodgkins
• can be malignant B or T cells

Question 13

what are the two types of B cell non-hodgkins lymphoma

Answer 13

Low grade B cell

High grade B cell