Lymphatic System Flashcards
Role of lymphatic system?
Maintain fluid balance within tissues
Absorb and carriage of water soluble fats from intestine
Protection of the body through generation of immune response
Components of lymphatic system?
Lymphatic vessels
Lymph nodes
Spells
Thymus
What is the cisterna Chyli?
Sac on Right side L1/2 and receives lumber and intestinal lymph trunks
Where does most lymph drain into?
The left lymph duct (lower limbs, and left upper limb)
Where does the right upper lymph drain into?
Into the right lymph duct
Role of lymph node?
Allows interaction of antigen, APC and Lymphoid cells in generation of immune response
Lymph nodes all around body
Symptoms that suggest lymphadenopathy?
Tenderness and pain in the lymph nodes
Swelling >1cm of concern
Role of spleen?
Traps and presenting antigens in circulating blood
Culling of old red cells
Symptoms of splenomegaly?
-typically, won’t present with any
- Pain or fullness in left upper belly that can spread to left shoulder
- Feeling of fullness without eating much – spleen presses on stomach
- Hypersplenism – low RBC anaemia, becomes overactive, removes too many RBCs
- Frequent infections
- Bleeding easily
- Becomes palpable – even easily visible if serious
- Can rupture if not treated – life threatening
What size should be spleen be?
Less than 12cm
Infective causes of splenomegaly?
B - TB, endocarditis
V - Infective mononucleosis
P - Malaria, leishmaniasis
Other causes of splenomegaly?
Haem - Haemolytic anaemia
Immunological - RA, sarcoidosis
metabolic - Rare inherited enzyme deficiency, Gauchers
Vascular - Portal hypertension (cirrhosis)
Neoplastic - lymphoma, leukaemia, myeloproliferative disorders
Causes of lymphadenopathy?
Infective - bacterial infection/ infective mononucleosis/ TB/ HIV
Neoplastic - primary (lymphoma) secondary (mets)
Immunological - sarcoidosis, RA
Metabolic - thyrotoxicosis
Drugs - phenytoin, penicillin, allopurinol
What are the two main groups of lymphoma?
Hodgkin and non-Hodgkin
Describe Hodgkin lymphoma
Characterised by proliferation of atypical lymphoid cell
Half of cases triggered by EBV
Describe two types non-Hodgkin lymphoma
High grade (fast growing)
Low grade (slow growing)
Difference between Hodgkin and non Hodgkin lymphoma?
HL - tend to present earlier in malignancy
NHL - later presentation
HL - spread to nodes in contiguous manner
NHL - more haphazard spread
NHL - extra nodal sites more common
Describe disease staging of lymphoma?
Stage 1 - one lymph node group involved
s2 - two node groups involved on same side of diagram
S3 - more than 2 node group on different sides of diaphragm
S4 - mets lymph (bone marrow involvement and liver)
Best way to stage lymphoma?
PET scan to see the glucose uptake(metabolic activity) of the nodes
