Lymphoid

Question 1

Benign or Malignant LN?

Answer 1

Benign: tender, discrete, small, mobile, bilateral

Malignant: non-tender, discrete/matted, large, fixed to skin/underlying structures

Question 2

Causes of benign LN

Answer 2

Bacterial or viral infection (EBV)
Granulomatous infection (TB, bartonella henselae)
Autoimmune disease (SLE)
Drugs (antiepileptics)
Sarcoidosis

Question 3

Causes of malignant LN

Answer 3

Primary: NHL, HL
Secondary: metastasis from NPC, SCC, breast carcinoma

Question 4

Defining characteristic of HL

Answer 4

Reed Sternberg cell (owl eyes)

Question 5

Identifying primary tumours from LN metastasis

Answer 5

Type: carcinoma more likely through lymph, sarcoma via blood

Location of LN:
> upper cervical: nasopharynx, upper GIT
> supraclavicular: lung, breast
> inguinal: external genital organs, lower limbs

Immunohistochemistry: detect small tumour deposits to distinguish between primary and secondary tumour, use specific antibody markers to identify primary site

Question 6

Staging of lymphoma

Answer 6

Determine disease extent to determine therapy and prognosis

Based on physical/radiographic examination and bone marrow biopsy/aspiration to check for spread to bone marrow

B symptoms: fever, weight loss (>10% body weight loss), night sweats

TNM