October 5, 2015 - Clinical Cases in Lymphadenopathy Flashcards

1
Q

Key Features to Assess on Lymph Node

A

Location: consider drainage area

Size: abnormal is generally >1 cm

Consistency: hard may be carcinoma, rubbery may be lymphoma, fluctuant may be infectious

Fixation: normal nodes are freely mobile

Tenderness: often inflammatory, but may be malignant

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2
Q

Localized vs Generalized/Diffuse

A

Localized is 1 or 2 lymph node groups enlarged

Diffuse is multiple

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3
Q

Hodgekin’s Lymphoma

A

Is a malignancy of the lymphoid tissue characterized by the presence of the malignant Reed-Sternberg cell. It always originates in a lymph node and spreads through adjacent lymphoid tissues.

Neoplastic cells only account for 1-2% of the cellular composition.

EBV is present in 50% of cases. This causes rapid division and increased chance for mutations to occur.

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4
Q

Reed-Sternberg Cell

A

A hallmark of Hodgkin’s Lymphoma.

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5
Q

Treatment for Neoplastic Lymphadenopathy

A

Surgery for diagnosis, but it is not enough for a cure.

Chemotherapy and radiation are used to eliminate all cells.

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6
Q

Polyclonal vs Monoclonal

A

Polyclonal is reactive

Monoclonal is malignant

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7
Q

Classical Hodgekin’s Lymphoma

A

Presentation in a bimodal age distribution.

Mostly presents as cervical lymphadenopathy.

Night sweats, weight loss, lack of appetite.

On exam, soft, rubbery, mobile, non-tender lymph nodes.

Spreads in an orderly fashion.

One of the few curable cancers.

Has the Reed-Sternberg cells.

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8
Q

Non-Hodgekin’s Lymphoma

A

Most common subtypes are diffuse large B-cell lymphoma, follicular lymphoma, and chronic lymphocytic leukemia (CLL).

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9
Q

Burkitt’s Lymphoma

A

Often in humid, malarial regions of Africa.

Presents as a huge swelling around the jaw.

Linked to EBV.

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