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Lymphoreticular and haematopoeitic > Pathology of the LHS > Flashcards

Pathology of the LHS Flashcards

1
Q

Name the primary lymphoid organs

A

BM and thymus

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2
Q

Name secondary lymphoid organs

A

LNs, spleen and MALT

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3
Q

What is the origin of most pathology of the lymphoreticular system?

A

infection, immune-mediated disease, neoplasia

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4
Q

Name 3 thymic diseases

A
  • thymic hypoplasia
  • thymic lymphoma (cats)
  • thymoma (dogs)
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5
Q

Outline thymic hypoplasia

A
  • congenital/developmental (often associated with primary immunodeficiency e.g. X-linked SCID)
  • systemic viral lymphoid depleton (FeLV, FIV, CDV)
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6
Q

Outline feline thymic lymphoma

A
  • association with FeLV infection

- it is of immature TCs

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7
Q

CS - thymic lymphoma

A
  • dyspnoea*
  • anorexia
  • wt loss
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8
Q

Dx - thymic lymphoma

A
  • thoracic radiography (mass in anterior thorax, effusion)

- cytology of pleural fluid / FNAB

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9
Q

Tx - thymic lymphoma

A

Chemotherapy

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10
Q

Outline canine thymoma

A
  • neoplasia of thymic epithelial cells

- GSDs and labrador retrievers

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11
Q

CS - canine thymoma

A
  • dyspnoea
  • dysphagia
  • thoracic effusion
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12
Q

Dx - canine thymoma

A
  • thoracic radiography
  • ultrasound
  • cytology of fluid / FNAB
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13
Q

Tx - canine thymoma

A

sugical excision +/- chemotherapy

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14
Q

Px - canine thymoma

A

Good if tumour has not spread beyond thymic capsule (i.e. stage 1 without paraneoplastic disease)

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15
Q

What is canine thymoma associated with?

A

paraneoplastic syndromes (myasthenia gravis/ hypercalcaemia of malignancy)

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16
Q

How do lymphocytes enter LNs?

A

Via High Endothelial Venules (HEVs)

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17
Q

How do lymphocytes return to blood if they don’t recognise an antigen?

A

via the efferent lymphatic vessels and thoracic duct

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18
Q

T/F: antigen presenting cells (APCs) migrate into the LNs from teh tissues and present Ag to incoming TCs

A

True (so LNs trap foreign material and optimise exposure of lymphocytes to Ag)

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19
Q

Origin of effector TCs and Ab

A

both from plasma cells

20
Q

What happens to thoracic duct in chylothorax?

A

it is damaged, perforated or eroded (often by a tumour) and the ‘efferent’ lymph leaks out into thoracic cavity

21
Q

CS - chylothorax

A
  • compromised respiratory function

- disrupted migratory pathway of lymphocytes leading to a lymphopaenia

22
Q

What happens when malignant cells attempt to metastasise via lymphatics?

A

the can become trapped in drainage LNs, establishing secondary sites of tumour formation: e.g. tonsillar SCC, MCT and malignant melanoma

23
Q

Define lymphadenopathy

A

LN enlargement

24
Q

What should you determine when lymphadenopathy has been identified?

A

if:

  • localised (regional disease)
  • generalised (systemic disease - is spleen enlarged too?)
25
Q

2 most common causes of enlarged LNs

A
  • infection

- neop;asia

26
Q

Diagnosis of generalised lymphadenopathy

A 
HAEMATOLOGY:
- lymphopaenia suggests viral infxn
- neutrophilia with left shift suggests bacterial infxn
- eosinophilia suggests parasitic infection or allergy
LYMPH NODE BIOPSY:
- FNAB
- Core biopsy (TruCut)
- Excisional biopsy
27
Q

Ddx - generalised lymphadenopathy

A
  • Reactive LN
  • lymphadenitis
  • primary neoplasia (lymphoma)
  • secondary neoplasia (metastasis)
28
Q

Describe reactive LN histopathology

A

normal architecture with increased cellularity. secondary follicles with germinal centres.

29
Q

Describe lymphadenitis histopathology

A

active infection within the LN itsel. Similar to reactive LN except areas of pyogranulomatous inflammation often present. Can be subdivided into suppurative, caseous or granulomatous.

30
Q

Describe primary neoplasia histopathology

A

usually complete lack of normal architecture. Large numbers of abnormal lymphocytes present.

31
Q

Describe secondary neoplasia (metastasis) histopathology

A

areas of normal lymphoid tissue infiltrated by neoplastic cells (focal or diffuse)

32
Q

Cause of strangles

A

Streptococcus equi

33
Q

Cause of caseous lymphadenitis (sheep, goats)

A

Corynebacterium pseudotuberculosis

34
Q

Cause of granulomatous lymphadenitis

A

Mycobacterium (TB/ Johne’s), many macrophages in these lesions

35
Q

T/F: mast cells are not usually found in LN

A

True

36
Q

List types of spleen pathology

A
  • trauma/ rupture/ haematoma (e.g. RTA)
  • torsion
  • infarcation (Classical Swine Fever)
37
Q

What to determine with spleen pathology

A

Diffuse or nodular?

38
Q

Ddx - diffuse splenomegaly

A
  • Venous congestion
  • Lymphoid hyperplasia
  • Systemic amyloidosis
  • Neoplasia (lymphoma, myeloma)
39
Q

Causes of venous congestion causing diffuse splenomegaly

A
  • following torsion

- post-mortem artefact following barbiturate administration

40
Q

Cause of lymphoid hyperplasia causing diffuse splenomegaly

A

systemic infectious/ inflammatory/ I-M disease

41
Q

Ddx - nodular splenomegaly

A
  • nodular hyperplasia (incidental in older animals)
  • abscess / cyst (infectious agent)
  • primary neoplasia (lymphoma, haemangioma, HSA)
  • metastatic disease (e.g. MCT)
42
Q

Which viruses particularly impact on the lymphoreticular system?

A
  • Malignant Catarrhal fever (a herpes virus)
  • Classical Swine Fever
  • FeLV/ FIV/ Canine distemper virus
  • EIA
43
Q

Describe classical swine fever (CSF)

A
  • notifiable
  • CS: pyrexia, diarrhoea, petechial haemorrhages (classically splenic infarcts), neuro signs
  • CAUSE: last in Norfolk 2000 d/t imported infected meat
44
Q

Which bacteria particularly impact on the lymphoreticular system?

A
  • Bacillus anthracis (Anthrax)
  • Streptococcus equi (Strangles, suppurative lymphadenitis)
  • Corynebacterium pseudotuberculosis (caseous lymphadenitis)
  • Mycobacterium boviis (TB) / M. avium paratuberculosis (Johne’s, granulomatous lymphadenitis)
45
Q

Name 4 protozoa which particularly impact on the lymphoreticular system

A
  • leishmaniosis
  • babesiosis
  • ehrlichiosis
  • theileriosis
46
Q

Describe Bacillus anthracis (anthrax)

A
  • DON’T PME but notify the APHA
  • UK notifiable
  • ruminant sudden death with haemorrhage from orifices, splenomegaly
  • pigs/ horses have a more protracted illness

Lymphoreticular and haematopoeitic (21 decks)

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