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Haematology > Structure and function of lymph node and spleen > Flashcards

Structure and function of lymph node and spleen Flashcards

1
Q

name primary/central lymphoid structures

A

bone marrow and thymus

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2
Q

name secondary/peripheral lymphoid structures

A

lymph nodes
spleen
tonsils/adenoids
Peyer’s patch in intestine

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3
Q

lymphadenopathy causes

A

local inflammation
- infection
- others e.g. vaccination, dermatopathic

systemic inflammatory processes
- infection e.g. viral infections
- autoimmune/CT disorders

malignancy
- haematological - lymphoma/leukaemia
- metastatic

others
- e.g. sarcoidosis, Kikuchi’s lymphadenitis, Castlemans Disease; IgG4 related disease

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4
Q

how can internal lymph nodes be viewed

A

radiologically

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5
Q

give 2 examples of internal lymph node groups

A

mediastinal
para-aortic

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6
Q

what is the sentinel lymph node

A

the first lymph node to which cancer cells are most likely to spread
there may be more than one sentinel node

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7
Q

what is the sentinel lymph node identified by

A

dye or radioactive isotopes

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8
Q

afferent lymphatics penetrate the capsule (connective tissue surrounding the node) and drain into ________ ______

A

subcapsular sinus

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9
Q

flow of lymphatics (6 points)

A
  • Node is surrounded by connective tissue CAPSULE
  • AFFERENT LYMPHATICS penetrate the capsule and drain into SUBCAPSULAR SINUS
  • Lymph from subcapsular sinus percolates THROUGH THE NODE
  • Lymph enters MEDULLARY CORDS and SINUSES
  • Sinuses merge at HILUM and form EFFERENT LYMPHATICS
  • Lymph rejoins extranodal lymphatic circulation
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10
Q

lymphangitis

A

inflammation of your lymphatic vessels

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11
Q

what are the 3 important regions of lymph node

A

cortex
paracortex
medulla

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12
Q

lymph node cortex

A

Nodules of B lymphocytes arranged in follicles (primary / secondary)

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13
Q

lymph node paracortex

A
  • Mainly T lymphocytes
  • Forms the interfollicular tissue which surrounds follicles and extends out and merges with medulla
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14
Q

lymph node medulla

A

Cords and sinuses draining into hilum

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15
Q

what cell populations are in lymph nodes

A
  • B cells
  • T cells
  • Mononuclear phagocytes (macrophages), antigen presenting cells, and dendritic cells
  • endothelial cells
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16
Q

CD20 is a __-cell marker

A

B

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17
Q

CD3 is a __-cell marker

A

T

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18
Q

two types of follicles in a lymph node

A

primary
secondary

19
Q

primary follicles in lymph node

A

Small quiescent lymphocytes
Unstimulated
No germinal centre

20
Q

secondary follicles in lymph node

A

Activated follicles
Reactive
Germinal centre

21
Q

what are follicular dendritic cells

A

specialised antigen presenting cells in the follicle.
they are mesenchymal and form meshworks through the germinal centre

22
Q

in a follicle, antigen-antibody complexes are captured by _________ _________ ______(FDCs)

A

follicular dendritic cells

23
Q

in lymph node follicles, do B cells divide/clonal expansion in the light or dark zone

A

dark

24
Q

centroblast

A

proliferating B cell in dark zone of follicle in lymph node

25
Q

what will centroblast proliferate into

A

centrocyte

26
Q

positively selected B cells go one of 2 ways:

A

Reenter dark zone and keep proliferating (and expressing cMyc to regulate GC formation)
Differentiate into plasma cells
Differentiate into memory B cells

27
Q

what is a centrocyte

A

B cell in light zone
Will become either memory B cell or plasma cell

28
Q

what is in the lymph node medulla

A

Blood vessels
Sinuses
Medullary cords
- Plasma cells, B cells, macrophages

Medullary sinuses
- Histiocytes, reticular cells
- Lymph then drains into efferent vessels

29
Q

Granulomatous lymphadenitis

A

there are aggregates of histiocytes.
there is a wide differential diagnosis, e.g. sarcoidosis

30
Q

sarcoidosis

A

A granulomatous condition.
Systemic disease, requires clinical correlation

Sarcoid like reactions can also appear similar
May mask malignancy in a lymph node

31
Q

granulomatous inflammation - when caseous necrosis is present what are we thinking?

A

Infectious cause (Mycobacterial) until proven otherwise (TB bascially)

32
Q

what does generalised lymphadenopathy suggest

A

a systemic inflammatory / immunological process or widespread malignancy

33
Q

what are lymphomas

A

Malignant tumours derived from cells of the immune system

34
Q

what is the most common form of lymphoma

A

non hodgkins lymphoma

35
Q

what is the most common form of non hodgkins lymphoma

A

B cell lymphomas

36
Q

types of non hodgkins lymphoma

A

B cell
T cell

37
Q

hodgkin’s lymphoma prognosis

A

usually very good

38
Q

types of hodgkins lymphoma

A

classical

nodular lymphocyte predominant

39
Q

which is more common - non-hodgkins lymphoma or hodgkins lymphoma

A

non hodgkins

40
Q

where is the spleen located

A

Located high in the left upper quadrant of the abdomen

41
Q

spleen - two key aspects: __________ surface and ________ surface

A

diaphragmatic
visceral

42
Q

the spleen is a very vascular organ, true or false

A

true

43
Q

spleen vascular supply and drainage

A

supplied by splenic artery (branch of coeliac trunk) and drained by splenic vein (with superior mesenteric vein forms portal vein)

44
Q

splenic rupture (surgical emergency!) causes

A

trauma
a diseased spleen is more prone to rupture

Haematology (36 decks)

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