4: Investigation of lymphadenopathy

Question 1

What is lymphadenopathy?

Answer 1

Enlarged lymph nodes

Question 2

Is lymphadenopathy the same as lymphoma?

Answer 2

No

Question 3

What causes lymphadenopathy?

Answer 3

Infection

Malignancy (lymphoma or metastatic disease)

Connective tissue diseases

Question 4

What are some B symptoms which accompany lymphoma?

Answer 4

Night sweats

Weight loss

Fever

Question 5

What are some symptoms specific to Hodgkins lymphoma?

Answer 5

Itch without a rash

Alcohol-induced pain

Question 6

Which investigation is carried out to exclude lymphoma?

Answer 6

Lymph node biopsy

Question 7

What are the patterns of lymphadenopathy seen in

a) bacterial
b) viral infection?

Answer 7

a) Regional enlargement

b) Generalised enlargement

Question 8

Which virus causes glandular fever?

Answer 8

EBV

Question 9

Glandular fever causes ___ lymphadenopathy.

Why?

Answer 9

Generalised lymphadenopathy

EBV (viral) infection

Question 10

Malignancy causes ___ lymphadenopathy.

Answer 10

regional

but can also refer to weird places

Question 11

What is a specific lymphadenopathy seen in some apical lung cancers?

Answer 11

Virchow’s node (supraclavicular) enlargement

Question 12

Viral lymphadenopathy is an inflammatory process - true or false?

Answer 12

False

Question 13

Bacterial lymphadenopathy is an inflammatory process - true or false?

Answer 13

True

Question 14

What are some properties of malignancy lymphadenopathy?

Answer 14

Non-tender

Hard

Irregular

Tethered - invading local tissue

Question 15

How is lymphadenopathy investigated?

Answer 15

Whole node biopsy

Question 16

Can lymphoma be diagnosed by imaging?

Answer 16

No

Question 17

What is meant by reactive lymphadenopathy?

Answer 17

Enlarged lymph nodes in response to infection

Question 18

What lymph node structures enlarge in response to infection, malignancy or connective tissue disease?

Answer 18

Follicles

because the B cells are activated

Question 19

Immunohistochemistry is similar to immunophenotyping - what is the difference?

Answer 19

Immunophenotyping - fluorescent tags

Immunohistochemistry - chemical stains

Question 20

Non-Hodgkins lymphoma cells are ____ positive.

Answer 20

CD20+

Question 21

Which specific cells are seen in Hodgkins lymphoma?

Answer 21

Reed-Sternberg cells

presence of these is the criteria for calling it Hodgkins as opposed to Non-Hodgkins

Question 22

Which drug can be given to treat Non-Hodgkins lymphoma?

Answer 22

Rituximab

B cell inhibitor

Question 23

Non-Hodgkins lymphoma is ___ positive.

Answer 23

CD20+

Question 24

Which genetic analysis can be used to identify the specific type of lymphoma?

Answer 24

FISH

Question 25

How does **rituximab** work? Which type of lymphoma is it used to treat?

Answer 25

**Binds to CD20 and induces apoptosis** **Non-Hodgkins lymphoma**

Question 26

Which **grade of lymphoma** is curable using **chemotherapy**?

Answer 26

**High grade lymphoma only**

Question 27

What is a **specific, highly aggressive Non-Hodgkins lymphoma?**

Answer 27

**Burkitt's lymphoma**

Question 28

Which type of lymphoma **doesn't respond** **to chemotherapy** but is **high grade?**

Answer 28

**Mantle cell lymphoma**