22. Pathology of nodal and bone marrow metastasis

Question 1

What drains to inguinal lymph nodes?

Answer 1

Lower 1/2 of GIT
Genitals
Melanoma of lower limb

Question 2

Why is it unusual to get a squamous cell carcinoma on the lower limb?

Answer 2

More likely to get one on head, neck or lower arms as they occur where the skin is uncovered

Question 3

What drains to supraclavicular lymph nodes?

Answer 3

Upper GIT

Bronchi

Question 4

What drains to cervical lymph nodes?

Answer 4

Oro and naso pharynx

Head and neck carcinoma

Question 5

What disease should be suspected in a 20-40 year old with an enlarged cervical node?

Answer 5

Hodgkin’s lymphoma

Question 6

What drains to axillary lymph nodes?

Answer 6

Breast

Question 7

How can a squamous metastasis be identified?

Answer 7

Keratin production

Question 8

How can gland metastasis be identified?

Answer 8

Mucin

Tubules

Question 9

What protein indicates epithelial tissue?

Answer 9

Cytokeratin

Question 10

What protein indicates connective tissue?

Answer 10

Vimentin

Question 11

What marker shows a neoplasm is lymphoid?

Answer 11

CD45

Question 12

What marker shows a metastasis a melanoma originally?

Answer 12

S100P

Question 13

Which cancers commonly metastasise to bone?

Answer 13

Breast
Prostate
Bronchus
Kidney 
Thyroid

Question 14

What general principles allow you to recognise a metastasis in bone?

Answer 14

Usually one spot
Stromal reaction (fibrosis, inflammation, necrosis)
Reticulin stain