Approach to Investigating Lymphadenopathy Flashcards
(12 cards)
What are causes of lumps?
Infection
Lymphoma
Metastatic cancer
Connective tissue disease e.g. SLE or sarcoidosis
What are general symptoms associated with lump?
Night sweats - infection, lymphoma, menopause, too thick a duvet / central heating
Weight loss - lymphoma, other malignancy, infections
How can we differentiate between the various diagnoses for lymphadenopathy?
Bacteria infection - regional
Viral infection - generalised
Metastatic malignancy
Lymphoma
In viral causes of lump - is it tender, consistency, surface, skin inflamed, tethered?
Tender - yes
Consistency - hard
Surface - smooth
Skin inflamed - no
Tethered - no
In bacterial causes of lump - is it tender, consistency, surface, skin inflamed, tethered?
Tender - yes
Consistency - hard
Surface - smooth
Skin inflamed - yes
Tethered - maybe
In a lymphoma cause of lump - is it tender, consistency, surface, skin inflamed, tethered?
Tender - no
Consistency - rubber / soft
Surface - smooth
Skin inflamed - no
Tethered - no
In a metastatic carcinoma cause of lump - is it tender, consistency, surface, skin inflamed, tethered?
Tender - no
Consistency - hard
surface - irregular
Skin inflamed - no
Tethered - yes
What biopsy is often needed for lymphoma?
Fine needle aspirate or core biopsy often insufficient
Need a larger lesion biopsy
Why can immunohistochemistry be helpful in lymphoma?
Confirming it is a lymphoma and helping sub classify
How does immunophenotyping work?
Use cells in liquid phase (blood or bone marrow)
Cells tagged with antibodies attached to a fluorochrome emits a specific colour of light when a laser is shone on it
How does cytogenetic analysis work?
Specific patterns of chromosome abnormality in certain lymphomas
G banding - aspirate node, grow cells in culture and look at spread of chromosomes
FISH - look for specific abnormalities in chromosomes using probs that emit a specific light colour
How can we classify lymphoma?
