Inflammatory disease Of Lymoh nodes

Question 1

What are the causes of Lymphadenopathy

Answer 1

M- Malignancy
I  - Infection 
A- Autoimmune 
M- Miscellaneous 
I.  - Iatrogenic

Question 2

What are two types of Reactive Hyperplasia Lymphadenopathy

Answer 2

Acute & Chronic
Local & Generalized

Question 3

Describe the morphology seen in follicular hyperplasia

Answer 3

germinal centres surrounded by mantle zone of small resting B cells

Question 4

The Histology of Reactive Hyperplasia depends on what five factors

Answer 4

Patient’s age
Immune capability 
Inciting factor
Past Exposure
Time/ Duration

Question 5

Reactive Hyperplasia Lymphadenopathy Histology taken before 8days of progression shows what type of cell Hyperplasia

Answer 5

Para cortical/Diffuse Hyperplasia (T cell)

Question 6

Reactive Hyperplasia Lymphadenopathy Histology taken after 15days of progression shows what type of cell Hyperplasia

Answer 6

Follicular Hyperplasia (B cell)

Question 7

List three types of Chronic Reactive Hyperplasia Lymphadenopathy

Answer 7

Follicular (B Cell)
Paracortical/ diffuse (T cell)
Sinus histiocytosis (macrophages)

Question 8

What are six diseases that cause Follicular Hyperplasia

Answer 8

SCRATCH
Syphilis
Cat Scratch
Arthritis
Toxoplasmosis
Castleman’s Disease
HIV

Question 9

What are the three patterns of Hyperplasia seen in HIV associated Lymphadenopathy

Answer 9

Pattern A - Acute: Explosive Follicular Hyperplasia
Pattern B - Chronic : Mixed
Pattern C - Burn out : Follicular Involution

Question 10

What is the aetiology of Castleman’s Disease (Giant Lymoh node hyperplasia)

Answer 10

Unknown Aetiology

Question 11

What are three histological types found in Castleman’s Disease (Giant lymph node Hyperplasia)

Answer 11

Hyaline vascular
Plasma cell
Overlap

Question 12

Describe the Histology “Hyaline Vascular” type of Castleman’s Disease (Giant lymph node Hyperplasia)

Answer 12

Localized
Mediastinal
Self limiting

Question 13

Describe the Histology “Plasma cell” type of Castleman’s Disease (Giant lymph node Hyperplasia)

Answer 13

Generalized 
Systemic Symptoms (fever, ^ ESR , ^ y-globulins, anaemia)

Question 14

List six causes of Diffuse Hyperplasia (Paracorticol) Lymphadenopathy - Tcell

Answer 14

Postvaccinial lymphadenitis
Infectious mononucleosis (EBV)
Angioimmunoblastic Lymphadenopathy
Herpes Zoster
CMV
Drugs (dilatin, penicillin, atenolol, allopurinol, gold)

Question 15

What are the prototypes for Postvaccinial Lympadenitis

Answer 15

Diffuse
Follicular
Combined

Question 16

Describe the Histology of Postvaccinial Lymphadenitis

A type of Diffuse Hyperplasia Lymphadenopathy

Answer 16

Increase in immunoblasts - mottled appearance

Vascular proliferation

Sinusoidal congestion

Plasma cells, eosinophils, mast cells

Question 17

Which virus causes Infectious Mononucleosis

Answer 17

Epstein-Barr Virus (EBV)

Question 18

What is the Histology seen in Infectious Mononucleosis (cause of Diffuse Hyperplasia )

Answer 18

Transformed cells
Reed Sternberg like giant cells
Capsular and pericapsular infiltration

Question 19

Which age group is more susceptible to Angioimmunoblastic Lymphadenopathy

Answer 19

Elderly

Question 20

What usually causes dermatopathic lymphadenitis

Answer 20

it is usually found in lymph nodes draining chronic inflammation

Question 21

What are the clinical features of Sinus Histiocytosis with massive Lymphadenopathy (SHML)

Answer 21

Massive Lymphadenopathy (bull neck)
Fever, ^ y- globulins

Question 22

SHML (Sinus Histiocytosis with massive Lymphadenopathy) is most susceptible in which group of people

Answer 22

Black children

Question 23

What is the Histology of SHML (Sinus Histiocytosis with massive Lymphadenopathy)

Answer 23

EMPERIPOLESIS (Histiocytic engulfment of lymphocytes)

Sinusoidal distention with histocytes

Medullary plasma cell infiltration

Capsular fibrosis

Question 24

What is the toxoplasmosis triad

Answer 24

Reactive follicular hyperplasia

Monocytoid B-cell reaction

Epithelioid histiocytic aggregates

Question 25

What is the name of the protozoan that causes Toxoplasmosis

Answer 25

Toxoplasma gondii

Question 26

Which animal is the definitive host of Toxoplasma gondii

Answer 26

Cats

Question 27

What are three major clinical Syndromes associated with Toxoplasmosis

Answer 27

Toxoplasma lymphadenitis Systemic Toxoplasmosis in immunodeficient pt Fetal Toxoplasmosis -(transplacental infection)

Question 28

Which nodes would you commonly see paracortical hyperplasia?

Answer 28

Axillary and Inguinal lymph nodes

Question 29

What is differential diagnosis for Dermatopathic Lymphadenopathy

Answer 29

Mycosis Fungodes

Question 30

What is the Histology of Dermatopathic Lymphadenopathy

Answer 30

Paracortical pallor | paracortical Hyperplasia

Question 31

What is the aetiology of Histiocytic Necrotizing Lymphadenitis ( Kikuchi Fujimoto)

Answer 31

Unknown proposed to be viral

Question 32

Which ethnicity is more susceptible to Histiocytic Necrotizing Lymphadenitis

Answer 32

Asian females

Question 33

What is the Histology of Histiocytic Necrotizing Lymphadenitis

Answer 33

Histiocytic cells | Atypical lymphoid cells

Question 34

What type of granuloma is Cat scratch disease

Answer 34

Necrotizing / Supprative Granuloma

Question 35

What organism causes Cat scratch disease

Answer 35

Gram neg bacteria Bartonella Henselae

Question 36

WHat organism causes Toxoplasmosis

Answer 36

Protozoan (parasite) Toxoplasma Gondii CAT host

Question 37

What type of granuloma is Cat scratch disease

Answer 37

Necrotizing / Supprative Granuloma

Question 38

What organism causes Cat scratch disease

Answer 38

Gram neg bacteria Bartonella Henselae

Question 39

WHat organism causes Toxoplasmosis

Answer 39

Protozoan (parasite) Toxoplasma Gondii CAT host

Question 39

What type of granuloma is Cat scratch disease

Answer 39

Necrotizing / Supprative Granuloma

Question 40

What organism causes Cat scratch disease

Answer 40

Gram neg bacteria Bartonella Henselae

Question 41

WHat organism causes Toxoplasmosis

Answer 41

Protozoan (parasite) Toxoplasma Gondii CAT host

Question 42

Which cells can be seen in Dermatopathic lymphadenitis

Answer 42

Langerhans cells Interdigitting reticulum cells

Question 43

What is another name for Sinus Histiocytosis with massive lymphadenopathy

Answer 43

Rosai- Dorfman disease

Question 44

What generally causes Sinus histiocytosis

Answer 44

Malignancy drainage

Question 45

Infectious Mononucleosis (EBV) affects which lymph nodes?

Answer 45

Cervical

Question 46

Toxoplasmosis affects which lymph nodes ?

Answer 46

Post cervical

Question 47

Cat scratch disease affects which lymph nodes?

Answer 47

Axillary & Cervical

Question 48

STIs affect which lymph nodes

Answer 48

Inguinal

Question 49

HIV affects which lymph nodes?

Answer 49

Parotid, Sub-mandibular, epitrochlear

Question 50

Pathologies of the lungs and oesophagus drain to which lymph nodes

Answer 50

Right supraclavicular

Question 51

Pathologies of the stomach, pancreas and gall bladder drain to which lymph nodes?

Answer 51

Left supraclavicular (aka Virchow's sign)

Question 52

Acute Appendicitis would affect which lymph nodes

Answer 52

Mesenteric

Question 53

A lymphadenopathy in a pt less than 30 is likely to be benign or malignant and what percent

Answer 53

80% benign

Question 54

What type of granuloma is Cat scratch disease

Answer 54

Necrotizing / Supprative Granuloma

Question 54

What organism causes Cat scratch disease

Answer 54

Gram neg bacteria Bartonella Henselae

Question 55

A lymphadenopathy in a pt over 50 is likely to be benign or malignant and what percent

Answer 55

malignant 60%

Question 55

What generally causes Sinus histiocytosis

Answer 55

Malignancy drainage

Question 56

WHat organism causes Toxoplasmosis

Answer 56

Protozoan (parasite) Toxoplasma Gondii CAT host

Question 56

Which cells can be seen in Dermatopathic lymphadenitis

Answer 56

Langerhans cells Interdigitting reticulum cells

Question 56

What is another name for Sinus Histiocytosis with massive lymphadenopathy

Answer 56

Rosai- Dorfman disease

Question 57

What is another name for Sinus Histiocytosis with massive lymphadenopathy

Answer 57

Rosai- Dorfman disease

Question 57

What generally causes Sinus histiocytosis

Answer 57

Malignancy drainage

Question 58

What type of granuloma is Cat scratch disease

Answer 58

Necrotizing / Supprative Granuloma

Question 58

WHat organism causes Toxoplasmosis

Answer 58

Protozoan (parasite) Toxoplasma Gondii CAT host

Question 58

What organism causes Cat scratch disease

Answer 58

Gram neg bacteria Bartonella Henselae

Question 58

Which cells can be seen in Dermatopathic lymphadenitis

Answer 58

Langerhans cells Interdigitting reticulum cells