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Anatomic pathology > Lymph Nodes > Flashcards

Flashcards in Lymph Nodes Deck (343)
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120

Cat-scratch disease: Prognosis in the immunocompetent.

Resolution in 2 to 6 months.

121

Cat-scratch disease: Prognosis in the immunocompromised (3).

Can lead to

- Widespread granulomatous inflammation.
- Bacillary angiomatosis.
- Bacillary peliosis.

122

Cat-scratch disease: Other bacteria that may cause histologically similar lymphadenitis (4).

Chlamydia trachomatis.

Francisella tularensis.

Haemophilus ducreyi.

Yersinia enterocolitica.

123

Sarcoidal lymphadenitis: Frequency.

Occurs in 40% of patients with sarcoidosis.

124

Sarcoidal lymphadenitis: Necrosis.

Not typical, but small foci of fibrinoid necrosis can be seen.

125

Sarcoidal lymphadenitis: Lymphoma that must be excluded.

Classic Hodgkin's lymphoma: Granulomas may be seen in affected nodes and in benign ones.

126

Brucellosis:

A. Histology of lymphadenitis.
B. Diagnosis (2).

A. May mimic tuberculous or sarcoidal lymphadenitis.

B. Culture, serology.

127

Castleman's disease: Types.

Hyaline-vascular: Most common.

Plasma-cell.

Multicentric.

128

Castleman's disease, hyaline-vascular type:

A. Typical patient.
B. Typical presentation.
C. Typical site.

A. Young adult.

B. Incidental finding.

C. Mediastinal lymph node.

129

Castleman's disease, plasma-cell type: Presentation.

Half of patients have

- Anemia.
- Increased ESR.
- Increased gamma globulins in the serum.
- Increased plasma cells in the bone marrow.

130

Castleman's disease, multicentric type: Typical patient.

Middle-aged or older adult.

131

Castleman's disease, multicentric type: Presentation (4).

Generalized peripheral lymphadenopathy.

Hepatosplenomegaly.

Frequent fevers.

Night sweats.

132

Castleman's disease, multicentric type: Associated malignancies (3).

Kaposi's sarcoma.

Hodgkin's lymphoma.

Non-Hodgkin's lymphoma.

133

Castleman's disease, multicentric type: Additional association.

Polyneuropathy.

Organomegaly.

Endocrinopathy.

Monoclonal gammopathy.

Skin changes.

134

Castleman's disease, hyaline-vascular type, histology:

A. Mantle zones (2).
B. Sinuses.
C. Interfollicular area.

A. "Onion-skin" pattern; one mantle zone may surround two or more germinal centers.

B. Obliterated.

C. Hypervascular.

135

Castleman's disease, plasma-cell type, histology:

A. Germinal centers.
B. Sinuses.
C. Interfollicular area.

A. Some are atrophic, some hyperplastic.

B. May be patent.

C. Hypervascular; sheets of plasma cells.

136

Castleman's disease, multicentric type, histology.

Similar to that of plasma-cell type, but occurring in many lymph nodes.

137

Castleman's disease, plasmablastic type.

Type of multicentric Castleman's disease in which plasmablast-like cells occupy germinal centers and the interfollicular area.

138

Castleman's disease: Monoclonality (3).

Plasma-cell type: Plasma cells may be restricted to IgG-lambda or IgA-lambda.

Plasmablastic type: Plasmablasts are restricted to IgM-lambda.

No clonality of rearrangement of IgH.

139

Castleman's disease: Immunohistochemistry (2).

Regressed follicles: CD21 and CD23.

Multicentric type (up to 40%): HHV8.

140

Castleman's disease: Laboratory abnormality.

Increased IL-6 in the serum.

141

Castleman's disease vs. B-cell lymphoma: Molecular test.

B-cell lymphoma: IgH is clonality rearranged.

142

Castleman's disease vs. HIV-associated lymphadenopathy (3).

HIV-associated lymphadenopathy:

- Attenuated mantle zones.
- No "onion-skin" pattern.
- No "lollipop" follicles.

143

Castleman's disease vs. angioimmunoblastic T-cell lymphoma.

AITCL: Atypical small to medium-sized lymphocytes with clear cytoplasm.

144

Castleman's disease vs. thymoma.

Thymoma: Epithelial cells (confirmable by IHC).

145

Castleman's disease vs. autoimmune lymphadenopathy.

Autoimmune lymphadenopathy can also show sheets of plasma cells.

Distinction requires clinical correlation.

146

Castleman's disease vs. plasma-cell neoplasm.

Plasma-cell neoplasm lacks the typical follicular changes of Castleman's disease.

147

SLL/CLL: Components of the proliferation centers (3).

Small lymphocytes.

Prolymphocytes.

Paraimmunoblasts.

148

SLL/CLL: Flow cytometry (2,2,1).

Positive: CD5, CD23.

Dim: CD20, sIg.

Negative: FMC7.

149

SLL/CLL: Chromosomal abnormalities (4).

del(13q14).

+12.

del(11q22).

del(17p13).