Lymphadenopathy, Coagulation and bleeding disorders (Pales CIS) Flashcards
(42 cards)
what populates lymph nodes
populated by macrophages, dendritic cells, B lymphocytes, and T lymphocytes.
what are the functions of lymph nodes
Participate in antigen processing, antigen presentation, antigen recognition, and proliferation of effector B and T lymphocytes as part of the normal immune response
why do lymph nodes enlarge
Proliferation of WBCs inside of lymph nodes leads to lymph node enlargement.
In young children, palpable lymphadenopathy is the rule.
In adults, lymph nodes larger than 1 to 2cm in diameter are generally considered abnormal. (except for groin, where they can be bigger normally)
localized lymphadenopathy
Local lymphadenopathy reflects the area those lymph nodes drain
generalized lymphadenopathy
Generalized lymphadenopathy occur with a systemic disorders
supraclavicular on the right
left
R mediastinum, lungs
L - abdomen
axillary lymph nodes
arm, breast, thorax, neck
Infections
Cat scratch disease
Cellulitis
Cancer
Breast
Other metastasis
Silicone breast implants
( may cause both supraclavicular and axillary lymphadenopathy)
inguinal lymph nodes drainage
problems?
lower extremity
genitalia
buttock
abdominal wall below umbilicus
Lower extremity infection
Sexually transmitted diseases
Cancer Skin of the lower extremities and trunk Cervix, vulva, and ovary Rectum and anus Penis
what are some causes of peripheral lymphadenopathy
bacterial viral mycobacterial fungal protozoal spirochetal
Cancer
lymphoproliferative
immunologic
endocrine
miscellaneous
localized lymphadenopathy of the cervical region?
anterior or posterior worse?
Anterior– usually benign
Localized strep** or staph infections, rubella, dental
Systemic infections: Epstein-Barr virus (EBV), cytomegalovirus infection, or toxoplasmosis
Posterior – could be benign, but malignancy*** is more common than with anterior lymph nodes
EBV infection, tuberculosis, lymphoma, or head and neck malignancy
supraclavicular lymphadenopathy
what does right side drain
left side?
High risk for malignancy***
Right
Cancer of mediastinum, lungs or esophagus
Left (Virchow’s node***) Abdominal malignancy (stomach**, gall bladder, pancreas, kidneys, testicles, ovaries, or prostate
mediastinal localized lymphadenopathy causes
Infectious
TB, fungal infection, anthrax
Neoplastic
Lymphoma, lung cancer, germ cell tumor
Other
Sarcoidosis
with HIV what kinds of lymph nodes do you see
when do they develop
Nontender.
Primarily axillary, cervical, and occipital nodes
Usually develops during the second week** of acute symptomatic HIV infection.
The nodes then decrease in size but a modest degree of adenopathy persists.
with mycobacterial infection what kinds of lymph nodes do you see
Can present with lymphadenopathy alone, especially in the neck (scrofula)
M. tuberculosis in adults
Atypical mycobacteria (M. avium complex and M. scrofulaceum) in kids
Nontender
Enlarge over weeks to months without prominent systemic symptoms
Can progress to matting and fluctuation (necrosis, casseation)
what kind of LAD is seen in the infectious mononucleosis
Triad of fever, pharyngitis, and lymphadenopathy***
Symmetric enlargement
Posterior cervical more than anterior cervical***
Axillary and inguinal are common too (as opposed to other causes of pharyngitis
Lymphadenopathy peaks in the first week and then gradually subsides over two to three weeks
Generalized LAD of SLE
In approximately 50 percent of patients
Lymph nodes are soft, nontender
Cervical, axillary, and inguinal areas
Usually develops at the onset of disease or in association with an exacerbation.
what are some drugs that cause LAD
allopurinol atenolol carbamazepine cephalosporins phenytoin quinidine
Castleman’s disease
Uncommon lymphoproliferative disorder Massive lymphadenopathy with Fever Hepatomegaly Splenomegaly polyclonal hypergammaglobulinemia Amyloidosis
Kikuchi’s disease
Rare, benign condition of unknown cause***
Affect young women***
Cervical lymphadenopathy only or generalized
Fever
Kawasaki disease
Childhood vasculitis
Cervical lymphadenopathy with
Fever Conjunctivitis Mucositis (strawberry tongue) Rash Coronary artery aneurysms*** heart attacks in young age. need to take aspirin
angioimmunoblastic T cell lymphoma
Systemic disease Generalized lymphadenopathy with Fever Hepatosplenomegaly Hemolytic anemia Polyclonal hypergammaglobulinemia
inflammatory pseudotumor
Syndrome of lymphadenopathy in one or more node groups
Systemic symptoms.
Nodes usually show a fibrosing and inflammatory process
generalized LAD of amyloidosis
Systemic disease with deposition of specific type of protein called Amyloid.
Most often will have amyloid deposition in other organs, but occasionally can be deposited only in lymph nodes
Kimura disease
Inflammatory condition of subcutaneous tissue and lymph nodes of the head and neck
Associated with elevations in serum IG E levels and eosinophilia
