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Haematology > The lymphoid system > Flashcards

The lymphoid system Flashcards

1
Q

Where does B cell maturation take place?

A

Bone marrow

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2
Q

Where does T cell maturation take place?

A

Thymus

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3
Q

What are the primary and secondary lymphoid tissues?

A
  • Primary (central) - bone marrow and thymus
  • Secondary (peripheral) - lymph nodes, spleen, tonsils (Waldeyer’s ring), epithelio-lymphoid tissues, bone marrow
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4
Q

What is the function of the lymphatic system?

A
  • Return lymph to the circulation - prevent excessive accumulation of fluid in the tissues (oedema)
  • Permits cell traffic, cell trapping and interaction of cells and molecules with cells of the immune system
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5
Q

Describe lymph nodes

A
  • Small, oval bodies, up to 2.5cm
  • Located along the course of lymphatic vessels
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6
Q

Lymph nodes have afferent and efferent channels, what role do each of these channel types have?

A
  • Afferent channels drain lymph through the capsule into the peripheral sinus
  • An efferent vessel leaves from the hilum and eventually drains into the venous system
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7
Q

Where is lymph filtered within the node?

A

Within the node parenchyma before return to the blood stream

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8
Q

How is the lymphoid system important in defence mechanisms?

A
  • Contains cells of the innate immune system
  • Traffic of APCs links innate and adaptive immune responses
  • Seat of the adaptive immune response
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9
Q

What cell types are present in lymph nodes?

A

B cells, T cells, NK cells, macrophages, APCs, dendritic cells, endothelial cells

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10
Q

What can cause lymphadenopathy?

A
  • Local inflammation - infection e.g. TB
  • Systemic inflammation - infection e.g. viral infections., autoimmune disorders
  • Malignancy - haematological (lymphoma, leukaemia), metastatic
  • Sarcoidosis
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11
Q

What is sarcoidosis?

A
  • A granulomatous condition
  • Wide differential diagnosis
  • Not a histological diagnosis
  • Sarcoid like reactions are a pit fall - may mask malignancy in a lymph node
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12
Q

What does this diagram show in relation to stimulation of immune reaction in a lymph node and what conditions might this occur in?

A
  • Predominant B-cell response
  • Auto-immune conditions and infections
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13
Q

What does this diagram show in relation to stimulation of immune reaction in a lymph node and what conditions might this occur in?

A
  • Predominant phagocytic response
  • Draining a tumour site
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14
Q

What does this diagram show in relation to stimulation of immune reaction in a lymph node and what conditions might this occur in?

A
  • Predominant T-cell response
  • Viral infections, drugs e.g. phenytoin
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15
Q

Where is the spleen located?

A
  • Located high in the LUQ of the abdomen
  • Normally 150-200g and 12x7x3cm
  • Not usually palpable
  • Two key aspects - diaphragmatic surface and visceral surface (left kidney, gastric fundus, tail of pancreas, splenic flexure of colon)
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16
Q

Describe the vascular supply to the spleen

A
  • Supplied by splenic artery (branch of coeliac artery) and drained by splenic vein (combines with superior mesenteric vein to form portal vein)
  • Rupture is a surgical emergency - diseased spleen is more prone to rupture
17
Q

What are the two parts of the spleen parenchyma?

A
  • White pulp and red pulp
  • Red pulp contains sinusoids and cords
  • Spleen is an encapsulated organ
18
Q

What is the function of the spleen?

A

Same as lymph nodes do for lymph fluid - filter the blood

19
Q

What does the white pulp do?

A
  • Antigen reaches white pulp via the blood
  • APCs in the white pulp present antigen to immune reactive cells
  • When stimulated by antigen, T and B cell responses may occur
20
Q

What are the features of splenomegaly?

A
  • Dragging sensation in LUQ
  • Discomfort when eating
  • Pain if infarction
21
Q

What is the triad of hypersplenism?

A
  1. Splenomegaly
  2. Fall in one or more cellular components of blood
  3. Correction of cytopenias by splenctomy
22
Q

What can cause splenomegaly?

A
  • Infection - EBV, HIV, TB
  • Congestion - hepatic cirrhosis, portal vein thombosis, HF
  • Haematological diseases - lymphoma/leukaemia, haemolytic anaemia, ITP, myeloproliferative
  • Inflammatory conditions - RA, SLE
23
Q

What is the arrow pointing to in this diagram?

A

Howell-Jolly body

Haematology (22 decks)

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