Lecture plan

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Lecture plan

• Lymph node disorders
• Non neoplastic or Inflammatory
• Acute Lymphadenitis
• Chronic Lymphadenitis
• Neoplastic or Lymphomas
• Hodgkins lymphoma
• Non- Hodgkins Lymphoma
• Miscellaneous
• Langerhans cell Histiocytosis
• Splenic disorders
• Disorders of thymus

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Acute lymphadenitis

• Causes
• Microbes, Cell debris, Foreign material
• Sites
• Generalized (esp. children) Viral, Bacteremia
• Localized
• Cervical infections in oral cavity
• axillary/ inguinal infections in limbs
• Mesenteric acute appendicitis
• Morphology
• Large lymphoid follicles with prominent germinal
  centers
• Tingible body macrophages
• Clinically
• Enlarged Tender lymph nodes
• Clinical Course
• Heal with scar

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Chronic lymphadenitis

• Morphological types
• Follicular hyperplasia
• Humoral response esp. RA, Toxoplasma, HIV
• Germinal centers with secondary follicles,
• Mantle zone- surrounding the sec. follicles
• Gives dark and light zones
• Differential Diagnosis Follicular Lymphoma
• Marginal zone hyperplasia
• Subtype, common in Toxoplasma, HIV
• It is outside the Mantle zone
• Monocytoid B cells (memory cells)

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Chronic lymphadenitis

• Para-cortical Hyperplasia
• Cellular response
• Dilantin Rx, Viral (IM), Viral vaccines
• Large T immunoblasts in Para cortical areas
• Sinus Histiocytosis
• Prominent lymphatic sinusoids
• Due to immune response to tumors or their
  products

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Lecture plan

• Lymph node disorders
• Non neoplastic or Inflammatory
• Acute Lymphadenitis
• Chronic Lymphadenitis
• Neoplastic or Lymphomas
• Hodgkins lymphoma
• Non- Hodgkins Lymphoma
• Miscellaneous
• Langerhans cell Histiocytosis
• Splenic disorders
• Disorders of thymus

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Malignant Lymphoma
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Right neck mass
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Right neck mass
Row of enlarged lymph nodes
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Hodgkin's Lymphoma

• Children adults double peak.
• Lymphadenopathy, painless, firm
• Fever, Eosinophilia
• Reed-Sternberg cells
• B lymphocytes.
• ? Viral etiology
• Prognosis gt Inflammation
• Rx-
• Localized - RT
• Systemic - CT
• Rx related complications Secondary
  malignancies( ALL)

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Splenomegaly
Spleen
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Hodgkin's lymphoma
? cells
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HD Staging Classification
Clinical
Histological
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Non-Hodgkin's Lymphoma

• Fever, anemia, infections
• Marked Lymphadenopathy
• No RS cells or Eosinophilia
• Large group of different lymphomas
• Clinical low, intermediate high grade.
• Cell type B cell, T cell, Histiocyte other
• Histology Follicular diffuse.

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Diffuse Follicular
NHL- Histologic types
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NHL
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Small Intermediate Large
NHL- Histologic types
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Burkitts Lymphoma

• Small cell non cleaving NHL
• Bx-Starry sky pattern (due to macrophages)
• t(814) translocation- C-myc gene
• Three types
• African Endemic type
• Sporadic Non endemic
• With AIDS
• 30 of childhood NHLs in USA Burkitts
• Prognosis
• Children- good
• Adult Guarded

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Burkitts Lymphoma
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HD vs. NHL