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Reactive Conditions Causing Lymphadenopathy
Infectious causes, Drug Reactions, Connective Tissue Disorders
Features of Reactive Lymphadenitis
1 Partially distort lymph node architecture 2 Often limited to certain lymph node groups 3 May have a distinctive histologic pattern
Cat Scratch Disease causitive organism
Bartonella henselae
Classic Triad 1 Follicular hyperplasia 2 Epithelioid histiocytes impinging on germinal centers 3 Monocytoid B cell hyperplasia (i) B cells in the sinuses with a lot of cytoplasm (ii) “fried egg” appearance
Infectious Mononucleosis pathological appearance
1 Expansion of the paracortex (T cell zone) 2 “moth-eaten” appearance 3 Scattered large immunoblasts among small T cells 4 Reactive atypical lymphocytes in the peripheral blood
Cat Scratch Disease microscopic appearancen
1 Follicular hyperplasia 2 Stellate microabscesses 3 Necrotizing granulomas with lots of neutrophils
Solid Tumors vs HP Neoplasms
Solid Tumors: Carcinomas and sarcomas.Characterized by: 1Localized growth 2 Invasion 3 Metastasis HP Neoplasms: Leukemias and lymphomas. Characterized by: 1 Systemic disease 2 Replacement of normal marrow or lymph node elements 3Circulating tumor cells in the peripheral blood
Acute vs. Chronic Leukemias
Chronic Composed of more
Lymphoma Classification (Hodgkin vs Non H)
Hodgkin Lymphoma 1 Less common, 2 Pleomorphic growth pattern 3 Neoplastic cell is rare Non-Hodgkin Lyphomas 1 More commmon 2 Usually have a monomorphic growth pattern, 3 neoplastic cell = predominant cell
Follicular Lymphoma
1 Peripheral B cell lymphoma; 2 Morphology & immunophenotype reminiscent of germinal center B cells; (i) Nodular follicular architecture; (iii) Small cleaved lymphocytes
A change in histologic appearance and clinical behavior from an indolent process to a more aggressive neoplasm
Diagnosing Hematolymphoid Disordersn
Step 1: History & Physical Step 2: Draw blood, Laboratory testing guided by H&P Step 3: get tissue; Peripheral blood, bone marrow, lymph node Step 4:Morphology, Immunophenotype, Cytogenetic and Molecular Analysis

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