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MBCHB III
Lymphoreticular system
Lymph nodes Spleen Mucosa associated lymphatic system (Peyer patches) Thymus Bone marrow Tonsills, adenoids
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Macrophages / monocytes B-lymphocytes Dendritic cells (interdigitating) Follicular dendritic cells Langerhans cells
Moleculargenetic methods
Immunoglobulin rearrangements T-cell receptor rearrangements
Activation markers
Antigen CD30 Ki67 Detection Activated B-cells, T-cells and monocytes, Reed-Sternberg cells Proliferative phase of cell cycle
Leukocyte marker
Antigen CD45 Detection Present on all leukocytes, Leukocyte common antigen
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Macrophage response:
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Dermatopathic lymphadenopathy
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Dermatopathic lymphadenopathy
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Malignant lymphoma, diffuse small lymphocytic type, lymph node, low power
Types of lymphadenitis
Acute lymphadenitis:
Bacterial infections
Chronic lymphadenitis
Yersinia Tuberculosis Fungal diseases Lympogranuloma venerum (Chlamydia) Cat-scratch disease (small gram-negative bacillae, Bartonella henselae) Syphilis Toxoplasomosis Leishmanioisis
Types of lymphadenitis
Infectious mononucleosis Others:
Drugs, foreign body material
Autoimmune lymphadenitis
Rheumatoid arthritis Lupus erytematodes
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Mycobacterial lymphadenitis
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Mycobacteria
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LN sarcoidosis
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LN sarcoidosis
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LN sarcoidosis
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Sarcoidosis
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LN sarcoidosis
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Anthracosis
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AIDS
Persistent generalised lymphadenpathy
Follicular hyperplasia Follicular involution with regressively transformed germinal centers Lymphocyte depletion
Phase II
FOLLICULAR TRANSFORMATION WITH DESTRUCTION/ BEGINNING OF FOLLICULAR DESTRUCTION (BFD) Follicle - Large irregularly formed follicles - Reticular cells (FDCs) and starry sky cells - Irregular formed and broken mantle zone with -The occurrence of monocytoid B lymphocytes - Incipient dissolution of the reticular fibre structure Interfollicular space - Reduction of cell density - Small groups of epitheliod cells - Monocytoid B lymphocytes - Reduction of lymphoblasts and immunoblasts - Nests of interdigitating reticulum cells (IRCs) - angioneogenesis
Phase III
PROGRESSIVE FOLLICULAR DESTRUCTION (PFD) Follicle - Large indistinctly demarcated, fading (exploding) and /or shrinking follicles - Loss of mantle zone - Depletion of monocytoid B lymphocytes - Marked reduction of lymphatic germinal centre cells and starry sky macrophages - Marked increase in lymphocytes - Incipient vascularisation of large fading follicles Interfollicular space - Increased angioneogenesis
Phase V
COMPLETE LOSS OF LYMPHNODE STRUCTURE (CLLNS)
- naked connective tissue structure - Diffuse distribution of macrophages, plasma cells and scattered lymphocytes - Hyaline plaques and foci of vascular proliferation as follicle remnants - Occasionally extreme angioneogenesis
The spleen
Normal function: Filtration of blood Secondary organ of the immune system Source of lymphoreticular cells Reserve and storage side
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Splenomegaly
Infections Congestion related to portal hypertension Lymphohaematogenous disorders Immunologic-inflammatory conditions Storage diseases Miscellanous
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Splenic infarcts
Thymus
Developmental disorders
Thymic hypoplasia DiGeorge syndrome Thymic cysts
Thymic hyperplasia
Thymic follicular hyperplasia Linked to myasthenia gravis in 70% of cases
Thymomas
Benign thymoma Malignant thymoma
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