After a brief review of lymphoma classification and how we evaluate lymphoid proliferations in 2012, each of the major types of lymphomas will be discussed with pragmatic diagnostic issues emphasized, together with newer biologic concepts. The goal of the course is not to simply be a recitation of the 2008 WHO Bluebook, which is now 3 1/2 years old, but to assist in the interpretation of what is in the Bluebook; provide updates related to new information published subsequent to the 2008 monograph; review our current standards of practice as they relate to specific lymphomas; and convey the unanswered questions actively being pursued including a glimpse at what one might expect in the future. The course will conclude with the seasoned observations of a clinician who must use the information we provide for the benefit of the patient. The lectures are aimed more at general surgical pathologists, who have an interest in keeping up with hematopathology rather than aimed at expert hematopathologists.

Introduction Steven H. Swerdlow, M.D., University of Pittsburgh School of Medicine, Pittsburgh, PA

Lymphoma Classification and the Tools of Our Trade Steven H. Swerdlow, M.D., University of Pittsburgh School of Medicine, Pittsburgh, PA Upon completion of this presentation, participants should be able to: Describe basic philosophy of 2008 WHO lymphoma classification. Establish a standard up-to-date protocol for handling lymphoid proliferations. Explain the role of ancillary testing in lymphoma diagnosis.

Nodal and Leukemic Small B-Cell Neoplasms James R. Cook, M.D., Ph.D., Cleveland Clinic, Cleveland, OH Upon completion of this presentation, participants should be able to: Recognize typical examples of nodal and leukemic small B-cell neoplasms including follicular lymphoma, small lymphocytic lymphoma /chronic lymphocytic leukemia, mantle cell lymphoma, nodal marginal zone lymphoma, and lymphoplasmacytic lymphoma. Select and interpret ancillary studies including immunohistochemistry, flow cytometry, FISH, and metaphase cytogenetics to address the differential diagnosis of these small B-cell neoplasms. Enumerate recent changes to the diagnostic criteria for these entities.

Non-Cutaneous Extranodal and Splenic Small B-Cell Lymphomas Andrew Wotherspoon, MB, BCh, FRCPath, Royal Marsden Hospital, London, England Upon completion of this presentation, participants should be able to: Distinguish small B-cell lymphomas that are encountered at extranodal sites. Identify clinical and pathological differences between extranodal small B-cell lymphomas and their nodal counterparts. Describe new/provisional small B-cell entities in the spleen.

Aggressive B-Cell Lymphomas – How Many Categories Do We Need? Jonathan Said, M.D., University of California, Los Angeles, Los Angeles, CA Upon completion of this presentation, participants should be able to: Articulate new knowledge regarding the origin of mature aggressive B-cell lymphomas provided by histologic, immunohistochemical, and genomic profiling studies. Explain the role of the compromised immune system in the pathogenesis of aggressive B-cell lymphomas. Recognize unresolved issues including the nature of high grade unclassifiable, double and triple hit lymphomas. Identify features most helpful in diagnosing problematic subtypes of aggressive B-cell lymphoma.

The Bridge From Large B-cell Lymphomas to Hodgkin Lymphomas and Their Differential Diagnosis Nancy Lee Harris, M.D., Massachusetts General Hospital, Boston, MA Upon completion of this presentation, participants should be able to: List the defined categories of Hodgkin lymphomas and their definitions. Recognize the “gray zones” between Hodgkin lymphomas and aggressive B-cell lymphomas. Describe the use of morphology and immunophenotyping in differential diagnosis and classification.

Nodal and Extranodal T-Cell and NK-Cell Lymphomas Elaine S. Jaffe, M.D., National Cancer Institute, Bethesda, MD Upon completion of this presentation, participants should be able to: Summarize functional characteristics of T-cell and NK-cell subsets. Describe pathological and immunophenotypic criteria for the most common T-cell and NK-cell lymphomas. Explain pitfalls in the differential diagnosis of T-cell and NK-cell lymphomas.

Non-Neoplastic Mimics of Malignant Lymphoma Lawrence M. Weiss, M.D., Clarient, a GE Healthcare Company, Aliso Viejo, CA Upon completion of this presentation, participants should be able to: Identify the best methods for distinguishing reactive follicular hyperplasia from follicular lymphoma. Delineate the types of benign hyperplasia that can mimic diffuse lymphoma. Discuss the role of special studies in the distinction of hyperplasia from lymphoma at extranodal sites.

Whole Genome Profiling and Other High Throughput Technologies – Current Contributions and Future Hopes Elias Campo, M.D., Hospital Clinic, University of Barcelona, Barcelona, Spain Upon completion of this presentation, participants should be able to: Interpret the main contributions of genomic studies to the clinical diagnosis and management of lymphoid neoplasms. Identify current developments and new perspectives in genomic technologies including next generation sequencing that may have a practical impact over the next 5 years.

The Clinician’s Perspective – A View From the “Receiving” End Joseph M. Connors, M.D., BC Cancer Agency, Vancouver, BC, Canada Upon completion of this presentation, participants should be able to: State the crucial distinctions – aggressive versus indolent. Define the key biological determinants of treatment response. Distinguish what is essential from what is just nice to know in the pathology report.

Concluding Remarks Steven H. Swerdlow, M.D., University of Pittsburgh School of Medicine, Pittsburgh, PA