BHARAT NATHWANI, M.D., University of Southern California School of Medicine, Los Angeles, CA
The diagnostic difficulties of pathologists are often compounded by the explosion of new knowledge in immunology and molecular biology. There are now >200 antibodies available for diagnostic purpose. Many pathologists are overwhelmed by the sheer volume and the complexity of new information. They have discovered that it is not only difficult to synthesize all of this new information, but also to integrate this new information in their daily practice in a cost-effective manner. The rapid progress over the last 20 years, as well as the great complexity in the field of lymphomas, is well reflected in the new WHO classification, wherein not only have the nomenclature and criteria of many malignant lymphomas changed substantially, but now includes >100 categories [e.g., lymphomas (B-cell, T-cell, post-transplant, lymphoproliferative, plasma cell, immunosecretory, and Hodgkin's) including their subtypes, grades and variants]. In view of all these difficulties, diagnostic mistakes can be readily made.
B-cell lymphomas comprise about 90% of non-Hodgkin's lymphomas in the U.S.A. This course covers the following B-cell lymphomas: follicular, mantle cell, marginal zone (nodal, extranodal, splenic), small lymphocytic, lymphoplasmacytoid, lymphoplasmacytic, diffuse large B-cell, Burkitt's and Burkitt's-like. The histiologic grades, variants and subtypes of these B-cell lymphomas are discussed. The course relates the various entities to their normal compartments within the immune system, presents criteria for the recognition of the various entities based on morphologic features, and imparts when and which immunostains and molecular studies are needed for confirming the diagnosis. The differential diagnosis of the various entities is also discussed. Importantly, a cost-effective approach to the use of ancillary testing is emphasized. This is particularly important in this era of markedly diminished resources and reduced reimbursements by payers.
Upon completion of the course, participants should be able to:
- Utilize presented criteria to recognize the grades, variants, and subtypes of the various B-cell lymphomas; and
- Formulate cost-effective diagnoses using appropriate immunologic and molecular studies whenever necessary.
A limited number of loan sets of glass slides of typical cases will be available for advance mailing and all registrants will be mailed a set of transparencies after the meeting. A syllabus will be distributed at the course.