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Short Course 06 - Pearls and Pitfalls in Lymph Node Diagnosis
Tuesday, September 19, 2006 08:00 - 12:00
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Directors:
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Judith Ferry
Massachusetts General Hospital, Boston, MA
Leticia Quintanilla-Martinez
Ingolstaedter Landstraße 1, Oberschleissheim, Germany
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Disclosure:
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In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Short Course) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. Faculty members for this Short Course have indicated they have no disclosures to make.
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Clinical histories are displayed below.
Click on the case numbers to display the text and references for each case.
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- Follicular Lymphoma, Grade 1 of 3, with Numerous Signet Ring Cells
Submitted by: Judith Ferry
54-year-old female with isolated left axillary lymphadenopathy. Immunoperoxidase stains on frozen sections showed monotypic lambda staining. Immunoperoxidase stains on paraffin sections showed a predominant population of CD20+, CD10+/-, bcl6+, bcl2+, CD5-, cyclin D1- B cells, with Ki67 ~ 10-15%, and many interfollicular T cells (CD3+).
Case 1 - Slide 1
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- Peripheral T-NHL, Unspecified with B-cell Proliferation and RS-like Cells of B-cell Phenotype Associated with EBV
Submitted by: Leticia Quintanilla-Martinez
Cervical lymph node in a 52-year-old male patient. The bone marrow was free of disease. The patient received CHOP and achieved remission. Two years later developed again cervical adenopathy that was diagnosed as atypical lymphadenopathy.
Case 2 - Slide 1
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- AILT Classic Type
Submitted by: Leticia Quintanilla-Martinez
Cervical lymph node in a 79-year-old female patient. The patient had generalized lymphadenopathy and general symptoms.
Case 3 - Slide 1
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- Mantle Cell Lymphoma (MCL), with Peripheral Blood Involvement
Submitted by: Judith Ferry
50-year-old female with diffuse lymphadenopathy and a peripheral blood lymphocytosis. WBC= 64,100 with predominance of atypical lymphoid cells, hematocrit= 29%, platelets = 28,000. An inguinal lymph node was biopsied. Flow cytometry on the lymph node showed a population of CD19+, CD20+, CD5+, CD10-, CD23- B cells expressing bright monotypic lambda light chain. Immunoperoxidase stains on paraffin sections showed a predominance of B cells (CD20+) expressing dim CD5 and cyclin D1, associated with patchy CD21+ dendritic staining.
Case 4 - Slide 1
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- Nodular Lymphocyte Predominant Hodgkin's Lymphoma (NLPHL)
Submitted by: Judith Ferry
20-year-old male with a 3 cm left neck mass. Within the large, ill-defined nodules filling the node are numerous small B cells (CD20+) and scattered large atypical B cells (CD20+, CD15-, CD30-, bcl6+). Also present are many T cells (CD3+), including many co-expressing CD57. T cells cluster around the large B cells. CD21 highlights expanded dendritic networks of follicular dendritic cells.
Case 5 - Slide 1
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- Castleman's Disease, Hyaline-Vascular Type (HVCD)
Submitted by: Judith Ferry
28-year-old woman with abdominal pain, found to have retroperitoneal lymphadenopathy. FNA showed a monotonous population of small lymphocytes. Laparotomy was performed and an enlarged lymph node was excised. Flow cytometry showed polytypic B cells and T cells with a normal CD4:CD8 ratio. Immunohistochemistry showed B cells confined to follicles and many interfollicular T cells.
Case 6 - Slide 1
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- Anaplastic Large Cell Lymphoma, Common Type, ALK1+ with Variant Translocation
Submitted by: Leticia Quintanilla-Martinez
Cervical lymph node in a 30-year-old male patient. The bone marrow at diagnosis was free of disease.
Case 7 - Slide 1
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- Interdigitating Dendritic Cell Sarcoma/Tumor
Submitted by: Leticia Quintanilla-Martinez
Cervical lymph node in a 68-year-old male patient.
Case 8 - Slide 1
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