Atlas of Lymph Node Pathology: A Pattern Based Approach

Description:

Closely mirroring the daily sign-out process, Atlas of Lymph Node Pathology: A Pattern Based Approach is a highly illustrated, efficient guide to accurate diagnosis. This practical reference uses a proven, pattern-based approach to clearly explain how to interpret challenging cases by highlighting red flags in the clinical chart and locating hidden clues in the slides. Useful as a daily “scope-side guide,” it features numerous clinical and educational features that help you find pertinent information, reach a correct diagnosis, and assemble a thorough and streamlined pathology report.

Table of Contents:

1. INTRODUCTION TO THE LYMPH NODE

Lymph Node Structure

Capsule

Sinuses

Cortex

Paracortex

Medulla

Specimen Preparation

Fixation

Frozen Sections

Limited Specimens

Clinical Context

Anatomic Site

Patient Demographics

Clinical Information

Ancillary Studies

Flow Cytometry

Cytogenetic/FISH Studies

Molecular Studies

Near Misses

IgG4-Reactive Lymphadenopathy

Nodal Marginal Zone B-Cell Lymphoma With Colonization of Reactive Follicles

Intrafollicular Neoplasia

Interfollicular Classical Hodgkin Lymphoma

Early Angioimmunoblastic T-cell Lymphoma

2. THE LYMPH NODE CAPSULE

Normal Lymph Node Capsule

Absent Capsule

Lymph Node Versus Lymphoid Tissue

Capsular Inclusions

Disrupted Capsule

Thickened Capsule

Reactive Conditions

Neoplastic Conditions

Near Misses

Angioimmunoblastic T-cell Lymphoma

Kaposi Sarcoma

Tumor-Infiltrating Lymphocytes Versus Metastatic Disease

Capsular Nevi Versus Metastatic Melanoma

3. THE LYMPHATIC SINUSES

Introduction

Conditions With Dilated Prominent Sinuses

Sinus Histiocytosis and Dermatopathic Lymphadenopathy

Sinus Histiocytosis With Massive Lymphadenopathy (SHML)

Langerhans Cell Histiocytosis (LCH)

Lymphoplasmacytic Lymphoma

Node Draining Suppurative Area

Lipid-Associated Lymphadenopathy (Lymphangiogram, Prosthesis, or Storage Diseases)

Vascular Transformation of Sinuses

Near Miss

Sinusoidal Involvement by Kaposi Sarcoma Mimicking Vascular Transformation of Sinuses

Sinusoidal Lymphomatous Infiltrates

Near Miss

ALCL Mimicking Metastatic Carcinoma

Metastatic Cancer

Near Miss

Benign Mesothelial Cells

Leukemic Infiltrates

Other Perisinusoidal Cellular Clusters

Conditions With Inconspicuous/Obliterated Sinuses

Follicular Lymphoma

Castleman Disease

Angioimmunoblastic T-cell Lymphoma

4. CORTEX

Introduction

Clinical Correlation

Site-Specific Variations in Follicles

Abnormal Follicles

Reactive Follicular Hyperplasia

Giant Follicular Hyperplasia

Reactive Follicular Hyperplasia In Altered Immune States

Intrafollicular Plasmacytosis-IgG4 Disease

Other Clonal Conditions With Reactive Hyperplasia

Abnormal Expanded Mantle Zones

Castleman-Like Proliferations

Progressive Transformation of Germinal Centers

Kimura Disease

Attenuated Mantle Zones

Other Infectious Processes

Toxoplasma

5. PARACORTEX

Paracortical Hyperplasia

Dermatopathic Lymphadenopathy

Infection

Drug-Associated Lymphadenopathy

Autoimmune Conditions

Systemic Lupus Erythematosus Lymphadenopathy

Atypical Paracortical Hyperplasia

Histiocytic Proliferations

Singly/Small Clusters

Granulomas

Extensive/Diffuse

Vascular Changes

Vascular Proliferation

Abnormalities of Vessel Walls

Expansion/Infiltration of the Paracortex by Unexpected Cells

Atypical Lymphocytes/Lymphomas

Plasma Cells

Spindled Cells

Necrosis

Near Misses

Hamazaki-Wesenberg Bodies in Sarcoidosis Lymphadenopathy

Indolent T-Lymphoblastic Proliferation

Lymph Node Involvement by Myeloid/Lymphoid Neoplasms With PDGFRA Rearrangement

6. OBLITERATED NODULAR PATTERN

Introduction

List of Entities to Consider in Cases With Nodular Pattern

Follicular lymphoma

Some Histologic Variations That Represent Pitfalls in the Diagnosis of Follicular Lymphoma

Grading and Follicular Lymphoma

Unconventional Wisdom Relating to FL Grading

Immunostains and Approach in Nodular Proliferations

Scenarios and Clinical Details That Determine How You Look at and Sign Out Some Follicular Lymphoma Cases

Pitfall Cases of Nodular Proliferations

Pitfall Case 1: Nodal Marginal Zone lymphoma with Follicular Colonization

Pitfall Case 2: Germinotropic lymphoproliferative disorder, EBV+/ HHV8+

Pitfall Case 3: Follicular variant of peripheral T-cell lymphoma (Figures 6.66-6.70)

7. OBLITERATED NODAL ARCHITECTURE

B-Cell Lymphomas

Small Lymphocytic Lymphoma and Richter Syndrome

Mantle Cell Lymphoma

Diffuse Follicular Lymphoma

Follicular Lymphoma With Transformation to DLBCL

Plasmacytoma/Plasma Cell Myeloma

Diffuse Large B-Cell Lymphoma, Not Otherwise Specified

T-Cell–/Histiocyte-Rich Large B-Cell Lymphoma

Plasmablastic Lymphoma

Primary Mediastinal Large B-Cell Lymphoma

B-Cell Lymphoma, Unclassifiable, With Features Intermediate Between Diffuse Large B-Cell Lymphoma and Classical Hodgkin Lymphoma (Gray Zone Lymphoma)

Burkitt Lymphoma

High-Grade B-Cell Lymphoma

T-Cell Lymphomas

Anaplastic Large-Cell Lymphoma

Peripheral T-Cell Lymphoma

Lymphoepithelioid Variant of PTCL (Lennert Lymphoma)

Precursor Lesion

Myeloid Sarcoma

B-Lymphoblastic Lymphoma

T-Lymphoblastic Lymphoma

Near Misses

Blastoid Variant of Mantle Cell Lymphoma

Nodal Involvement by CD30-Positive T-Cell Lymphoproliferative Disorder

Peripheral T-Cell Lymphoma With Hodgkin-Like Cells

Anaplastic Large-Cell Lymphoma With Aberrant Expression of PAX5

8. NECROSIS

Introduction

Lymphoma/Aggressive Lymphoproliferative Neoplasms

B-Cell Lymphoma

B Lymphoblastic Lymphoma

Diffuse Large B-Cell Lymphoma, Not Otherwise Specified

EBV-Positive Diffuse Large B-Cell Lymphoma, Not Otherwise Specified

Post-Transplant Lymphoproliferative Disorder

Plasmablastic Lymphoma

Classical Hodgkin Lymphoma

T-Cell and NK Cell Lymphoma

Peripheral T-Cell Lymphoma, Not Otherwise Specified

NK/T-Cell Lymphoma

Anaplastic Large Cell Lymphoma

Infectious Etiologies

Mycobacterial Lymphadenitis

Cytomegalovirus Infection

Herpes Simplex Lymphadenitis

Cat Scratch Disease

Fungal Infection/Lymphadenitis

Benign Reactive Lymphoproliferative Disorders

Systemic Lupus Erythematosus

Near Misses

Epstein-Barr Virus: Infectious Mononucleosis

Kikuchi-Fujimoto Lymphadenitis

9. IMMUNOHISTOCHEMISTRY

Introduction

Key Features Related to Technical Points in Immunohistochemistry

List of Common Antibodies in Lymphoma Immunohistochemistry

Near Miss

CD20-Negative Follicular Lymphoma

Incidental Mantle Cell Lymphoma in Reactive Looking Node

Peripheral T-cell Lymphoma With Hodgkin-Like Cells of B-Cell Derivation

Stains Related to Microorganisms

Extracavitary Primary Effusion Lymphoma

Exercise in Interpretation, Sample Write-Ups in One Single Case, and Best Practices in Write-Ups

SELF-ASSESSMENT QUESTIONS

INDEX