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44 Cards in this Set
- Front
- Back
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Benign conditions with a follicular pattern
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Follicular hyperplasia
Castleman disease PTGC HIV related lymphadenopathy Rheumatoid lymphadenopathy Syphilitic lymphadenopathy |
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Benign conditions with a paracortical pattern
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Viral infections NOS
Post vaccinial lymphadenitis EBV Drug induced Dermatopathic SLE Histiocytic necrotizing lymphadenitis |
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Benign conditions with a sinus pattern
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Sinus histiocytosis
LCH Rosai Dorfman Monocytoid B cell hyperplasia Whipple disease |
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Stains?
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CD20 left
CD3 right |
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Stains?
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CD21 left, BCL2 right
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Stains?
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BCL6 right, CD10 left
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What are some features that distinguish follicular hyperplasia from follicular lymphoma?
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Hyperplasia: increased mitosis, BCL2 negative, T14:18 negative, architecture preserved, GC varied, no back to back follicles
Lymphoma: Decreased mitosis, decreased macrophages, BCL2+ t15:18 positive Architecture effaced, little variation in GC, back to back follicles |
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What form of castleman disease has a worse prognosis?
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Multicentric
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What is POEMS?
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Syndrome associated with castleman
Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin abnormalities |
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What are the three stages of HIV lymphadenopathy
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Follicular hyperplasia
Follicular involution Lymphocyte depletion |
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What are the histologic features of toxoplasma?
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Follicular pattern hyperlasia
Epithelioid histiocytes near GC Monocytoid B cells in sinuses Serology confirms diagnosis |
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Histologic features of infectious mononucleosis?
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Paracortical proliferation of immunoblasts
Sinuses distended by monocytoid B cells or immunoblasts Focal necrosis/apoptosis LMP+ EBER+ DDx: DLBCL |
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What markers do you see in acute EBV (serology)?
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IGM+ IgG VCA
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What serology do you see with remote EBV infection?
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IgG EBNA, IgG VCA
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Histologic features of dermatopathic lymphadenopathy?
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Paracortical expansion with many pale, sometimes melanin filled histiocytes
(Mycosis fungoides must be considered if confluence is present) |
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Dermatopathic lymphadenitis
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Clinical presentation of kikuchi?
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Young asian women, cervical nodes, serology negative
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Architecture/cytology of Kikuchi?
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Necrosis with karyorrhectic dust
ABSENT acute inflammation Plasmacytoid monocytes, crescentic histiocytes Absent plasma cells |
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How can you tell Kikuchi from SLE?
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Absence of plasma cells in Kikuchi
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Architecture/cytology of cat scratch disease?
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Suppurative granolumas (Stellate abcesses)
Neutrophils and monocytoid B cell hyperplasia Granulomas can be seen outside of the LN Warthy starry demonstrates organisms (B.henselae) |
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Diagosis?process?
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Rosai Dorfman
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Diagnosis
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Rosai dorfman
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Architecture/cytology of rosai dorfman?
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Distended sinuses with foamy histiocytes
Emperipoiesis No erythroid phagocytosis S100+ CD68+ Lysozyme + |
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Architecture/cytology of Bacillary angiomatosis?
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Vascular nodal parenchymal proliferation
Amphophilic and eosinophilic material Vascular spaces are lined by plump endothelium Warthy starry shows organisms |
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Diagnosis?
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Bacillary angiomatosis
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How can you distinguish bacillary angiomatosis from kaposi sarcoma?
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Bacillary: Plump endothelial cells, little atypia, HHV8-, pos for organisms
Kaposi: Spindle cels, slit shaped vessels, more atypic, more mitosis, negative for organisms, HHV8+ |
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What is a pseudofollicle?
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Pale staining spherical structures not surrounded by a mantle zone and seen in CLL
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Phenotype of CLL?
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CD20 weak, CD79a, CD5, CD23, CD43, CD11c dim
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Good prognosis for CLL?
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CD38 and Zap70 negative, means hypermutated
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Good prognosis genetics for CLL?
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Del 13q
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Bad prognosis for CLL?
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Trisomy 12, Del 11q, Del 17p
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Bone marrow findings in HCL?
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Subtle infiltrate, dispersed B cells with pale cytoplasm (fried egg)
Increased reticulin fibrosis |
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Immunophenotype for HCL?
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Bright: CD11c, CD25, CD103
Annexin A1, TRAP, DBA.44 |
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Immunophenotype for Follicular lymphoma?
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CD10+, BCL-2 + , T(14:18) IgH-Bcl-2
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Immunophenotype of Mantle Cell Lymphoma?
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CD10 -
CD 5 + BCL2 + CD23 - CD20 - Bright CD43 + |
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Immunophenotype of Marginal Zone Lymphoma?
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CD10 -
CD5 - No specific Marker |
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Genetics for Mantle Cell?
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t(11;14) CCND1-IgH
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Diagnosis?
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Mantle cell lymphoma
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Histologic features of marginal zone lymphoma?
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Monocytoid cells, plasmacytoid cells, dutcher bodies, confluent marginal zones, lymphoepithelial lesions
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Genetics for marginal zone lymphoma?
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t(11;18) MLT and API2
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How does t(11;18) vary amongst other lymphomas
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Not seen in primary nodal MZL
Not in MALT with DLBCL It is resistant to antibiotic therapy |
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What are some precursor lesions for MZL?
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H Pylori (90% for gastric)
Sjogren Hashimoto HepC Borrelia burgdorferi for skin Campylobacter jejuni for eye lymphoma |
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What is the WHO definitions of Waldenstrom macroglobulinemia?
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LPL with bone marrow involvement + IgM monoclonal gammopathy
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Clinical findings in waldenstrom?
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Hyperviscosity, neuropathy, cryoglobulinemia
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