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Anatomic pathology > Lymph Nodes > Flashcards

Flashcards in Lymph Nodes Deck (343)
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270

Peripheral T-cell lymphoma, NOS: Typical patient.

Middle-aged or elderly male.

271

Peripheral T-cell lymphoma, NOS:

A. Typical presentation.
B. Prognosis.

A. Advanced disease.

B. Poor.

272

Peripheral T-cell lymphoma, NOS: Pattern of infiltrate.

Paracortical, follicular, or diffuse.

273

Peripheral T-cell lymphoma, NOS: Tumor cells (3).

Medium-sized or large, pleomorphic, and monotonous.

Cells form sheets.

Clear cells or Reed-Sternberg cells may be visible.

274

Peripheral T-cell lymphoma, NOS: Other cells (4).

Small lymphocytes, plasma cells, eosinophils, histiocytes.

275

Peripheral T-cell lymphoma, NOS: Additional possible histologic feature.

Large high-endothelial venules.

276

Peripheral T-cell lymphoma, NOS: Histologic variants (3).

Lymphoepithelioid (Lennert's lymphoma): Small tumor cells are obscured by epithelioid histiocytes.

Follicular: Atypical clear cells in germinal centers or in mantle zones.

T-zone: Perifollicular growth with minimal cytologic atypia.

277

Peripheral T-cell lymphoma, NOS: Expression of T-cell antigens (3).

Frequent loss of CD5 and CD7.

CD4 is usually expressed.

CD8 is more often expressed in Lennert's lymphoma.

278

Peripheral T-cell lymphoma, NOS: Expression of CD30.

Absent, weak, or focal.

279

Peripheral T-cell lymphoma, NOS: Rate of proliferation.

High.

280

Peripheral T-cell lymphoma, NOS: Association with EBV.

Present in the Reed-Sternberg-like cells.

281

Peripheral T-cell lymphoma, NOS: Additional immunohistochemistry.

Some tumors (esp. the follicular variant) express markers of follicular T-helper cells:
- CD10.
- Bcl-6.
- PD-1.
- CXCL13.

282

Peripheral T-cell lymphoma, NOS, T-zone variant: Differential diagnosis.

Reactive paracortical hyperplasia:

- No loss of T-cell antigens.
- Normal ratio of CD4-positive to CD8-positive lymphocytes.

283

Peripheral T-cell lymphoma, NOS vs. angioimmunoblastic T-cell lymphoma.

AITCL: Expanded FDC networks.

284

Nodular lymphocyte-predominant Hodgkin's lymphoma: Proportion of all Hodgkin's lymphomas.

5%.

285

Nodular lymphocyte-predominant Hodgkin's lymphoma: Epidemiology.

Young patients.

Strong male predominance.

286

Nodular lymphocyte-predominant Hodgkin's lymphoma: Typical presentation.

Localized lymphadenopathy.

287

Nodular lymphocyte-predominant Hodgkin's lymphoma: Names of large tumor cell.

Lymphocyte-predominant.

Lymphocytic and histiocytic.

Popcorn.

288

Nodular lymphocyte-predominant Hodgkin's lymphoma: What should not be seen (4).

Neutrophils.

Eosinophils.

Fibrosis.

Necrosis.

289

Nodular lymphocyte-predominant Hodgkin's lymphoma: Antigens expressed by tumor cells (8).

CD45.

CD20, CD79a, Pax-5.

Bcl-6, EMA.

Both Oct-2 and Bob.1 are expressed.

290

Nodular lymphocyte-predominant Hodgkin's lymphoma: Antigens not expressed by tumor cells (4).

CD30, CD15, EBV, fascin.

291

Nodular lymphocyte-predominant Hodgkin's lymphoma: Antigens expressed by the T lymphocytes in the nodules (4).

CD3, CD4, CD57, PD-1.

292

Nodular lymphocyte-predominant Hodgkin's lymphoma: Additional immunohistochemistry (2).

CD21 and CD23 highlight the expanded FDC meshworks.

293

Nodular lymphocyte-predominant Hodgkin's lymphoma:

A. Flow cytometry.
B. PCR.

A. May reveal CD4/CD8 double-positive T cells.

B. Does not detect clonal rearrangement of IGH.

294

Nodular lymphocyte-predominant Hodgkin's lymphoma vs. T-cell/histiocyte-rich DLBCL

T-cell/histiocyte-rich DLBCL:

- Diffuse, not nodular; complete effacement of architecture.
- CD21 and CD23 reveal no expansion of FDC meshworks.
- No rosettes of PD-1-positive T cells.

295

Nodular lymphocyte-predominant Hodgkin's lymphoma: Prognosis (3).

Cured if excised early.

Otherwise:
- Relapses and recurrences are frequent.
- Patients are predisposed to develop DLBCL.

296

Nodular-sclerosis Hodgkin's lymphoma: Most common sites.

Cervical lymph nodes.

Mediastinum (involved in 80% of cases).

297

Nodular-sclerosis Hodgkin's lymphoma: Variants of Reed-Sternberg cells (4).

Hodgkin's cells: Mononuclear.

Wreath cells: Multinucleate.

Mummified cells: Condensed cytoplasm, pyknotic nuclei.

Lacunar cells: Due to formalin-induced retraction of cytoplasm.

298

Nodular-sclerosis Hodgkin's lymphoma: Non-neoplastic cells (5).

Small lymphocytes.

Histiocytes.

Eosinophils.

Plasma cells.

Neutrophils occasionally.

299

Nodular-sclerosis Hodgkin's lymphoma: Additional histologic features (2).

Broad bands of sclerosis.

Necrosis and granulomas in some cases.