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Flashcards in Lymph Nodes Deck (343)
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301

Nodular-sclerosis Hodgkin's lymphoma: Immunohistochemistry (4,2).

Positive: CD30, CD15, Pax-5, Mum-1.

Negative: CD45, EMA.

302

Nodular-sclerosis Hodgkin's lymphoma: Expression of CD20.

Usually negative but may be weak in some of the tumor cells in some cases.

303

Nodular-sclerosis Hodgkin's lymphoma: Expression of Oct-2 and Bob.1.

One or the other is positive, but not both.

304

Nodular-sclerosis Hodgkin's lymphoma: Expression of EBV.

Detectable by EBER in 10-40% of cases.

305

Nodular-sclerosis Hodgkin's lymphoma vs. HL of mixed-cellularity type.

Mixed-cellularity type:

- Inconspicuous or absent fibrous bands.
- Much stronger association with EBV.

306

Nodular-sclerosis Hodgkin's lymphoma vs. PTCL, NOS with true Reed-Sternberg cells.

In the latter, the T cells are morphologically (usually) and immunophenotypically aberrant.

307

Nodular-sclerosis Hodgkin's lymphoma vs. reactive immunoblasts.

Reactive immunoblasts express CD30 but not CD15.

308

Nodular-sclerosis Hodgkin's lymphoma: Best place to look for Reed-Sternberg cells.

Around the necrotic areas.

309

Mixed-cellularity Hodgkin's lymphoma:

A. Associations (3).
B. Median age at presentation.

A. Male sex, HIV, residence in developing country.

B. 38 years (older than that of NS-CHL).

310

Mixed-cellularity Hodgkin's lymphoma:

A. Most common site.
B. Prognosis.

A. Cervical lymph nodes; rarely involves mediastinum.

B. Excellent.

311

Mixed-cellularity Hodgkin's lymphoma: Immunohistochemistry.

Same as that of NS-CHL.

312

Lymphocyte-rich Hodgkin's lymphoma:

A. Median age.
B. Gender predilection.

A. Older than that of other subtypes of CHL.

B. Mainly affects males.

313

Lymphocyte-rich Hodgkin's lymphoma:

A. Typical site.
B. Prognosis.

A. Cervical lymph nodes; rarely involves mediastinum.

B. Excellent.

314

Lymphocyte-rich Hodgkin's lymphoma: Histology (4).

Small lymphocytes form nodules that contain

- Small regressed germinal centers.
- Scattered Reed-Sternberg cells.
- Few or no granulocytes.

315

Lymphocyte-rich Hodgkin's lymphoma: Immunohistochemistry of tumor cells.

Same as that of NS-CHL.

316

Lymphocyte-rich Hodgkin's lymphoma: Other immunohistochemistry (2).

Small lymphocytes are mantle cells that express IgD.

Small regressed germinal centers express CD21 and CD23.

317

Lymphocyte-rich Hodgkin's lymphoma: Association with EBV.

Detectable by EBER in about half of cases.

318

Langerhans'-cell histiocytosis: Age group of peak incidence.

One to three years.

319

Langerhans'-cell histiocytosis: Pattern of infiltration.

Sinusoidal.

320

Langerhans'-cell histiocytosis: Cellular components.

Langerhans' cells.

Eosinophils, neutrophils, small lymphocytes.

321

Langerhans'-cell histiocytosis: Cytology of tumor cells.

Nuclei: Irregular; nuclear groove sometimes; inconspicuous nucleolus.

Cytoplasm: Ill-defined, acidophilic.

322

Langerhans'-cell histiocytosis: Immunohistochemistry (3).

S100: All Langerhans' cells.

CD1a, langerin: Some Langerhans' cells..

323

Langerhans'-cell histiocytosis: Mutation.

V600E in BRAF in about half of cases.

324

Langerhans'-cell histiocytosis vs. Rosai-Dorfman disease (3).

Rosai-Dorfman disease:

- Large nucleoli.
- Emperipolesis.
- Absence of CD1a and langerin (but S100 is expressed).

325

Langerhans'-cell histiocytosis vs. dermatopathic lymphadenopathy (2).

Dermatopathic lymphadenopathy:

- Paracortical, not sinusoidal, infiltrate.
- Langerhans' cells are not accompanied by granulocytes or plasma cells.

326

Langerhans' cells:

A. Functions (2).
B. Origin.

A. Antigen presentation, phagocytosis.

B. The skin.

327

Mixed-cellularity Hodgkin's lymphoma: Histology.

Similar to that of NS-CHL, but without broad bands of collagen.

328

Kaposi's sarcoma: Locations in the lymph node (4).

Early:

- Capsule.
- Hilum.
- Fat around the node.

Late: Entire node may be replaced.

329

Kaposi's sarcoma: Immunohistochemistry (5).

Positive: CD34, CD31, ERG, FVIII-related antigen, LANA (HHV8).

330

Vascular transformation of lymph nodes: Histology

Congestion of all subcapsular and medullary sinuses.

Anastomosing network of small vascular channels lined by reactive endothelial cells.