Difference between revisions of "Haematopathology"

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Haematopathology (view source)

Revision as of 12:41, 4 August 2010

1,985 bytes removed ,  12:41, 4 August 2010
split-out Hodgkin's lymphoma
m (replace PMID)
(split-out Hodgkin's lymphoma)
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==Hodgkin's lymphoma==
==Hodgkin's lymphoma==
*Abbreviated ''HL''.
{{main|Hodgkin's lymphoma}}


===Clinical===
===Microscopic===
Sx:<ref name=Ref_WMSP567>{{Ref WMSP|567}}</ref>
Features:
*Fever, night sweats, weight loss.
*Infections (due to immune dysfunction).
 
Diagnosis:
*HL cannot be diagnosed with standard flow cytometry (FC) - but has been diagnosed with specialized FC.<ref>{{cite journal |author=Fromm JR, Thomas A, Wood BL |title=Flow cytometry can diagnose classical hodgkin lymphoma in lymph nodes with high sensitivity and specificity |journal=Am. J. Clin. Pathol. |volume=131 |issue=3 |pages=322–32 |year=2009 |month=March |pmid=19228638 |doi=10.1309/AJCPW3UN9DYLDSPB |url=}}</ref>
===Histology===
*Reed-Sternberg cell (by definition).
*Reed-Sternberg cell (by definition).
**Large binucleated cell.
**Large binucleated cell.
**Macronucleolus - approximately the size of a RBC.
**Macronucleolus - approximately the size of a RBC (~8 micrometers).
 
**Well-defined cell border.
===HL subtypes===
Types:<ref name=Ref_WMSP567/>
*Classical HL (CHL) - ~95% of HL.
*Nodular lymphocyte-predominant HL (NLPHL) - ~5% of HL.
 
 
===Classical HL===
There are four CHL subtypes:<ref name=Ref_WMSP567/>
#Nodular sclerosis CHL - ~70% of CHL.
#*Mixed cellular background - T cell, plasma cells, eosinophils, neutrophils and histiocytes.
#*Nodular sclerosing fibrosis - thick strands fibrosis.
#Mixed cellularity CHL - ~20-25% of CHL.
#*Like nodular sclerosis - but no fibrosis.
#Lymphocyte-rich CHL - rare.
#*T lymphocytes only (no mix of cells).
#Lymphocyte-depleted CHL - rare.
#*Assoc. with HIV infection.
 
Memory device:
*The subtypes prevalence is in reverse alphabetical order.
 
===Nodular lymphocyte-predominant HL===
*AKA ''lympho-histiocytic variant''.
 
Features:
*The diagnostic cells in this variant: relatively small, lobulated nucleus, small nucleoli.
 
Image:
*[http://webpathology.com/image.asp?case=388&n=16 Popcorn cell (webpathology.com)].
 
===IHC===
Abbreviated panel:<ref name=Ref_WMSP568>{{Ref_WMSP|568}}</ref>
*CD30 Reed-Sternberg cells (RSCs) +ve ~98%
*CD15 Reed-Sternberg cells +ve ~80%, stains neutrophils.
*CD45 '''often negative''' in RSCs.
*CD20 may stain RSCs.
*PAX5 +ve.<ref name=Ref_APBR683>{{Ref APBR|683}}</ref>
 
Additional - for completeness:
*CD3 (T lymphocytes)
 
NLPHL IHC '''differs''' from the classical HL:<ref name=Ref_APBR683>{{Ref APBR|683}}</ref>
*LCA +ve.
*CD20 +ve.
*CD10 +ve.
*Bcl-6 +ve.
*EMA +ve.
*CD30 -ve
*CD15 -ve.


==Follicular lymphoma==
==Follicular lymphoma==
Michael
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