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Difference between revisions of "Lymph node pathology"
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| Metastasis | |||
| foreign cell population, usu. in subcapsular sinuses | |||
| +/-nuclear atypia, +/-malignant architecture | |||
| dependent on tumour type (see ''[[IHC]]'') | |||
| dependent on morphology | |||
| [http://commons.wikimedia.org/wiki/File:Crc_met_to_node1.jpg CRC met], [http://commons.wikimedia.org/wiki/File:Breast_carcinoma_in_a_lymph_node.jpg Breast met], [http://commons.wikimedia.org/wiki/File:Lymph_node_with_papillary_thyroid_carcinoma.jpg PTC met] | |||
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==Metastasis== | |||
===General=== | |||
*Determination of ''lymph node status'' is probably the most common indication for the examination of lymph nodes. | |||
*It is a good idea to look at the tumour (if available) ...before looking at the LNs for mets. | |||
===Microscopic=== | |||
Features: | |||
*Foreign cell population - '''key feature'''. | |||
**Classic location: subcapsular sinuses. | |||
*+/-Cells with cytologic features of malignancy. | |||
**Nuclear pleomorphism (variation in size, shape and staining). | |||
**Nuclear atypia: | |||
***Nuclear enlargement. | |||
***Irregular nuclear membrane. | |||
***Irregular chromatin pattern, esp. asymmetry. | |||
***Large or irregular nucleolus. | |||
**Abundant mitotic figures. | |||
*+/-Cells in architectural arrangements seen in malignancy; highly variable - dependent on tumour type and differentiation. | |||
**+/-Gland formation. | |||
**+/-Single cells. | |||
**+/-Small clusters of cells. | |||
Notes: | |||
*Cytologic features of malignancy may not be present; some tumours, e.g. gallbladder carcinoma, do not always have overt cytologic features of malignancy. | |||
**The diagnosis is based on the fact that they are foreign to the lymph node ''and'' architecturally consistent with a well-differentiated malignancy. | |||
Images: | |||
*[http://commons.wikimedia.org/wiki/File:Breast_carcinoma_in_a_lymph_node.jpg Breast carcinoma LN metastasis (WC)]. | |||
*[http://commons.wikimedia.org/wiki/File:Lymph_node_with_papillary_thyroid_carcinoma.jpg Thyroid carcinoma LN metastasis (WC)]. | |||
*[http://commons.wikimedia.org/wiki/File:Crc_met_to_node1.jpg Colorectal carcinoma LN metastasis (WC)]. | |||
==Progressive transformation of germinal centers== | ==Progressive transformation of germinal centers== | ||