Hematology/Oncology Lymph Node Seminar for Medical II Students

Slides 2A-D Cervical Lymph Node Biopsy

This is a cervical lymph node biopsy from a 54-year-old female with a non-tender, firm, 4 cm mass under the left jaw. The mass has been increasing in size over the last month. The patient also complains of recent weight loss and fatigue.

Upon physical examination, the patient is noted to have enlarged, non-tender lymph nodes in the cervical, supraclavicular, and inguinal regions. The spleen and liver are not enlarged.

Laboratory results include:

• Hgb. 9.0 g/dl (nl 12-16)
• Hct. 29% (nl 37-47)
• WBC 5,000 1(nl 4,800-10,800)

Discussion:

1. What major architectural changes are present in this lymph node?
2. What size are the lymphocytes (small, intermediate, or large)? Compare them to the size of histiocytes and endothelial cells.
3. Is this a reactive (benign) or malignant process? If malignant, is it high-grade, low-grade, or intermediate?
4. What is your diagnosis?
5. How does the prognosis of follicular lymphoma differ from diffuse lymphoma?
6. Can you tell whether this process is a proliferation of B-cells or T-cells?
7. What futher studies are needed to determine the stage of disease in this patient?

Slides A  & B | Slides C & D

Slide C same as B
Slide D comparison of cell size. One frame is a non-Hodgkin's lymphoma composed of small-cleaved lymphocytes. The other frame is an example of a large cell lymphoma. Some lymphomas have a mixture of both cell sizes, and are termed "mixed small cleaved and large cell." As with the other types, mixed lymphomas are follicular (nodular) or diffuse (or both).

Digital Legends for Labs
Slides 1a-c | Slides 1d-f | Slides 2a-d | Slides 3a-c | Slides 3d-f | Slides 4a-c | Slides 5a-c 
Slides 5d-e | Slides 6a-b | Slides 7a-b

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Medical II

Updated October 1, 2007