On this resource, the following formatting is used for comprehensiveness:
- Minimal depth
- (Moderate depth)
Whenever there is a suspicion of lymphoma, perform the following before putting the specimen in formalin:
- Take a small sample for flow cytometry.
- Make a "touch prep": lightly press a glass slide against the cut surface of the lymph node, apply cytologic fixative solution immediately (to avoid drying artifacts) and stain with H&E.
- Submit sections for histologic processing and H&E staining.
On the histologically processed slides, first compare the lymphoid cells with endothelial cells, and designate the lymphoid cells as large if a significant amount are larger than the transverse diameter of endothelial cells, otherwise as medium to small.
Small to medium sized lymphocytes
In addition, you generally need to order immunohistochemistry, consisting of:
- CD3, to raise the possibility of a T cell lymphoma if it stains a vast majority of cells.
- CD20, to raise the possibility of a B cell lymphoma if predominant.
- BCL2, to suggest a follicular lymphoma if it stains B cells in secondary follicles.
- (CD5, mainly to suggest chronic lymphocytic leukemia or mantle zone lymphoma if it positive in the CD20 positive cells.)
- (CD10, essentially confirming a follicular lymphoma if stains the BCL2 positive cells of secondary follicles.)
- (CD23, suggesting a small lymphocytic lymphoma (SLL) / chronic lymphocytic leukemia (CLL) if it is present in CD20 and CD5 positive cells.)
- (Cyclin D, suggesting a mantle cell lymphoma if it is present in CD20 and CD5 positive cells.)
If CD20 positive cells (B cells) are predominant, attempt to fit their pattern into one of the following:
|Follicular lymphoma||Marginal zone B-cell lymphoma (MZL) or mucosa-associated lymphatic tissue (MALT) lymphoma||Small lymphocytic lymphoma (SLL) / chronic lymphocytic leukemia (CLL)||Mantle cell lymphoma (MCL)|
- Error on call to Template:cite web: Parameters url and title must be specifiedProPath Staff. . Retrieved on 2022-01-09.
- Attanoos, Richard (2018). "Lymphoid Malignancies of the Pleura and Peritoneum". Practical Pathology of Serous Membranes . pp. 203–208. doi:10.1017/9781316402009.016. ISBN 9781316402009.