Role of Excisional lymph node biopsy, Core needle biopsy and FNAC in Lymphoma diagnosis
The newly developed and more sophisticated techniques for
analysis of lymphoma cells have provided us with the tools necessary for
precise classification of non-Hodgkin’s lymphoma. Nonetheless, routine
histologic studies remain the gold standard for diagnosis.
Excisional Biopsy
A well-processed hematoxylin and eosin (H&E) stained
section of an excised lymph node is the mainstay of pathologic diagnosis. Most
often, the diagnosis of difficult lesions relies heavily on a careful
assessment of the underlying architecture. Lymphoma diagnoses are much less
about cytologic detail and far more about altered architecture. For example,
follicular small-cleaved cell lymphoma (FSC) is characterized by an abundance
of neoplastic lymphoid follicles containing monomorphous small-cleaved
lymphocytes. The individual cells themselves, however, are otherwise typical
small cleaved lymphocytes seen in the benign follicles of reactive lymph nodes.
The loss of normal nodal architecture that accompanies an
infiltrate is of paramount importance in making a diagnosis. An incisional
lymph node provides only a glimpse of the architecture, making interpretation
difficult. Our surgical colleagues must be instructed to biopsy the most
clinically significant site, and whenever possible, to remove an intact lymph
node for pathological processing. The tissue should be delivered fresh to
pathology at an appropriate time of the day in order to maximize the material
for lymphoma protocol studi...
Source: Oncopathology - Category: Pathologists Tags: FNAC lymph node biopsy lymphoma core boiopsy. Source Type: blogs
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