Pathology Cheat Sheet
Classify the Nodal Lesion
Lymphoma for NEET-PG: Reed-Sternberg CD15 CD30, nodular sclerosis, Ann Arbor staging, follicular t(14;18), Burkitt t(8;14), mantle cell, and FNAC limits.
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Classify the Nodal Lesion
Lymphoma for NEET-PG: Reed-Sternberg CD15 CD30, nodular sclerosis, Ann Arbor staging, follicular t(14;18), Burkitt t(8;14), mantle cell, and FNAC limits.
The classification and pathology of Hodgkin and non-Hodgkin lymphoma, metastatic nodal disease, and the role of FNAC.
High-yield lines
- Hodgkin lymphoma is defined by malignant Reed-Sternberg cells within an abundant reactive inflammatory background.
- The Reed-Sternberg cell is a large binucleate cell with owl-eye eosinophilic nucleoli.
- Classic Reed-Sternberg cells are CD15 positive, CD30 positive, and CD45 negative.
- Nodular sclerosis is the most common Hodgkin subtype and shows lacunar cells and broad collagen bands.
- EBV is implicated in a substantial subset of Hodgkin lymphoma, especially the mixed cellularity subtype.
- Hodgkin lymphoma spreads in an orderly contiguous fashion, which underlies the Ann Arbor staging system.
- An excisional biopsy, not FNAC, is required to diagnose lymphoma because architecture is essential.
- Follicular lymphoma is the most common indolent non-Hodgkin lymphoma and carries the t(14;18) translocation overexpressing BCL2.
- Burkitt lymphoma shows a starry-sky pattern and the t(8;14) translocation driving MYC.
- Diffuse large B-cell lymphoma is the most common aggressive non-Hodgkin lymphoma.
- Mantle cell lymphoma carries the t(11;14) translocation overexpressing cyclin D1.
- Fine-needle aspiration cytology can suggest metastatic carcinoma in a node but cannot reliably subtype lymphoma.
Mapped competency codes
- PA19.4
- PA19.5
- PA19.6
- PA19.7
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This summary maps to PA19-lymph-node-and-spleen.
Frequently Asked Questions
What is the immunophenotype of classic Reed-Sternberg cells?
CD15 positive, CD30 positive, and CD45 negative, which is the most frequently tested immunophenotype triad in Hodgkin lymphoma.
Which translocation characterises follicular lymphoma?
The t(14;18) translocation, which places BCL2 under the immunoglobulin heavy chain promoter, preventing apoptosis of the lymphoma cells.
Why is excisional biopsy preferred over FNAC for lymphoma?
Because lymphoma diagnosis depends on tissue architecture, which is preserved in an excisional biopsy but lost in a needle aspirate.
What is the classic histology of Burkitt lymphoma?
A starry-sky appearance from tingible body macrophages among a monotonous population of MYC-driven cells with the t(8;14) translocation.
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