Lymph nodes - not lymphoma
Grossing of lymph nodes

Topic Completed: 1 June 2006

Revised: 5 February 2019

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Grossing of lymph nodes

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Cite this page: DePond W. Grossing of lymph nodes. website. Accessed December 5th, 2019.
Definition / general
  • Biopsy the largest and most abnormal regional node
  • Axillary or cervical nodes are preferred; not inguinal nodes due to frequent inflammatory and fibrotic changes
  • Frozen sections may confirm involvement of node by a disease process - don't use to obtain a specific diagnosis because freezing artifacts may hinder diagnosis
  • Fine needle aspiration may confirm metastatic carcinoma or be used to diagnose lymphoma
  • Nodes should be received fresh, not in formalin or other fixative
  • Procedure:
    • Bisect lymph node perpendicular to long axis
    • Obtain portion for culture if needed from end of node (under sterile conditions)
    • Obtain touch imprints, fix in ethanol, stain with H&E and Wright stain
    • Sections for formalin or B5 fixation should be 3 - 4 mm thick to allow for proper fixation
    • Submit portion for flow cytometry from end of node
    • Submit portion for cytogenetics, if needed
    • Avoid squeezing nodes, which may cause changes in histology
    • Note: H&E sections are the most important - more important than immunostains
    • EM is helpful only rarely, to diagnose Langerhans histiocytosis or occasionally metastatic tumors
Additional references
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