Lymph nodes - not lymphoma
Grossing of lymph nodes
Reviewer: William D. DePond, M.D. (see Reviewers page)
Revised: 25 July 2013, last major update June 2006
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.
- 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
- 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’s 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
End of Lymph nodes - not lymphoma > Miscellaneous > Grossing of lymph nodes
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