Lymphoma and plasma cell neoplasms
Lymph nodes
Grossing lymph nodes

Topic Completed: 1 December 2010

Revised: 5 February 2019

Copyright: (c) 2001-2017,, Inc.

PubMed Search: lymph node grossing

Nikhil Sangle, M.D.
Page views in 2018: 415
Page views in 2019 to date: 315
Table of Contents
Definition / general
Cite this page: Sangle N. Grossing lymph nodes. website. Accessed September 16th, 2019.
Definition / general
  • Best to obtain fresh and intact, NOT in formalin or other fixative
  • Obtain portion for culture (if clinically indicated) from end of node under sterile conditions
  • Submit portion for flow cytometry from end of node
  • Cut perpendicular to long axis if possible
  • Avoid squeezing nodes, which may alter histology
  • Obtain touch imprints, fix in ethanol, stain with H&E, Wright stain or use for immunocytochemistry
  • Use scrapes / cell suspension for flow cytometry, cytogenetics, molecular gene rearrangement studies, FISH
  • Sections for formalin or B5 fixation should be 3 - 4 mm thick to allow for proper fixation
  • Snap freezing is best for research, some immunohistochemistry, future molecular studies
  • B5 (mercury containing fixative) provides best morphologic details
  • Formalin fixation is best for PCR
  • EM is helpful only rarely to diagnose Langerhans histiocytosis or occasionally metastatic tumors
  • Include extranodal fat (infiltration implies malignant process)
  • Note: the most important slides to obtain are sufficient H&E for diagnosis
  • Frozen sections may confirm involvement of node by a disease process, but do not use to obtain a specific diagnosis because freezing artifacts may hinder diagnosis
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