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Lymphoma - B cell neoplasms

Lymph nodes

Grossing lymph nodes


Reviewer: Nikhil Sangle, M.D., University of Utah and ARUP Laboratories (see Reviewers page)
Revised: 22 December 2010, last major update December 2010
Copyright: (c) 2001-2010, PathologyOutlines.com, Inc.

General
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● 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’s 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 don’t use to obtain a specific diagnosis because freezing artifacts may hinder diagnosis

End of Lymphoma - B cell neoplasms > Lymph nodes > Grossing lymph nodes


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