Mediastinum
Cytopathology Competency Assessment
Lymph Node

Author: Gordon H. Yu, M.D. (see Authors page)

Revised: 28 April 2016, last major update September 2012

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

Cite this page: Cytology/Competency Assessment - Lymph Node. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/mdstnmcytcomplymph.html. Accessed December 17th, 2017.
Medical Knowledge, Practice Based Learning and Systems Based Practice
  1. Reactive Hyperplasia
    1. Recognize frequently encountered clinical scenarios associated with reactive lymphoid hyperplasia
    2. Become familiar with the typical cytologic smear appearance of a reactive lymphoid proliferation and the differential diagnosis of a lymphoid-rich FNA biopsy from a mediastinal mass
  2. Castleman Disease (Angiofollicular Hyperplasia)
    1. Learn the typical clinical and radiologic presentation of Castleman disease, its clinical course and other potential anatomic locations
    2. Learn the two major subtypes of Castleman Disease
      1. Hyaline vascular type
        • Become familiar with the clinical presentation of this subtype (lack of systemic symptoms)
        • Become familiar with the typical histologic features of this lesion and correlate it to potential FNA findings
      2. Plasma cell type
        • Recognize the frequent association of this subtype with systemic symptoms and its association with other clinical syndromes
        • Become familiar with typical FNA findings and its differential diagnosis
  3. Lymphoma
    1. Recognize that lymphoma represents the most common primary neoplasm of the middle mediastinum as well as its frequent occurrence in other compartments of the mediastinum
    2. Recognize the diagnostic utility of FNA biopsy in the diagnosis of lymphoma, as well as histologic features which may interfere with the consistent acquisition of diagnostic material
      1. Hodgkin lymphoma
        • Recognize Hodgkin lymphoma as the most common primary mediastinal lymphoma
        • Become familiar with the typical morphologic features of FNA biopsy of this tumor, and the differential diagnoses which must be considered
        • Identify useful immunohistochemical stains to exclude other potential entities when making this diagnosis
      2. Non-Hodgkin lymphoma
        • Become familiar with the expected FNA findings of primary mediastinal large B-cell lymphoma as well as its expected immunohistochemical staining pattern based on its cell of origin
        • Become familiar with the typical FNA findings of lymphoblastic lymphoma, including background features typically seen as a result of its rapid growth and cell turnover
        • Learn the expected FNA features of thymic MALToma and its expected immunohistochemical staining pattern