Lymphoid Pathology

Question 1

What is the term for:

• A white cell neoplasm in the blood?
• A myeloid cell mass not in the blood?
• A lymphoid cell mass not in the blood?

Answer 1

• Leukaemia
• Myeloid sarcoma (not myeloma!) - very rare
• Lymphoma

Question 2

Can you have metastatic lymphoma?

Answer 2

No. Lymphoid tissue is everywhere, so the primary/secondary terms are meaningless

Question 3

What cell line is associated with Hodgkin’s lymphoma? What histologically confirms the diagnosis?

Answer 3

• B cell (probably EBV-associated)
• Reed-Sternberg cell (binucleate) or variants

Question 4

Can you use flow cytometry to diagnose Hodgkin’s lymphoma?

Answer 4

• No. The population census it undertakes will not detect the sporadic Reed-Sternberg cells

Question 5

Which two lymphoma and leukaemia often co-exist?

Answer 5

Small lymphocytic lymphoma and CLL

Question 6

Which non-Hodgkin lymphoma is associated with EBV infection?

Answer 6

Burkitt’s

Question 7

Which lymphoma can be the end-point of other lymphomas?

Answer 7

Diffuse large-B cell

Question 8

What is a Richter transformation?

Answer 8

• Transformation of SLL into diffuse large-B cell lymphoma
• Other lymphomas can also do this, without the eponymous name

Question 9

What is the histological characteristic distinguishing between sarcoidosis and TB?

Answer 9

• Non-caseating granulomatous inflammation (sarcoid)
• Caseating granulomatous inflammation (TB)