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Back on Track - One case
Theme : #hemepath
Generalized lymphadenopathy
Axillary lymph node
@TristanRutland7 @MattieFarzin @KMirza @pembeoltulu @TheKarenPinto @DrGeeONE @MAHoureih @SDeMicheleMD @kis_lorand @AmandaIreland1
#PathTwitter #pathology #surgpath #Liverpoolpath
Theme : #hemepath
Generalized lymphadenopathy
Axillary lymph node
@TristanRutland7 @MattieFarzin @KMirza @pembeoltulu @TheKarenPinto @DrGeeONE @MAHoureih @SDeMicheleMD @kis_lorand @AmandaIreland1
#PathTwitter #pathology #surgpath #Liverpoolpath
What is your favored diagnosis:
A. Classic Hodgkin lymphoma (CHL)
B. Diffuse Large B-Cell lymphoma (DLBCL)
C. Angioimmunoblastic T-cell lymphoma (AITL)
D. Reactive lymphadenopathy
A. Classic Hodgkin lymphoma (CHL)
B. Diffuse Large B-Cell lymphoma (DLBCL)
C. Angioimmunoblastic T-cell lymphoma (AITL)
D. Reactive lymphadenopathy
AITL
- Neoplastic small-medium pale/clear T cells CD3,CD2, CD5 &usually CD4 with TFH markers CD10, CXCL13, ICOS, BCL6&PD1
- High endothelial venules
- Follicular dendritic cells-CD21, CD23 &CD35
- Large B immunoblasts (usually EBV+) while T-cells neg
- Mixed inflammatory B/G
- Neoplastic small-medium pale/clear T cells CD3,CD2, CD5 &usually CD4 with TFH markers CD10, CXCL13, ICOS, BCL6&PD1
- High endothelial venules
- Follicular dendritic cells-CD21, CD23 &CD35
- Large B immunoblasts (usually EBV+) while T-cells neg
- Mixed inflammatory B/G
AITL
- Gen. lymphadenopathy is common & frequently involves spleen, liver, skin & bone marrow
- 3 patterns (WHO them out
)
- If not all classical features are met think of these sister entities:
Follicular T-cell lymphoma
Nodal peripheral T-cell lymphoma with TFH phenotype
- Gen. lymphadenopathy is common & frequently involves spleen, liver, skin & bone marrow
- 3 patterns (WHO them out
)- If not all classical features are met think of these sister entities:
Follicular T-cell lymphomaNodal peripheral T-cell lymphoma with TFH phenotype
AITL
Extremely EASY to diagnose
The only issues are:
- It can look like reactive LN (pattern 1)
- Can have RS-like cells (simulate HL)
- Tumor cellârich AITL ( if too much clear cells) can simulate PTCL,NOS
Also it can progress to EBV-DLBCL (if too much B cells)
Extremely EASY to diagnose
The only issues are:- It can look like reactive LN (pattern 1)
- Can have RS-like cells (simulate HL)
- Tumor cellârich AITL ( if too much clear cells) can simulate PTCL,NOS
Also it can progress to EBV-DLBCL (if too much B cells)
Giveaway bonus question(s): Of the following,
The mutation associated with AITL is:
All are made up mutations expect:
All are things you can send to others except:
The mutation associated with AITL is:
All are made up mutations expect:
All are things you can send to others except:
IDH2
Other associated mutations are:
TET2, DNMT3A, and GTPase RHOA mutations.
---END OF THREAD--- https://pubmed.ncbi.nlm.nih.gov/26268241/
Other associated mutations are:
TET2, DNMT3A, and GTPase RHOA mutations.
---END OF THREAD--- https://pubmed.ncbi.nlm.nih.gov/26268241/
