Preliminary materials Practical Cytological and Histological Approach to Lymphoid Lesions Workshop 8, 55 th annual meeting Canadian Association of Pathologists Montréal, Saturday July 3, 2004 Manon Auger and René P. Michel McGill University and McGill University Health Center, Montreal, QC

Case 1: clinical Hx 55 y.o. F In 2001, presented with superior vena cava syndrome Diagnosis made and she was treated In 2003, left Virchow node FNA to rule out recurrent disease

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Case 2: clinical Hx 28 y.o. F presents with left cervical enlarged lymph node FNA and subsequent biopsy performed

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56 y.o. F, longstanding history of multiple sclerosis Admitted with massive adenopathy in neck, chest, axilla and abdomen, X few months, growing rapidly over 1 week In acute respiratory distress, fever; LDH 700 CT showed 3 lesions in liver, splenomegaly of 22 cm CXR: RUL sub-segmental consolidation, left pleural effusion and LLL atelectasis FNA submandibular mass, Bx axillary lymph node Case 3: clinical history

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Case 4: clinical Hx 40 y.o. HIV+ M, smoker, presented with neck mass, fever and weight loss FNA of right neck node

Case 4 FNA Aspirate

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Case 5: clinical Hx 57 y.o. M presents with a 4 month history of enlarged neck nodes No systemic symptoms Physical exam shows parotid mass and multiple lymph nodes in the neck Fine needle aspiration of submental lymph node performed

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Case 6: clinical history 61 y.o. M with solitary enlarged lymph node in femoral canal FNA performed: suggestive of malignancy, but cells very degenerated and air-dried Core biopsy of the lymph node then performed

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Case 7: clinical history 80 y.o. M with past history of gastric symptoms with diagnosis in 1999 and 2001 of gastric M.A.L.T. lymphoma In 2001, presents with abdominal pain and CT scan shows right lower quadrant mass with prominent small bowel mural thickening Fine needle aspiration of this mass was performed

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Case 8: clinical history 44 y.o. M, HIV positive for approx. 6 years Presented to his physician for abdominal distention, weight loss and fatigue of 2 mo duration Physical exam: abdominal distention due to ascites, but no lymphadenopathy, hepatosplenomegaly Normal chest radiograph

Case 8: clinical Dx and procedure Abdominal CT scan: ascites, no adenopathy Clinical diagnosis: abdominal tuberculosis Abdominal paracentesis X 2

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Case 9: clinical history 59 y.o. Haitian M presented with a history of anorexia, nausea, vomiting, and weight loss Had hypertension, renal failure and normocytic anemia Chest radiograph showed multiple lung nodules, mostly in lower lobes Also, submental lymph node on which a fine needle aspirate was done

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Case 10: clinical Hx 55 year old M presents with tonsillar enlargement Palpable cervical adenopathy FNA of cervical lymph node performed

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