1. 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

2. 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

3. Case 1 Smearx200

4. Case 1 Smearx400

5. Case 1 Smearx600

7. Case 1 Cell BlockX400

8. Case 1 Cell BlockX600

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

10. Case 2: smear x400

11. Case 2: smear x600

13. Case 2: cell block X400

14. 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

15. Case 3

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

19. Case 4 FNA Aspirate

20. Case 4

21. Cell Block

22. Case 4

23. 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

24. Case 5: Smear X200

25. Case 5: Smear X400

26. Case 5: Smear X600

27. Case 5: Cell block X600

28. 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

29. Case 6: core x20

30. Case 6: core x100

32. Case 6: core x600

33. 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

34. Case 7: Smear X200

35. Case 7: Smear X400

36. Case 7: Smear X600

37. Case 7: Cell block X400

38. 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

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

40. Case 8: smear x10

41. Case 8: cell block x200

42. 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

43. Case 9: Smear X400

44. Case 9: Smear X600

45. Case 9: Cell Block X400

46. Case 9: Cell Block X600

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

48. Case 10: Smear X400

49. Case 10: Smear X600

50. Case 10: Cell Block X400

51. Case 10: Cell Block X600