CPC #1 Pathology Right lung (unfixed) Multiple nodules in left - - PDF document

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CPC #1 Pathology Right lung (unfixed) Multiple nodules in left - - PDF document

Mar 18, 2024 281 likes •582 views

CPC #1 Pathology Right lung (unfixed) Multiple nodules in left lung (fixed) Left lung (fixed) Multiple Pulmonary Nodules Vascular Vasculitis (Wegeners) Pulmonary infarction Infection Bacteria Mycobacteria

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SLIDE 1

CPC #1

Pathology

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SLIDE 2

Right lung (unfixed)

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SLIDE 3

Multiple nodules in left lung (fixed)

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SLIDE 4

Left lung (fixed)

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SLIDE 5

Multiple Pulmonary Nodules

  • Vascular

– Vasculitis (Wegener’s) – Pulmonary infarction

  • Infection

– Bacteria

  • Mycobacteria

– Fungus

  • Neoplasms

– Primary

  • Benign
  • Malignant

– Metastatic

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SLIDE 6
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SLIDE 7
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SLIDE 8
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SLIDE 9

Malignant Neoplasms

  • Carcinomas
  • Sarcomas
  • Melanoma
  • Germ Cell Tumors
  • Leukemia/Lymphoma
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SLIDE 10
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SLIDE 11

Characterizing an Poorly- Differentiated Malignancy

  • Immunohistochemistry

– Stain slides with antibodies to proteins that are specific to certain cell types

  • Electron Microscopy

– Special microscope for extremely high resolution

  • Genetics

– Cytogenetics – Molecular Biology

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SLIDE 12

CD20 (B cell marker)

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SLIDE 13

CD20 (B cell marker)

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SLIDE 14

CD3 (T cell marker)

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SLIDE 15

Ki-67 (Proliferation marker)

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SLIDE 16

Diagnosis

Diffuse Large B Cell Lymphoma

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DIAPHRAGM IMPLANT

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SLIDE 18

DIAPHRAGM IMPLANT

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SLIDE 19

EPIDIDYMIS

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SLIDE 20

EPIDIDYMIS

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SLIDE 21

HEART-RIGHT ATRIUM

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SLIDE 22

HEART-RIGHT ATRIUM

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SLIDE 23

LEFT VENTRICLE

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SLIDE 24

Diagnosis

  • Diffuse Large B Cell Lymphoma, involving

– Lungs (bilateral nodules) – Middle Mediastinum – Paratesticular soft tissue (bilateral) – Diaphragm – Heart

  • Cardiomegaly
  • Atherosclerosis, Aorta
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Extranodal Lymphoma

  • Lymphoma arising outside of lymph nodes

– Lymphocytes normally circulate – Found in small numbers in virtually all organs

  • 25% of Non-Hodgkins lymphomas are

extranodal

  • Uncommon in Hodgkins lymphoma
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SLIDE 26

Common Extranodal Lymphomas

  • Low Grade

– B cell

  • Mucosa Associated Lymphoid Tissue (MALT) type

– Stomach (H. pylori) – Salivary gland (Sjogren’s syndrome) – Thyroid (Hasimoto’s thyroiditis)

– T cell

  • Mycosis fungoides of skin
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SLIDE 27

Common Extranodal Lymphomas (cont)

  • High Grade

– B cell

  • Diffuse Large B Cell Lymphoma

– Common sites include lung, GI tract, CNS – Can be solitary or multifocal – Can be associated with immunosuppression

  • Burkitt lymphoma

– Commonly involves ileocecal area in children

– T cell

  • Peripheral T Cell Lymphomas
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SLIDE 28

Summary-Key Points

  • Diffuse Large B Cell Lymphoma is the

most common high grade extranodal lymphoma

  • Differential diagnosis of disseminated

malignancy

  • Immunohistochemistry can be used to

characterize a poorly-differentiated malignancy

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SLIDE 29