Pediatric follicular lymphoma 🩸Localized nodal disease 🩸“Node-in-node” morphology: Normal architecture extensively altered, germinal centers are expanded, mantle zones attenuated, a rim of residual reactive lymph nodal tissue is frequently seen #hemepath #lymsm #pathtwitter

CML-chronic phase: 🩸Presence of fibrosis at time of diagnosis previously associated with a worse outcome in the pre-TKI era, later found not to have substantial impact on prognosis in patients treated with TKIs #hemepath #leusm #cml #cmlsm #pathtwitter

Plasma cell neoplasm, signet ring cell variant, in the bone marrow➡️ 🩸Abundant vacuolated cytoplasm 🩸Eccentric small nuclei 🩸Can be misdiagnosed as signet ring cell carcinoma 🩸Follicular lymphoma can also present with this morphology #hemepath #medtwitter #gipath #surgpath

Histioytic sarcoma possibly transdifferentiating from background CLL➡️ 🩸CLL component is patchy & obscured by the histiocytic sarcoma 🩸Clues to CLL: Small VERY monotonous clusters of cells➡️stains to the rescue 🩸Never stop at one diagnosis #Hemepath #pathtwitter #MedTwitter

Systemic mastocytosis & associated hematologic neoplasm (SM-AHN) 🩸MDS/MPN(s) are the most common AHN 🩸AML with t(8;21) can rarely also be an AHN 🩸These can obscure SM component 🩸Tryptase stain applied in these cases not to SM #hemepath #smsm #PathTwitter #leusm #MedTwitter

Limited biopsy of LN invovled by nodular lymphocyte predominant Hodgkin lymphoma➡️ 🩸Focal clusters of neoplastic cells 🩸With preserved B-cell program 🩸Background rich in PD1+ follicular helper T-cells forming rosettes around neoplastic cells #hemepath #lymsm #pathtwitter

Relapsed DLBCL with unusual spindle-cell morphology, reminiscent of follicular dendritic cell sarcoma (FDCS), with diffuse aberrant expression of FDC markers CD21 and CD23 #hemepath #lymsm #surgpath #pathtwitter #pathX #MedTwitter #MedX #MedEd

Example of focal nodal involvement by peri-follicular CLL/SLL, in an otherwise normal overall architecture. This is a very sneaky and easy to miss presentation, particularly in the absence of an established diagnosis. In the absence of flow cytometry analysis (as was the case

A rare case of Dasatinib-related "fluid overload- associated large B-cell lymphoma" (FO-LBCL) involving the preicardial fluid: 🩸FO-LBLCL is an HHV8 and EBV-negative primary effusion-based lymphoma, frequently associated with fluid overload related to diseases of the heart,

If you diagnose a nodal T-cell lymphoma with these features: -Morphology is blastoid -No monotypic pattern of TRBC1 by flow cytometry analysis -No TCR gene rearrangement by PCR Add a marker of cell immaturity like TDT, CD34, CD117 etc, even if the clinical features are not

Please join us for LUC by Dr. Medeiros @4PM CT tomorrow 📢 mdacc.zoom.us/j/85440503413?… #hemepath #pathedu #pathtwitter SHUYU E MD, PhD PaulYoungMD

Illustration of nodal CLL/SLL, with a spectrum of growth of proliferation centers (PCs), slowly evolving and replacing existing germinal centers (GCs)(represented in zones with high Ki67 expression in figures 1 & 2), until full nodal involvement (figures 3 & 4) #hemepath #lymsm

More on CLL/SLL, and the possible role of EBV infection in inducing disease acceleration➡️ Below is an example a lymph node, excised from a patient with CLL/SLL showing signs of clinical progression, to rule out Richter Transformation. Morphologic examination shows an

Rare cases of FL/ DLBCL with BCL2 and IRF4 rearrangements exist, and should not be confused with large B-cell lymphoma with IRF4 rearrangement. FL/ DLBCL with BCL2 and IRF4 rearrangements typically show triple expression of CD10, BCL6 and MUM1 by IHC stains. FL/ DLBCL with

Expanding on the theme of IRF4 rearrangement in B-cell lymphomas, beyond "large B-cell lymphoma with IRF4 rearrangement": EBV-associated DLBCL may in rare instances harbor IRF4 rearrangement. These cases appear to exhibit clinical, histologic, immunophenotypic and