Atlas of Lymph Node Pathology

493 Pages·2013·93.22 MB·English

by  Roberto N. Miranda

Roberto N. Miranda
Joseph D. Khoury
L. Jeff rey Medeiros
Atlas of Lymph
Node Pathology
123
Atlas of Anatomic Pathology
Series Editor
Liang Cheng

For further volumes:
http://www.springer.com/series/10144

Roberto N. Miranda (cid:129) Joseph D. Khoury
L. Jeffrey Medeiros
Atlas of Lymph Node
Pathology
Roberto N. Miranda, MD L. Jeffrey Medeiros, MD
Department of Hematopathology Department of Hematopathology
The University of Texas The University of Texas
M.D. Anderson Cancer Center M.D. Anderson Cancer Center
Houston Houston
Texas Texas
USA USA
Joseph D. Khoury, MD
Department of Hematopathology
The University of Texas
M.D. Anderson Cancer Center
Houston
Texas
USA
ISBN 978-1-4614-7958-1 ISBN 978-1-4614-7959-8 (eBook)
DOI 10.1007/978-1-4614-7959-8
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2013945180
© Springer Science+Business Media New York 2013
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To my wife Norma; my children Alonso and Andrea; my mother Milly
and my late father Hernan; my sisters Elena and Carina;
my brothers Hernan and Aaron.
Roberto N. Miranda, MD
To my wife Leah; my children Gabriel and Sophie;
my parents David and Jacqueline; my sister Christiane
and my brother Claude.
Joseph D. Khoury, MD
To my father, Leonard Luiz Medeiros (1919–2010);
he was a good man.
L. Jeffrey Medeiros, MD

Series Preface
One Picture is Worth Ten Thousand Words
– Frederick Barnard, 1927
Remarkable progress has been made in anatomic and surgical pathology during the last
10 years. The ability of surgical pathologists to reach a defi nite diagnosis is now enhanced by
immunohistochemical and molecular techniques. Many new clinically important histopatho-
logic entities and variants have been described using these techniques. Established diagnostic
entities are more fully defi ned for virtually every organ system. The emergence of personalized
medicine has also created a paradigm shift in surgical pathology. Both promptness and preci-
sion are required of modern pathologists. Newer diagnostic tests in anatomic pathology, how-
ever, cannot benefi t the patient unless the pathologist recognizes the lesion and requests the
necessary special studies. An up-to-date Atlas encompassing the full spectrum of benign and
malignant lesions, their variants, and evidence-based diagnostic criteria for each organ system
is needed. This Atlas is not intended as a comprehensive source of detailed clinical information
concerning the entities shown. Clinical and therapeutic guidelines are served admirably by a
large number of excellent textbooks. This Atlas, however, is intended as a “fi rst knowledge
base” in the quest for defi nitive and effi cient diagnosis of both usual and unusual diseases.
The Atlas of Anatomic Pathology is presented to the reader as a quick reference guide for
diagnosis and classifi cation of benign, congenital, infl ammatory, nonneoplastic, and neoplastic
lesions organized by organ systems. Normal and variations of “normal” histology are illus-
trated for each organ. The Atlas focuses on visual diagnostic criteria and differential diagnosis.
The organization is intended to provide quick access to images and confi rmatory tests for each
specifi c organ or site. The Atlas adopts the well-known and widely accepted terminology,
nomenclature, classifi cation schemes, and staging algorithms.
This book Series is intended chiefl y for use by pathologists in training and practicing surgi-
cal pathologists in their daily practice. It is also a useful resource for medical students, cyto-
technologists, pathologist assistants, and other medical professionals with special interest in
anatomic pathology. We hope that our trainees, students, and readers at all levels of expertise
will learn, understand, and gain insight into the pathophysiology of disease processes through
this comprehensive resource. Macroscopic and histological images are aesthetically pleasing
in many ways. We hope that the new Series will serve as a virtual pathology museum for the
edifi cation of our readers.
Indianapolis, IN, USA Liang Cheng, MD
vii

Preface
This Atlas represents a concise yet broad review of diseases and disorders that affect lymph
nodes. It is intended to serve as a quick reference to pathologists and pathologists-in-training,
medical oncologists, primary care physicians, and students interested in diagnostic non-
neoplastic and neoplastic lymph node pathology. The Atlas is organized in parts and chapters
that sequentially progress from infectious lymphadenitides to reactive lymphadenopathies and
ultimately to neoplastic processes classifi ed by cell of origin or differentiation. For neoplastic
disorders of lymphoid or hematopoietic cells, we have followed the diagnostic categories of
the 2008 World Health Organization classifi cation and illustrated characteristic as well as vari-
ant features.
Despite best intentions, the cell-of-origin paradigm that forms the basis of the present clas-
sifi cation of hematolymphoid neoplasms cannot be applied systematically to all disorders. In
addition, current classifi cation schemes have become more sophisticated, often necessitating
the use of ancillary techniques and incorporating clinical features including the patient’s
genetic background, immune status, history of or underlying disorders, and geographical dis-
tribution. With this in mind, we contend that understanding the basic disease pathogenesis and
emphasizing careful morphologic evaluation form a solid foundation for lymph node pathol-
ogy in clinical practice. In no way do we wish to underemphasize the necessity and value of
ancillary techniques for diagnosis, such as immunohistochemistry, fl ow cytometry immuno-
phenotyping, conventional cytogenetics, fl uorescence in situ hybridization, and molecular
diagnostics. We only wish to remind the reader that the springboard from which these tech-
niques are deployed in a judicious manner remains tissue morphology.
It is our hope that readers will fi nd this Atlas practical and helpful. We have enjoyed the
process of preparing it and sincerely hope it meets the reader’s needs.
Roberto N. Miranda, MD
Joseph D. Khoury, MD
L. Jeffrey Medeiros, MD
ix