PathWays Case Study: August 25



A 60-year-old female with generalized adenopathy had a lymph node biopsied. The lymph node was evaluated by morphology and immunohistochemistry.  The lymph node architecture was effaced by a population of abnormal small lymphocytes growing in a diffuse pattern.  The lymphocytes had round to slightly irregular nuclei, partially clumped chromatin, inconspicuous nucleoli, and sparse cytoplasm.  They were accompanied by a small number of singly distributed epithelioid histiocytes.  The neoplastic cells had a monotypic staining pattern for lambda light chains and were positive for CD5, CD20, CD43, and cyclin D1.  They were negative for CD10, CD23, CD138, and other T-cell lineage antigens.  A diagnosis of mantle cell lymphoma was made.

Three days later and prior to treatment, she had a bone marrow biopsy for staging purposes.  It contained paratrabecular and nodular lymphocytic infiltrates comprising 50% of the bone marrow cellularity.  The lymphocytes were small with irregular nuclei, partially-clumped chromatin, inconspicuous nucleoli, and sparse pale cytoplasm.  The composite H&E photograph above is from the bone marrow biopsy.

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Lisa Hartzheim, MT (ASCP)
Education Program Coordinator
Department of Laboratory Medicine and Pathology
Mayo Clinic
Instructor in Laboratory Medicine and Pathology,
Mayo Clinic College of Medicine



Paul Kurtin, M.D.

Paul Kurtin, M.D.
Consultant, Division of Hematopathology
Mayo Clinic
Professor of Laboratory Medicine and Pathology,
Mayo Clinic College of Medicine



April Josselyn

April Josselyn is a Marketing Associate at Mayo Medical Laboratories. She is the editor of Mayo Clinic PathWays and supports corporate communications strategies and internal communications. She has worked at Mayo Clinic since 2012. Outside of work, April enjoys the outdoors and being "hockey mom" for her two sports-crazed boys.


Ok !

I agree with this cost effective approach and not order additional unneeded tests.

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