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Lymph Nodes

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Part of the book series: Practical Anatomic Pathology ((PAP))

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Abstract

Fine-needle aspiration (FNA) of lymph nodes for the evaluation of suspected lymphoma is a controversial topic. More so than any other organ system, evaluation of lymph nodes requires a multimodal approach including morphology and immunophenotyping. In certain situations, molecular cytogenetic testing is needed for difficult cases and for diagnosis refinement. Although FNA cytomorphology provides important diagnostic clues, histomorphology (architecture) provided by core needle biopsy is often needed in the evaluation of lymphoma. The introduction of additional cytogenetics-based entities in the 2017 World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissue has made the cytopathological diagnosis of lymphoma even more challenging. Regardless, FNA can still play a valuable role in triaging patients with lymphadenopathy. This is especially impactful for patients who need a rapid diagnosis, have deep-seated site of disease inaccessible to core needle biopsy, or those who cannot tolerate a surgical procedure. Successful interpretation of lymph node FNA can only be achieved with proper clinical and radiological correlation, complete awareness of its limitations, and inputs from hematopathology colleagues.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, MA, USA

    John C. Lee M.D.

  2. Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Xiaohua Qian

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  1. John C. Lee M.D.
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  2. Xiaohua Qian
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Correspondence to Xiaohua Qian .

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  1. VA Boston Healthcare System, Boston, MA, USA

    Huihong Xu

  2. Brigham and Women’s Hospital, Boston, MA, USA

    Xiaohua Qian

  3. Robert Wood Johnson University Hospital, New Brunswick, NJ, USA

    He Wang

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Lee, J.C., Qian, X. (2020). Lymph Nodes. In: Xu, H., Qian, X., Wang, H. (eds) Practical Cytopathology . Practical Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-24059-2_15

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