Pathology Slides Presentation by Sir Asghar Javaid

SPECIAL THANKS to DR. NABEEL AKHTAR (N-57) for contibuting this Presentation. 

May Allah Bless him. Ameen!

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 This karyotype of 46, XY, t(8;14) demonstrates the translocation typical for a Burkitt type (small non-cleaved) lymphoma

 

 Burkitt lymphoma. A, At low power, numerous pale tingible body macrophages are evident, producing a "starry sky" appearance.

 

 B, At high power, tumor cells have multiple

small nucleoli and high mitotic index. The lack of significant variation in nuclear shape and size lends a monotonous appearance. (B, courtesy of Dr. José Hernandez, Department of

Pathology, University of Texas Southwestern Medical School, Dallas, TX.)

 Follicular lymphoma (lymph node). A, Nodular aggregates of lymphoma cells are present throughout lymph node.

 

 B, At high magnification, small lymphoid cells with

condensed chromatin and irregular or cleaved nuclear outlines (centrocytes) are mixed with a population of larger cells with nucleoli (centroblasts). (A, courtesy of Dr. Robert W.

McKenna, Department of Pathology, University of Texas Southwestern Medical School, Dallas, TX.)

 Diffuse large B-cell lymphoma. Tumor cells have large nuclei, open chromatin, and prominent nucleoli. (Courtesy of Dr. Robert W. McKenna, Department of Pathology,

University of Texas Southwestern Medical School, Dallas, TX.)

 diagnosis is: malignant lymphoma, small lymphocytic type, diffuse

 

 This is a malignant lymphoma, small cleaved cell type, follicular (also known as: malignant lymphoma, poorly differentiated lymphocytic type, nodular).

 

 The malignant lymphocytes here are very large with a moderately abundant cytoplasm, and the nuclei are round to ovoid with prominent nucleoli and occasional mitoses. The diagnosis is diffuse malignant lymphoma, large cell type (also known as: immunoblastic lymphoma).

 

 The cells are large, with prominent nucleoli and abundant cytoplasm

large cell lymphomas 

 Diagnostic Reed-Sternberg cell, with two nuclear lobes, large inclusion-like nucleoli and abundant cytoplasm, surrounded by lymphocytes, macrophages, and an eosinophil

 B, Reed-Sternberg cell, mononuclear variant

 C, Reed-Sternberg cell, lacunar variant.

 D, Reed-Sternberg cell, lymphohistiocytic (L&H) variant

  Hodgkin lymphoma, mixed cellularity type

 This is Hodgkin's disease, nodular sclerosis type. Note the bands of pink collagenous tissue dividing the field.

 

 Hodgkin lymphoma, nodular sclerosis type

 nodular sclerosing Hodgkin's disease has prominent bands of fibrosis

 the lacunar cells characteristic for the nodular sclerosis type of Hodgkin's disease.

 

 Hodgkin lymphoma, lymphocyte predominance type

 large cells with large, pale nuclei containing large purple nucleoli at the arrowheads. These are Reed-Sternberg cells

 

 With antibody to CD-15, this immunoperoxidase stain demonstrates the Reed-Sternberg and lacunar cells characteristic for Hodgkin's disease

 

 CML

 CML

 Myeloid cells of CML are also characterized by the Philadelphia chromosome (Ph1) on karyotyping. This is a translocation of a portion of the q arm of chromosome 22 to the q arm of chromosome 9, designated t(9:22).

 Cml spleen

 A, Nucleated red cell progenitors with multilobated or multiple nuclei

 B, Ringed sideroblasts, erythroid progenitors with iron-laden mitochondria, seen as blue perinuclear granules (Prussian blue stain) 

 C, Pseudo-Pelger-Hüet cells, neutrophils with only two nuclear lobes instead of normal three to four, are observed at the top and bottom of this field

D, Megakaryocytes with multiple nuclei instead of the normal single multilobated nucleus. (A, B, D, marrow aspirates; C, peripheral blood smear.)

 AML

 acute myelogenous leukemia is seen here. There is one lone megakaryocyte at the right center 

 Acute promyelocytic leukemia (FAB M3 subtype)

 Acute monocytic leukemia (FAB M5b subtype)

 CLL

  NORMAL BONE MARROW

 CLL

 Anaplastic large cell lymphoma. A, Several "hallmark" cells with horseshoe-like or "embryo-like" nuclei and abundant cytoplasm lie near the center of the field

 . B,

Immunohistochemical stain demonstrating expression of ALK protein. (Courtesy of Dr. Jeffrey Kutok, Department of Pathology, Brigham and Women's Hospital, Boston, MA.)

 BENIGN THYMOMA

 MALIGNANT THYMOMA

 Mantle cell lymphoma. A, At low power, neoplastic lymphoid cells surround a small, atrophic germinal center, exhibiting a mantle zone pattern of growth.

 

 B, High-power

view shows a homogeneous population of small lymphoid cells with somewhat irregular nuclear outlines, condensed chromatin, and scant cytoplasm. Large cells resembling

prolymphocytes (seen in chronic lymphocytic leukemia) and centroblasts (seen in follicular lymp

Lymphoplasmacytic lymphoma. Bone marrow biopsy shows a characteristic mixture of small lymphoid cells exhibiting various degrees of plasma cell differentiation. In

addition, a mast cell with purplish-red cytoplasmic granules is present at the left-hand side of the field.

BCL2 expression in reactive and neoplastic follicles. BCL2 protein was detected by using an immunohistochemical technique that produces a brown stain. In reactive

follicles (A), BCL2 is present in mantle zone cells but not follicular center B cells, whereas follicular lymphoma cells (B) exhibit strong BCL2 staining