Document Detail

Incidental small lymphocytic lymphoma/chronic lymphocytic leukemia in pelvic lymph nodes excised at radical prostatectomy.
MedLine Citation:
PMID:  12708899     Owner:  NLM     Status:  MEDLINE    
CONTEXT: Incidental non-Hodgkin lymphoma is often unrecognized at the time of radical prostatectomy in patients with prostate cancer because of nonspecific symptoms and an inconspicuous pathology. The early identification of lymphoma allows optimal long-term management and prevention of significant morbidity. OBJECTIVE: To show the subtlety of pathologic findings in cases of non-Hodgkin lymphoma in pelvic lymph nodes and the need for scrupulous attention to detail for diagnostic accuracy. DESIGN: Histologic and immunohistochemical profiles of 18 consecutive cases of small lymphocytic lymphoma (SLL) incidentally identified in pelvic lymph node dissections were reviewed and compared with 22 cases of benign pelvic lymph node dissections. RESULTS: Malignant nodes were grossly enlarged and averaged 3.2 cm in their greatest dimension. Histologically, 16 of the SLL cases were characterized by diffuse architectural effacement with obliterated sinuses and rare cortical follicles. Twelve of these cases showed evidence of pseudofollicles. Two cases showed an interfollicular growth pattern with occasional small pseudofollicles. In contrast, benign pelvic lymph nodes averaged 1.7 cm in their greatest dimension. Although most were architecturally distorted by fibrosis, all benign nodes were notable for patent sinuses. Immunohistochemistry was diagnostically helpful in several cases with equivocal morphology. All malignant cases had a B-cell phenotype with aberrant coexpression of T-cell-related antigens typical of SLL. CONCLUSION: Incidental low-grade non-Hodgkin lymphoma identified at radical prostatectomy is often overlooked by both the urologist and the pathologist. Although malignant pelvic lymph node dissections frequently lack overt manifestations of lymphoma, attention to subtle morphologic features coupled with lymph node size and immunohistochemical findings should permit diagnostic accuracy.
Edward G Weir; Jonathan I Epstein
Related Documents :
12528279 - A case of visceral leishmaniasis in the northern adriatic region.
19795189 - Ct and mri findings with histopathologic correlation of a unique bilateral orbital mant...
19136769 - Cd20 positivity in classical hodgkin's lymphoma: diagnostic challenge or targeting oppo...
15692949 - Classical hodgkin lymphoma arising in the rectum.
17170729 - Polymerase chain reaction-based clonality testing in tissue samples with reactive lymph...
19065719 - Gastric lymphoma presenting as phlegmonous gastritis.
24815709 - Urinary ascites due to persistent urogenital sinus: a case report and review of literat...
16039359 - Lunate osteochondroma: a case report.
16175749 - Intraplacental choriocarcinoma: experience from a tertiary referral center and relation...
Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Archives of pathology & laboratory medicine     Volume:  127     ISSN:  1543-2165     ISO Abbreviation:  Arch. Pathol. Lab. Med.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-04-23     Completed Date:  2003-05-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7607091     Medline TA:  Arch Pathol Lab Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  567-72     Citation Subset:  AIM; IM    
Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Md 21231, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis,  epidemiology*
Lymph Node Excision / methods*
Lymph Nodes / pathology*,  surgery*
Middle Aged
Pelvis / pathology*
Prostatectomy / methods*
Prostatic Neoplasms / complications,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  CD79b expression in chronic lymphocytic leukemia. Association with trisomy 12 and atypical immunophe...
Next Document:  Nitrergic hyperinnervation in appendicitis and in appendices histologically classified as normal.