FRCPath Part1 Course
Lymphoreticular Pathology Granulomatous Lymphadenitis EMQ 1 For each of the following scenarios, select the most likely condition from the list of options.
1. A 35 year old woman develops enlarged left axillary lymph nodes. Excision biopsy shows serpiginous necrosis containing nuclear debris and surrounded by palisaded histiocytes. A WarthinStarry stain is positive. 2. A 24 year old woman presents with cervical lymphadenopathy. Lymph node histology shows follicular hyperplasia, monocytoid B-cell hyperplasia and small aggregates of epithelioid cells, some of which encroach on germinal centres. 3. A 55-year old man presented with weight loss, fever and polyarthralgia. An abdominal CT scan showed mesenteric and retroperitoneal lymphadenopathy. A laparoscopic lymph node biopsy shows collections PASD-positive mononuclear and multinucleated histiocytes with foamy cytoplasm. 4. A 30-year old woman presents with shortness of breath, a dry cough, weight loss and cervical lymphadenopathy. An excisional lymph node biopsy shows discrete nonnecrotising granulomas with focal fibrosis. 5. A 75-year old diabetic smoker presents with cough, fever and loss of weight. Lymph node biopsy shows granulomas with areas of central necrosis. Staining with PASD and Grocott is positive.
Reactive and Neoplastic Lymph Node Histology MCQ 2 A 20-year old Asian woman presents with painful enlarged lymph nodes in the neck, fever and flulike symptoms. Lymph node biopsy shows widespread apoptosis and necrosis with paracortical expansion by blast cells and histiocytes with crescentic nuclei. What is the most likely diagnosis? A. B. C. D. E.
Kikuchi’s disease Diffuse large B-cell lymphoma Kimura’s disease Cat scratch disease Infectious mononucleosis
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