PATH 3000 Lecture Notes - Lecture 28: Axillary Lymph Nodes, Cervical Lymph Nodes, Lymphadenopathy
19 Apr 2020
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PATH 3000 – Lecture 28 March 23, 2020 Case Study I
Objectives
• To demonstrate how a lab is involved with a patient throughout
their journey
• To demonstrate how pathology is consulted appropriately to
provide pertinent clinical information
Case 1
• A 62 years old male presents to a medical clinic with 1-month
history of “lumps growing” in axillae and cervical areas
• States new onset of fevers, night sweats, 10 lbs unexplained weight loss
• Physical exam finds multiple 2 to 4 cm nodules which are hard and fixed
Given this case was previously designed by a hematopathologist, this case potentially suggests the
diagnosis is lymphoma, but further examination is required. These lumps could be enlarged lymph
nodes, colloquially known as glands. However, other things could present symptoms as the case as well,
such as infection from tuberculosis, autoimmune conditions, or a sign of previous malignancy or
recurrence.
Other questions that should be asked should be guided by the differentials, such as childhood history,
past medical history, family history, any medications.
Because of the fever, night sweats, and unexplained weight loss along when accounting for his age and
the fairly rapid onset of his history, we can probably assume this could be lymphoma. When we want to
make a diagnosis, the best thing to do is to take a tissue sample.
Excisional/Incisional Lymph Node Biopsy
• Can be performed as an outpatient
These procedures are usually done under local anesthetic and in
outpatient setting such that the patient can go home afterwards.
Case 1: Tissue Is Always The Tissue
• Your patient is referred to a
surgeon who excises an
axillary lymph node
• One week later, pathology
report = Diffuse large B-cell
lymphoma
Document Summary
Path 3000 lecture 28 march 23, 2020 case study i. Objectives: to demonstrate how a lab is involved with a patient throughout their journey, to demonstrate how pathology is consulted appropriately to provide pertinent clinical information. Given this case was previously designed by a hematopathologist, this case potentially suggests the diagnosis is lymphoma, but further examination is required. These lumps could be enlarged lymph nodes, colloquially known as glands. However, other things could present symptoms as the case as well, such as infection from tuberculosis, autoimmune conditions, or a sign of previous malignancy or recurrence. Other questions that should be asked should be guided by the differentials, such as childhood history, past medical history, family history, any medications. Because of the fever, night sweats, and unexplained weight loss along when accounting for his age and the fairly rapid onset of his history, we can probably assume this could be lymphoma.
