PATHOLOGY OF LYMPH NODES
Norman Levy, MD
- A. Review the histology and cytology of the normal lymph node
- B. Review normal lymphopoiesis
- C. Present the major pathologic processes occurring within
the lymph nodes
- 1. Reactive hyperplasias
- 2. Malignant lymphoma (non-Hodgkin's Lymphoma - NHL)
- 3. Hodgkin's disease
- D. Relate lymphoid malignancies to their benign counterparts
- A. The student should know the anatomic regions of the normal
lymph node, and the cytologic populations
- that occupy them
- B. The student should know the relationship between lymph
node structure and the immunologic functions of the lymphoid immune
system that occur within them
- 1. The sites of B and T cell homing
- 2. The sites of B and T cell expansion in response to antigenic
- C. The student should know the basic features of normal lymphopoiesis
- 1. The locations and immunologic changes of antigen independent
maturation, B and T cell
- 2. The locations, morphologic changes, associated with antigen
stimulated B and T cell maturation and differentiation
- D. The student should be able to relate the cytologic features
of lymphoid cells to their physiologic state: resting, activated,
- E. The student should know the major patterns of lymph node
- F. The student should know the current classification and
major histologic subtypes of the non-Hodgkin's lymphomas and
- Hodgkin's disease.
- G. The student should be able to relate the major subtypes
of non Hodgkin's lymphomas to their benign counterparts, and understand
the biologic and therapeutic significance of these relationships.
- H. The student should know what types of ancillary diagnostic
studies are used in the diagnosis and prognosis of these diseases:
immunologic, cytogenetic, molecular.
- 1. Flow cytometry
- 2. Immunohistochemistry
- 3. Gene rearrangement studies
- 4. (The student is expected to know that these techniques
exist, and how they are generally used, but is not expected to
memorize the antigens / antibodies / molecular probes used in
- I. The student should know the common and unique clinical
presentations of lymphoid malignancies.
- J. The student should know the major staging system for lymphoid
- K. The student should know the basic treatment strategies
for lymphoid malignancies.
- A. 1-3:00 Lecture/Computer demonstration
- A. Robbins Pathologic Basis of Disease, 5th edition
V. Computer assisted learning
- A. This lecture and the microscopic images will be available
for review in Hypertext Markup Language (HTML) form over the World
Wide Web. It can be viewed through any WWW browser, such as the
Netscape World Wide Web browser available through the Dartmouth
College network. There are several ways it can be accessed.
- 1. Through the Medical library Macintosh workstations used
for review of other computer assisted programs. Search Levy lecture
- 2. Through any Macintosh with a color monitor, 8 megs of RAM,
and access to Netscape via the Dartmouth college network or any
other WWW access, by methods 3, 4 or 5. below
- 3. The program can be viewed on the WWW at URL HTTP://www.dartmouth.edu/~nlevy/levylecture.html
- 4 (Or you can take the more humorous route, and get there
by my personal homepage at URL: HTTP://www.dartmouth.edu/~nlevy
- a. Go to "Pathology Resources"
- b. Double click on "Pathology of lymph nodes, SBM Hematology"
- 5. It can also be downloaded by Internet file transfer protocol
(ftp) and viewed on your own computer, using Netscape or any other
WWW browser such as Microsoft Explorer. (This may speed up the
display of images, which can be quite slow over the internet when
all US time zones are awake and playing, when they should be working.
However, you will need the necessary diskspace.)
- a. Use Dartmouth College's Fetch program to access ftp:
- 1). Host: ftplocal.dartmouth.edu
- 2). User: Anonymous
- 3). Password: Leave blank
- 4). Directory: /levy
- 5). Double mouseclick the lecture, or highlight and click
the "Get" button
- 6). Fetch will ask where to place the file, and then deliver
it in compressed form, approximately four megabytes
- b. Double click file after download to initiate self extraction
of compressed files
- c. Start Netscape, use the FILE menu to access "Open
local file.." and then select lecture.html from the decompressed
folder on your computer.
- B. The lecture is based on WWW hypertext markup language.
All underlined words are linked to other text, graphics, or photomicrographs.
All images surrounded by a border are also linked, either to larger
versions of the same image, or to related information
C. Enjoy, curse or ignore- feedback appreciated via E-mail