Microscopic findings Microscopic findings Low cellularity Small mature

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• Microscopic findings

• Microscopic findings

• Microscopic findings • Low cellularity • Small mature lymphocytes • Large atypical

• Microscopic findings • Low cellularity • Small mature lymphocytes • Large atypical cells • Scattered, single, dyscohesive • Pleomorphic • Mononucleated, multinucleated (horseshoe-shaped, ring-shaped, Reed-Sternberg-like cell) • Prominent nucleoli • Abundant cytoplasm

• Differential diagnosis 1. Anaplastic large cell lymphoma 2. Hodgkin lymphoma 3. Poorly

• Differential diagnosis 1. Anaplastic large cell lymphoma 2. Hodgkin lymphoma 3. Poorly differentiated metastatic carcinoma 4. Malignant melanoma

Malignant melanoma • Known as “the great mimicker” – broad variety of cytomorphologic features

Malignant melanoma • Known as “the great mimicker” – broad variety of cytomorphologic features • Round or polygonal • Mirror-image binucleated and multinucleated cells – frequently seen • Nuclei – eccentrically located • One prominent nucleolus or several nucleoli • Abundant cytoplasm and well-defined cell border • Fine, granular melanin pigment in the cytoplasm

Metastatic poorly-differentiated carcinoma • Large, irregular cluster with irregular borders or loss of cohesiveness

Metastatic poorly-differentiated carcinoma • Large, irregular cluster with irregular borders or loss of cohesiveness • High N/C ratio • Large, pleomorphic nuclei and prominent nucleoli Urothelial ca. Endometrial ca.

Hodgkin lymphoma • Bimodal age incidence : 20 -30 yrs, >50 yrs • LAP

Hodgkin lymphoma • Bimodal age incidence : 20 -30 yrs, >50 yrs • LAP (Cervical LAP-60%) : m/c symptoms • Systemic Sx. (B Sx. , itching): relatively common • Background of lymphocytes, plasma cells, eosinophils, and histiocytes • Classic Reed-Sternberg cell • Hodgkin cell • Lacunar cell, popcorn cell

Anaplastic large cell lymphoma • Rare in elderly but frequently in children and young

Anaplastic large cell lymphoma • Rare in elderly but frequently in children and young adult (peak in first 3 decades) • B Sx. : common (75%) • Varying proportion of hallmark cells : large cells with pleomorphic nuclei; round to horseshoe-shaped, ring-shaped; multinucleation; abundant eosinophilic cytoplasm with perinuclear halo; Reed-Sternberg-like cells

• Diagnosis • 29/M • Mesenteric lymph node : Anaplastic large cell lymphoma

• Diagnosis • 29/M • Mesenteric lymph node : Anaplastic large cell lymphoma

• Further evaluation • Excision biopsy • Immunohistochemical staining • Anaplastic large cell

• Further evaluation • Excision biopsy • Immunohistochemical staining • Anaplastic large cell lymphoma: CD 30 (+), CD 15 (-), CD 45 (+), EMA (+/-), ALK (+), keratin (-), EBV (-) • Hodgkin’s lymphoma: CD 30 (+), CD 15 (+), CD 45 (-), EMA (-), ALK (-), EBV (+) • Melanoma: S-100 (+), HMB-45 (+) • Carcinoma: EMA (+), keratin (+)

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Microscopic finding Mucinous background Low cellularity Isolated orMicroscopic finding Mucinous background Low cellularity Isolated or
Cytological findings Moderate to low cellularity Bloody inflammatoryCytological findings Moderate to low cellularity Bloody inflammatory
Single bipolar nuclei Cytologic Findings Cellularity low NucleusSingle bipolar nuclei Cytologic Findings Cellularity low Nucleus
Cytologic Findings Cellularity moderate p Individually scattered orCytologic Findings Cellularity moderate p Individually scattered or
Summary of cytologic findings High cellularity Moderate toSummary of cytologic findings High cellularity Moderate to
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