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In order to further enhance the pathologist’s ability in the clinical differential diagnosis of common tissue diseases and lymphoma, and reduce the occurrence of missed lymphoma diagnosis, the "Knowledge of Lymphoma-Basic Lymphoma Diagnosis" series of interviews officially set sail, and Yimaitong will invite many people Experts in pathological diagnosis of lymphoma were interviewed to share the theories and practical experience in the differential diagnosis of common diseases and lymphomas in different tissues, so as to help pathologists to improve the comprehensive diagnosis ability of lymphoma
.
This issue of "Knowing Lymphology" specially invited Professor Shi Yunfei from the Department of Pathology, Peking University Cancer Hospital, Professor Xu Enwei from the Department of Pathology, Shanxi Cancer Hospital, and Professor Fang Jianchen from Renji Hospital affiliated to Shanghai Jiaotong University to be interviewed to share ideas on pathological diagnosis of lymphoma
.
Interview with Professor Yunfei Shi (the video is longer, it is recommended to watch it under WiFi conditions) What are the precautions for the differential diagnosis of common lymphoma and related lesions in Yimai Tongwei? Could you please share the clinical identification methods for primary gastrointestinal lymphoma? Professor Yunfei Shi’s differential diagnosis of common gastric lymphoma and related lesions starts with the classification of digestive system (gastric) lymphoma.
The two most common histological types are: extranodal mucosa-associated lymphoid tissue marginal zone (MALT) Lymphoma and diffuse large B-cell lymphoma (DLBCL)
.
In addition, it is necessary to further understand the prevalence and clinical manifestations of primary gastrointestinal lymphoma
.
The main clinical identification methods for primary gastrointestinal lymphoma are CT, PET-CT, and endoscopy
.
CT enhancement mode and parameter analysis can help distinguish advanced gastric cancer from gastric lymphoma; PET-CT can distinguish common lesions of gastric cancer and primary gastric lymphoma (PGL), which has important value in the differential diagnosis; endoscopy can be Distinguish lymphoma, PGL, and ulcer from the appearance, bottom of the ulcer and the morphology of the edge of the ulcer
.
Yimaitong would you like to specifically introduce the two most common histological types in digestive system (gastric) lymphoma: What are the precautions for the differential diagnosis of MALT and DLBCL? Could you please share your experience in differential diagnosis? Professor Shi Yunfei’s pathologist first needs to understand the characteristics, physiology, morphology, immunophenotype, and diagnostic criteria of MALT lymphoma
.
Among them, the differential diagnosis of MALT lymphoma, reactive inflammatory diseases, and lymphoepithelial/myoepithelial sialadenitis can be assisted in the diagnosis by asking the patient's medical history and autoimmune antibody testing
.
Regarding the identification of benign tumors and malignant tumors, to determine whether they are invasive growth, it is necessary to pay attention to the depth of the material to at least reach the mucosal basal layer.
In addition, the IG gene rearrangement test is very helpful for diagnosis
.
The key point for the identification of "large B transformation" in MALT lymphoma is the solid mass of large transformed B cells
.
The differential diagnosis of DLBCL requires an understanding of the characteristics, morphology, immunophenotype, and molecular genetic changes of DLBCL
.
In addition, EBV in situ hybridization is routinely carried out in the detection of lymphoma, which helps to differentiate and diagnose EBV-positive DLBCL
.
The differential diagnosis of DLBCL focuses on non-lymphoid hematopoietic tumors, such as poorly differentiated carcinoma, small cell carcinoma, and mucosal malignant melanoma
.
The differential diagnosis of DLBCL from small cell carcinoma, poorly differentiated adenocarcinoma, and malignant melanoma also requires the focus of the pathologist
.
Interview with Professor Xu Enwei (the video is longer, it is recommended to watch under WiFi conditions) What are the precautions for the differential diagnosis of common lymphoma and related lesions in the intestinal tract of Yimaitong? Could you please share which common intestinal lymphomas need to be focused on by pathologists? Professor Xu Enwei Among the common lymphomas in the intestine, MALT is a type of lymphoma that requires the pathologists to focus on
.
Understanding and mastering the distribution and structure of MALT, as well as the characteristics of cell structure, immunophenotype, etc.
, are the basis for the differential diagnosis of MALT lymphoma
.
In addition, the pathogenesis, cell morphology, and immunophenotype of mantle cell lymphoma (MCL) are also key points that pathologists need to master
.
MCL has three growth methods: mantle area growth, nodular growth, and diffuse growth.
These three growth methods can usually be observed in one lymph node at the same time
.
Attention should be paid to the distinction between DLBCL and DLBCL during diagnosis .
Classical MCL usually has a good prognosis, but the two subtypes of MCL: blastic variant MCL and pleomorphic variant MCL usually have a poor prognosis.
Try to identify them in the early diagnosis to help patients follow-up treatment
.
In addition to MALT and MCL, duodenal follicular lymphoma (DTFL), enteropathy-associated T-cell lymphoma (EATL), intestinal monomorphic epithelial pro-epithelial T-cell lymphoma (MEITL), gastrointestinal The epidemiology, onset characteristics, morphological characteristics, immunophenotypes of indolent T lymphocyte proliferative diseases are also the key points that pathologists need to master
.
In the process of clinical diagnosis of common intestinal lymphoma, it is necessary to analyze the cell morphology of the patient, and pay attention to the differential diagnosis of tumors similar to lymphoma
.
Interview with Professor Fang Jianchen (the video is longer, it is recommended to watch under WiFi conditions) What are the precautions for the differential diagnosis of Yimaitong lung lymphoma and related lesions? Could you please share which pulmonary lymphomas need to be focused on by pathologists? Professor Fang Jianchen Among common lung lymphomas, MALT is a type of lymphoma that needs to be paid attention to by pathologists
.
MALT tumor cells are nodularly distributed along the bronchi, vascular bundles and surrounding alveoli.
Generally, one alveolar grows first and then invades adjacent alveoli
.
In addition, it is necessary to focus on the differential diagnosis of MALT lymphoma and related diseases, such as lymphocytic interstitial pneumonia, non-specific chronic inflammation with nodular lymphoid tissue hyperplasia, IgG4-related diseases, and other small B-cell lymphomas
.
DLBCL is also a common type of pulmonary lymphoma.
When diagnosing primary pulmonary lymphoma, it is necessary to meet the conditions of onset or no extrapulmonary disease 3 months after diagnosis
.
In addition, pathologists also need to understand the clinical features, pathology, immunohistochemistry, molecular pathology of DLBCL, as well as diseases related to lung cancer, germ cell tumors, primary mediastinal large B-cell lymphoma, and anaplastic large cell lymphoma (ALCL).
Differential diagnosis
.
In addition to MALT and DLBCL, relatively rare lymphoma-like granulomas (LYG), intravascular large B-cell lymphoma, extranodal NK/T cell lymphoma, ALCL, ALK-ALCL, Langerhans histiocytosis The clinical features, pathology, immunohistochemistry, etc.
of IgG4-related diseases, Rosai-Dorfman disease, granulomatosis with polyangiitis (GPA) are also key points that pathologists need to master
.
Professor Yunfei Shi, Deputy Chief Physician of the Department of Pathology, Peking University Cancer Hospital, Doctor of Medicine, Deputy Director of the Department of Pathology, Xinjiang Medical University Affiliated Traditional Chinese Medicine Hospital (on post), has been engaged in pathology for more than 10 years.
He is good at pathological diagnosis of common tumors, focusing on pathological diagnosis and scientific research of lymphoma.
Member of the Youth Committee of the CSCO Anti-Leukemia and Lymphoma Alliance at the City of Hope National Cancer Center, USA Member of the Lymphoma Group of the Pathology Committee of the Chinese Anti-Cancer Association Member Professor Xu Enwei, Deputy Chief Physician of the Department of Pathology, Shanxi Cancer Hospital, Doctor of Medicine, went to Queen Elizabeth Hospital, Hong Kong in 2010, to study in the Chinese Medical Association Pathology Branch Youth Member, Chinese Anti-Cancer Association Pathology Professional Committee Young Member, Shanxi Provincial Medical Association Pathologist Branch Executive Member, Standing Committee of the Pathology Professional Committee of Shanxi Medical Association, Deputy Chairman of the Youth Committee of the Pathology Professional Committee of Shanxi Medical Association, AJSP Chinese Edition Youth Editor Professor Fang Jianchen, Chief Physician, Department of Pathology, Renji Hospital, Shanghai Jiaotong University, Chinese Medical Education Association, Lymphoma Major Member of the Committee Member of the Chinese Medical Association Urogenital Pathology Branch began to study the pathology of lymphohematopoietic diseases systematically in 2002, and published more than 30 articles on lymphoma, including 6 articles in the SCI, and presided over 2 related topics
.
The next preview of lymphoma, the third issue | Pathology expert talk: how to clarify the idea of differential diagnosis of lymphoma? RECOMMEND RECOMMENDED READING 1.
Knowing about Lymphology·Issue 1 | A gathering of big names, focusing on improving pathological techniques and helping accurate diagnosis of lymphoma
.
This issue of "Knowing Lymphology" specially invited Professor Shi Yunfei from the Department of Pathology, Peking University Cancer Hospital, Professor Xu Enwei from the Department of Pathology, Shanxi Cancer Hospital, and Professor Fang Jianchen from Renji Hospital affiliated to Shanghai Jiaotong University to be interviewed to share ideas on pathological diagnosis of lymphoma
.
Interview with Professor Yunfei Shi (the video is longer, it is recommended to watch it under WiFi conditions) What are the precautions for the differential diagnosis of common lymphoma and related lesions in Yimai Tongwei? Could you please share the clinical identification methods for primary gastrointestinal lymphoma? Professor Yunfei Shi’s differential diagnosis of common gastric lymphoma and related lesions starts with the classification of digestive system (gastric) lymphoma.
The two most common histological types are: extranodal mucosa-associated lymphoid tissue marginal zone (MALT) Lymphoma and diffuse large B-cell lymphoma (DLBCL)
.
In addition, it is necessary to further understand the prevalence and clinical manifestations of primary gastrointestinal lymphoma
.
The main clinical identification methods for primary gastrointestinal lymphoma are CT, PET-CT, and endoscopy
.
CT enhancement mode and parameter analysis can help distinguish advanced gastric cancer from gastric lymphoma; PET-CT can distinguish common lesions of gastric cancer and primary gastric lymphoma (PGL), which has important value in the differential diagnosis; endoscopy can be Distinguish lymphoma, PGL, and ulcer from the appearance, bottom of the ulcer and the morphology of the edge of the ulcer
.
Yimaitong would you like to specifically introduce the two most common histological types in digestive system (gastric) lymphoma: What are the precautions for the differential diagnosis of MALT and DLBCL? Could you please share your experience in differential diagnosis? Professor Shi Yunfei’s pathologist first needs to understand the characteristics, physiology, morphology, immunophenotype, and diagnostic criteria of MALT lymphoma
.
Among them, the differential diagnosis of MALT lymphoma, reactive inflammatory diseases, and lymphoepithelial/myoepithelial sialadenitis can be assisted in the diagnosis by asking the patient's medical history and autoimmune antibody testing
.
Regarding the identification of benign tumors and malignant tumors, to determine whether they are invasive growth, it is necessary to pay attention to the depth of the material to at least reach the mucosal basal layer.
In addition, the IG gene rearrangement test is very helpful for diagnosis
.
The key point for the identification of "large B transformation" in MALT lymphoma is the solid mass of large transformed B cells
.
The differential diagnosis of DLBCL requires an understanding of the characteristics, morphology, immunophenotype, and molecular genetic changes of DLBCL
.
In addition, EBV in situ hybridization is routinely carried out in the detection of lymphoma, which helps to differentiate and diagnose EBV-positive DLBCL
.
The differential diagnosis of DLBCL focuses on non-lymphoid hematopoietic tumors, such as poorly differentiated carcinoma, small cell carcinoma, and mucosal malignant melanoma
.
The differential diagnosis of DLBCL from small cell carcinoma, poorly differentiated adenocarcinoma, and malignant melanoma also requires the focus of the pathologist
.
Interview with Professor Xu Enwei (the video is longer, it is recommended to watch under WiFi conditions) What are the precautions for the differential diagnosis of common lymphoma and related lesions in the intestinal tract of Yimaitong? Could you please share which common intestinal lymphomas need to be focused on by pathologists? Professor Xu Enwei Among the common lymphomas in the intestine, MALT is a type of lymphoma that requires the pathologists to focus on
.
Understanding and mastering the distribution and structure of MALT, as well as the characteristics of cell structure, immunophenotype, etc.
, are the basis for the differential diagnosis of MALT lymphoma
.
In addition, the pathogenesis, cell morphology, and immunophenotype of mantle cell lymphoma (MCL) are also key points that pathologists need to master
.
MCL has three growth methods: mantle area growth, nodular growth, and diffuse growth.
These three growth methods can usually be observed in one lymph node at the same time
.
Attention should be paid to the distinction between DLBCL and DLBCL during diagnosis .
Classical MCL usually has a good prognosis, but the two subtypes of MCL: blastic variant MCL and pleomorphic variant MCL usually have a poor prognosis.
Try to identify them in the early diagnosis to help patients follow-up treatment
.
In addition to MALT and MCL, duodenal follicular lymphoma (DTFL), enteropathy-associated T-cell lymphoma (EATL), intestinal monomorphic epithelial pro-epithelial T-cell lymphoma (MEITL), gastrointestinal The epidemiology, onset characteristics, morphological characteristics, immunophenotypes of indolent T lymphocyte proliferative diseases are also the key points that pathologists need to master
.
In the process of clinical diagnosis of common intestinal lymphoma, it is necessary to analyze the cell morphology of the patient, and pay attention to the differential diagnosis of tumors similar to lymphoma
.
Interview with Professor Fang Jianchen (the video is longer, it is recommended to watch under WiFi conditions) What are the precautions for the differential diagnosis of Yimaitong lung lymphoma and related lesions? Could you please share which pulmonary lymphomas need to be focused on by pathologists? Professor Fang Jianchen Among common lung lymphomas, MALT is a type of lymphoma that needs to be paid attention to by pathologists
.
MALT tumor cells are nodularly distributed along the bronchi, vascular bundles and surrounding alveoli.
Generally, one alveolar grows first and then invades adjacent alveoli
.
In addition, it is necessary to focus on the differential diagnosis of MALT lymphoma and related diseases, such as lymphocytic interstitial pneumonia, non-specific chronic inflammation with nodular lymphoid tissue hyperplasia, IgG4-related diseases, and other small B-cell lymphomas
.
DLBCL is also a common type of pulmonary lymphoma.
When diagnosing primary pulmonary lymphoma, it is necessary to meet the conditions of onset or no extrapulmonary disease 3 months after diagnosis
.
In addition, pathologists also need to understand the clinical features, pathology, immunohistochemistry, molecular pathology of DLBCL, as well as diseases related to lung cancer, germ cell tumors, primary mediastinal large B-cell lymphoma, and anaplastic large cell lymphoma (ALCL).
Differential diagnosis
.
In addition to MALT and DLBCL, relatively rare lymphoma-like granulomas (LYG), intravascular large B-cell lymphoma, extranodal NK/T cell lymphoma, ALCL, ALK-ALCL, Langerhans histiocytosis The clinical features, pathology, immunohistochemistry, etc.
of IgG4-related diseases, Rosai-Dorfman disease, granulomatosis with polyangiitis (GPA) are also key points that pathologists need to master
.
Professor Yunfei Shi, Deputy Chief Physician of the Department of Pathology, Peking University Cancer Hospital, Doctor of Medicine, Deputy Director of the Department of Pathology, Xinjiang Medical University Affiliated Traditional Chinese Medicine Hospital (on post), has been engaged in pathology for more than 10 years.
He is good at pathological diagnosis of common tumors, focusing on pathological diagnosis and scientific research of lymphoma.
Member of the Youth Committee of the CSCO Anti-Leukemia and Lymphoma Alliance at the City of Hope National Cancer Center, USA Member of the Lymphoma Group of the Pathology Committee of the Chinese Anti-Cancer Association Member Professor Xu Enwei, Deputy Chief Physician of the Department of Pathology, Shanxi Cancer Hospital, Doctor of Medicine, went to Queen Elizabeth Hospital, Hong Kong in 2010, to study in the Chinese Medical Association Pathology Branch Youth Member, Chinese Anti-Cancer Association Pathology Professional Committee Young Member, Shanxi Provincial Medical Association Pathologist Branch Executive Member, Standing Committee of the Pathology Professional Committee of Shanxi Medical Association, Deputy Chairman of the Youth Committee of the Pathology Professional Committee of Shanxi Medical Association, AJSP Chinese Edition Youth Editor Professor Fang Jianchen, Chief Physician, Department of Pathology, Renji Hospital, Shanghai Jiaotong University, Chinese Medical Education Association, Lymphoma Major Member of the Committee Member of the Chinese Medical Association Urogenital Pathology Branch began to study the pathology of lymphohematopoietic diseases systematically in 2002, and published more than 30 articles on lymphoma, including 6 articles in the SCI, and presided over 2 related topics
.
The next preview of lymphoma, the third issue | Pathology expert talk: how to clarify the idea of differential diagnosis of lymphoma? RECOMMEND RECOMMENDED READING 1.
Knowing about Lymphology·Issue 1 | A gathering of big names, focusing on improving pathological techniques and helping accurate diagnosis of lymphoma
