Advice to a trainee pathologist: The Lymphoma maze is it REAL?
==============================================================

* Charles E Connolly

> All that glitters is not gold
> 
> How often have I heard that told
> 
> Examine a lymph node with attention,
> 
> Give the follicles special mention.
> 
> Reactive, neoplastic? If in doubt,
> 
> Immune markers will help you out.
> 
> CD20, BCL2, and CD3?
> 
> Essential to start, between you and me
> 
> Stratify with CD5,
> 
> If CLL—patient stays alive,
> 
> Low grade, nodular, blue, and bland,
> 
> Cyclin D1 may give a hand.
> 
> Mantle cell lymphoma is very shy,
> 
> And is so easy to pass by.
> 
> CD10 positive with a starry sky,
> 
> 100% on Ki?
> 
> Burkitt-like with a high IPI.
> 
> Lymphoma versus Carcinoma—cells big and bad,
> 
> Hodgkins? ALKL? Or the Grey zone fad?
> 
> CD30, 15, Mum, and Pax,
> 
> Always give Reed-Sternberg the max!
> 
> Decorates with CD45, maybe the T cell set?
> 
> Suggest ALCL, but hedge your bet!
> 
> Alk1 positive may give a clue,
> 
> BUT—B cell tumours can it stain too!
> 
> Null cell tumours are hard to nail,
> 
> Molecular studies, if all else fail,
> 
> Clonality is the holy grail.
> 
> Lymphoma diagnosis may be a difficult task,
> 
> To know all the markers, a big ask,
> 
> Brown stains are NOT always what they seem,
> 
> Aberrant expression can be a bad dream.
> 
> But with the Blue book you must be au fait,
> 
> WHO 2008—the new Réalité

## Footnotes

*   Competing interests None.

*   Provenance and peer review Not commissioned; not externally peer reviewed.