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Pathology/lymph node biopsy pathology report

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Question
My son had a lymph node removed for biopsy.

the report I got today has me confused. the gross:
1.2 x 0.8 x 0.4 cm  red-brown rubbery fragment consistent with lymph node. the cut surface is fleshy red-tan. two touch imprints were performed and examined. The tissue was sent for flow cytometry, however there were not enough cells for that analysis.

Microscopic diagnosis:Lymph node right ear are, excision :  begnin reactive lymph node with follicular hyperplasia, paracortical expansion with scattered neutrophils (see comment).

comment:  The changes appear reactive, and may represent an infectious (especially viral) etiology.  PCR for various infectious diseases will be done and the results reported separately.

my big concern is can this diagnosis be accurate without that flow cytometry?  and he has already been tested, via blood, by his infectious disease specialist who ordered the biopsy because she doesn't have a clue... do I need a second opinion or maybe another biopsy of the larger node in his neck?

Answer
Hello Kay:

A diagnosis of reactive lymph node does not require additional flow cytometry. If there was s uspicion of a malignancy then flow is impportant.

It is possible your son had ear infection or other infection in the past and the node reacted tp this. However the node takes awhile to reverty back to normal after the infection subsides.

PCR is a more sensitive test than routine blood tests and can pick up residual infectious disease.

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Neha Dahiya MD

Expertise

Help patients understand the medical terminology of their lab results and / or tissue biopsy reports.

Experience

I am a pathologist and director of clinical laboratory services. I have been a practicing pathologist for last 9 years in a 350 bed multi specialty hospital laboratory in India.

Organizations
Indian association of pathologists and microbiologists.
International Academy of Cytology
International association of Pathologists - Indian division
Indian association of Cytology

Education/Credentials
MD (pathology) MBA

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