Diagnostic Interpretation of Lymph Node Biopsies: A Pattern-Based Guide to Benign and Neoplastic Lymphadenopathy for Pathologists and Hematopathology Trainees
Ask a pathologist which specimens cause the most sleepless review, and the lymph node will be near the top of the list. A florid reactive hyperplasia can mimic lymphoma, an indolent lymphoma can masquerade as a reaction, and the consequences of getting it wrong fall directly on the patient. This book exists to make that judgment more reliable, and it does so by insisting on a single discipline: read the pattern before you reach for the antibody.
The table of contents is arranged to mirror that discipline from beginning to end. The opening chapters do the work most texts rush past. They ground the reader in normal nodal architecture and the pattern-based method, then turn to a problem the modern pathologist faces daily, the small or needle-core biopsy, with its triage decisions and real limitations. A dedicated chapter on ancillary studies treats immunohistochemistry, flow cytometry, FISH, and molecular diagnostics not as a reference dump but as tools deployed in response to a pattern, and a chapter on classification sets everything in the language of WHO-HAEM5 and the International Consensus Classification.
From there the contents follow the order a careful diagnostician actually thinks in. The benign and reactive patterns come first, because excluding them is the precondition for any malignant diagnosis: follicular hyperplasia and follicular patterns, paracortical and interfollicular hyperplasias, sinus and histiocytic patterns, the granulomatous and necrotizing lymphadenitides, infectious causes, and Castleman disease with its stromal and vascular company.
The neoplastic chapters then proceed in a logical lineage-based sequence rather than a scattered list. The B-cell neoplasms unfold from the small B-cell lymphomas through lymphoplasmacytic and plasma cell entities, follicular and marginal zone lymphomas, diffuse large B-cell lymphoma with its molecular subtypes, and the high-grade and Burkitt categories, before the Hodgkin lymphomas. The T-cell chapters cover peripheral T-cell lymphoma, the T-follicular helper entities, and anaplastic large cell lymphoma and its ALK-related variants. The contents close the malignant range with precursor neoplasms, myeloid sarcoma and BPDCN, the histiocytic and dendritic cell neoplasms, the immunodeficiency-associated lymphoproliferative disorders, and the diagnostic approach to metastatic disease in the node.
The book ends where sign-out happens. Its appendices gather immunohistochemistry quick-reference panels, an antibody and marker reference, recurrent genetic alterations, and selected WHO-HAEM5 and ICC terminology, and every chapter closes with review questions that turn reading into recall.
The result is a text that can be read cover to cover as a method and then kept beside the microscope as a reference, written for hematopathology fellows, pathology residents, and practicing pathologists who want to separate reaction from neoplasm with confidence and name the neoplasm correctly when it is there.
Rowena K. Garner presents a pattern-first approach to lymph node interpretation, built for the cases where the diagnosis is hardest to reach.
