"Virtual Curriculum" is a series of lectures designed to provide hematopathology educational resources to pathology trainees affected by the COVID-19 pandemic. The lectures cover relevant topics in bone marrow, lymph node and spleen pathology. Please note that you may submit a question to the presenter using the Q&A feature on each presentation details page.
New lectures will be posted on this page on a regular basis.
Organizers: Sonam Prakash MD, Flavia Rosado MD, and Laura Brown MD
We would also like to highlight the free educational materials in flow cytometry available on the website of the International Clinical Cytometry Society.
Disclaimer:
This content is for educational purposes only. It is not intended to be a substitute for professional medical advice. Views expressed by individual presenters do not necessarily reflect the opinion of the Society for Hematopathology.
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INTRODUCTION TO BONE MARROW INTERPRETATION Dr. Robert P. Hasserjian, Massacheusetts General Hospital and Harvard Medical School
This is a basic lecture on how to approach the morphologic evaluation of bone marrow biopsy and aspirate specimens, including identifying the hematopoietic lineages as well as the structure, architecture, and cytology of normal marrow. This lecture is intended for residents who have not yet rotated in hematopathology or are just beginning a hematopathology rotation.
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MYELODYSPLASTIC SYNDROMES AND MYELOPROLIFERATIVE NEOPLASMS - PART I: INTRODUCTION & MYELOPROLIFERATIVE NEOPLASMS Dr. Robert P. Hasserjian, Massacheusetts General Hospital and Harvard Medical School
This first part of the 2-part MDS and MPN lecture series includes an introduction to general principles of diagnosing myeloid neoplasms and the tools needed to effectively diagnose and classify MDS and MPN entities. The diagnosis of myeloproliferative neoplasm (MPN) entities is covered, including morphologic, clinical, and genetic criteria. Diseases covered are chronic myeloid leukemia, chronic neutrophilic leukemia, the JAK2-associated myeloproliferative neoplasms, and eosinophilic neoplasms (including the eosinophilias associated with specific genetic aberrations). This lecture is intended for residents during their hematopathology rotation as well as senior residents and hematopathology fellows wishing to review the principles of MPN diagnosis and classification.
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MYELODYSPLASTIC SYNDROMES AND MYELOPROLIFERATIVE NEOPLASMS - PART II: MYELODYSPLASTIC SYNDROMES Dr. Robert P. Hasserjian, Massacheusetts General Hospital and Harvard Medical School
This second part of the 2-part MDS and MPN lecture series covers the diagnosis of myelodysplastic syndromes (MDS), including the criteria required to establish a diagnosis of MDS, challenges in distinguishing MDS from non-neoplastic conditions, and the morphology, clinical features, and genetics of each MDS entity in the 2016 WHO Classification. This lecture is intended for residents during their hematopathology rotation as well as senior residents and hematopathology fellows wishing to review the principles of MDS diagnosis and classification.
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ACUTE MYELOID LEUKEMIA Dr. Olga Weinberg, Boston Children's Hospital
Acute myeloid leukemia (AML) is a neoplasm of immature myeloid cells and is associated with a wide variety of clinical presentations, morphological features, immunophenotypes, and genetic findings. This lecture will address diagnosis of AML with a focus on revised World Health Organization (WHO) classification. In addition, range of ancillary techniques including next generation sequencing and minimal residual disease significance in AML is discussed.
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PLASMA CELL NEOPLASMS Dr. James R. Cook, Cleveland Clinic
This video describes the diagnostic criteria and pathologic features of plasma cell disorders including multiple myeloma, monoclonal gammopathy of undetermined significance (MGUS), plasma cell leukemia and amyloidosis. Brief suggestions are provided for the workup of bone marrows performed for monoclonal proteins.
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BONE MARROW FAILURE SYNDROMES Dr. James R. Cook, Cleveland Clinic
This video reviews the clinical and pathologic features in the two major forms of acquired bone marrow failure leading to pancytopenia, aplastic anemia and paroxysmal nocturnal hemoglobinuria, as well as acquired uni-lineage disorders such as pure red cell aplasia, agranulocytosis, and amegakaryocytic thrombocytopenic purpura. Fanconi's anemia is also discussed as a paradigm of congenital bone marrow failure.
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BONE MARROW MANIFESTATIONS OF SYSTEMIC DISEASE Dr. Dita Gratzinger, Stanford University School of Medicine
Bone Marrow Manifestations of Systemic Disease: When evaluating a bone marrow biopsy, our instinct is to focus on finding the malignancy; however, the bone marrow is also a window into the overall health of the patient. We will explore broad categories of systemic disorders manifesting in the bone marrow, including heritable bone marrow failure, storage and immunodeficiency disorders; infection-related marrow abnormalities; drug/toxin-related abnormalities; nutritional, metabolic and endocrine disorders; and rheumatologic/autoimmune disorders. Recognition of systemic disorders can guide clinical management, and avoid pitfalls of overdiagnosing malignancy.
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NEW - MYELODYSPLASTIC/MYELOPROLIFERATIVE NEOPLASMS AND EOSINOPHILIC NEOPLASMS Dr. Robert P. Hasserjian, Massacheusetts General Hospital and Harvard Medical School
This lecture covers entities within the group of MDS/MPN overlap, including general principles of these diseases and their distinction from the 'pure' myelodysplastic syndromes and myeloproliferative neoplasms. The lecture also covers myeloid/lymphoid neoplasms with eosinophilias and gene rearrangement and their differential diagnosis with reactive eosinophilias, chronic eosinophilic leukemia, and idiopathic hypereosinophilic syndrome. The MDS/MPN and eosinophilic neoplasms are some of the most challenging diagnoses in hematopathology. The lecture is appropriate for hematopathology fellows, residents who have already had exposure to diagnostic hematopathology, and practicing pathologists.
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REACTIVE LYMPHOID HYPERPLASIA: DIAGNOSTIC PITFALLS AND HOW TO AVOID THEM Dr. Aliyah R. Sohani, Massachusetts General Hospital and Harvard Medical School
This lecture begins with an overview of normal lymph node morphology, followed by a discussion of the basic patterns of reactive lymphoid hyperplasia and how a pattern-based approach can be useful in both recognizing an enlarged lymph node as benign and determining an etiology for the lymphoid hyperplasia. Specific entities with illustrative case examples are reviewed, including toxoplasma, syphilis, dermatopathic and viral lymphadenitis, and Kikuchi-Fujimoto disease, with an emphasis on helpful ancillary testing and pitfalls to be aware of in order to avoid making an erroneous diagnosis of lymphoma. The lecture concludes with some general considerations to keep in mind when evaluating challenging lymph node specimens lacking a straightforward diagnosis.
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IMMUNOHISTOCHEMICAL AIDS FOR THE DIAGNOSIS AND CLASSIFICATION OF LYMPHOPROLIFERATIVE DISORDERS Dr. Elaine S. Jaffe, National Cancer Institute
This lecture reviews the basic principles of immunohistochemistry for the diagnosis of lymphoma. It covers low grade B-cell neoplasms, Aggressive B-cell lymphomas, peripheral T-cell lymphomas, Hodgkin lymphomas, and Blastic or immature lymphoid neoplasms.
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DEALING WITH THE SMALL B-CELL NEOPLASMS OF LYMPH NODE AND SPLEEN - PART 1 Dr. Steven H. Swerdlow, University of Pittsburgh School of Medicine
This discussion begins with a brief introduction to the approach we use to think about the small B-cell neoplasms, relating them to the normal B-cell maturational sequence and different B-cell compartments. It then covers CLL/SLL, follicular lymphoma, mantle cell lymphoma, lymphoplasmacytic lymphoma, nodal marginal zone lymphoma, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma - cheating slightly based on the title), splenic marginal zone lymphoma and splenic small B-cell lymphoma/leukemia, unclassifiable. The aim is to present both the basics, concentrating on our diagnostic approach and diagnostic pitfalls, and some more recent observations, recognizing that we cannot cover a topic like this in great depth even in two presentations.
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DEALING WITH THE SMALL B-CELL NEOPLASMS OF LYMPH NODE AND SPLEEN - PART 2 Dr. Steven H. Swerdlow, University of Pittsburgh School of Medicine
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HODGKIN LYMPHOMA CLASSIFICATION AND DIFFERENTIAL DIAGNOSIS Dr. Elaine S Jaffe, National Cancer Institute
This lecture reviews the historical background of Hodgkin lymphoma, and the rationale for the current classification system. The major histological subtypes are discussed in detail, with emphasis on distinguishing clinical and pathological features. Areas of emphasis include a discussion of mediastinal grey zone lymphomas, and its biological and clinical significance. EBV-positive B-cell neoplasms resembling classic Hodgkin lymphoma are reviewed.
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NODULAR LYMPHOCYTE PREDOMINANT HODGKIN LYMPHOMA Dr. Yaso Natkunam, Stanford University School of Medicine
This lecture discusses the clinicopathologic features and diagnostic approach to nodular lymphocyte predominant Hodgkin lymphoma. Challenges in the recognition of variant immunoarchitectural patterns and the boundaries with T-cell/histiocyte-rich large B cell lymphoma, diffuse large B cell lymphoma and classic Hodgkin lymphoma are discussed along with case examples to illustrate these diagnostic pitfalls.
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AGGRESSIVE B-CELL LYMPHOMAS Dr. Aliyah Sohani, Massachusetts General Hospital and Harvard Medical School
This lecture covers the entities of Burkitt lymphoma, including the provisional entity of Burkitt-like lymphoma with 11q aberration, and its differential diagnosis with other neoplastic and reactive conditions; diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) with an emphasis on morphologic, immunophenotypic and molecular genetic subgroups with prognostic implications; high-grade B-cell lymphoma (HGBCL) with rearrangements involving MYC, BCL2 and/or BCL6; and HGBCL, NOS. Also reviewed are other large cell lymphoma entities, including primary mediastinal (thymic) large B-cell lymphoma and ALK-positive DLBCL.
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PERIPHERAL T-CELL AND NK-CELL NEOPLASMS - PART 1 Dr. Elaine S Jaffe, National Cancer Institute
This is the first part in a two-part lecture series on T-cell and NK-cell neoplasms. Part 1 covers an introduction to the principles of the WHO classification, and reviews the nodal T-cell lymphomas, include the various forms of lymphoma of TFH derivation. Adult T-cell leukemia/ lymphoma is discussed along with the histological spectrum of anaplastic large cell lymphoma, ALK-positive.
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NEW - PERIPHERAL T-CELL AND NK-CELL NEOPLASMS - PART 2 Dr. Elaine S Jaffe, National Cancer Institute
Part 2 covers ALK-negative anaplastic large cell lymphoma, and extranodal T-cell lymphomas, including those with primary involvement of skin and GI tract. There is a review of T-cell and NK-cell neoplasms positive for EBV, with illustration of examples of each of the major entities. The lecture does not cover mycosis fungoides and primary cutaneous CD30-positive T-cell lymphoproliferative disorders.
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NEW - IMMUNODEFICIENCY ASSOCIATED LYMPHOPROLIFERATIVE DISORDERS: TIME FOR REAPPRAISAL? Dr. Yaso Natkunam, Stanford University School of Medicine
This lecture provides an overview of the heterogeneous spectrum of lymphoproliferative disorders that arise in various immunodeficiency settings. These disorders are variably associated with viruses such as EBV and HHV8 and may show overlapping features in clinically diverse settings. Recognition of an underlying immunodeficiency is important because it impacts treatment decisions. There is benefit in adopting a common framework and vocabulary across categories to better gain biological insights and guide clinical management.
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NEW - POST-TRANSPLANT LYMPHOPROLIFERATIVE DISORDERS Dr. Rebecca King. Mayo Clinic
This lecture covers post-transplant lymphoproliferative disorders (PTLD) with a focus on the WHO 2017 classification. Diagnostic approach as well as risk factors for development of PTLD are covered. PTLDs are the best-delineated immunosuppression-related lymphoproliferations in the WHO 2017. Their classification can provide a framework for learners to understand other immunosuppression-related lymphoproliferations, and other EBV-related lymphoproliferative disorders.
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SPLEEN: RED, WHITE AND HUNGRY FOR BLOOD Dr. Dita Gratzinger, Stanford University School of Medicine
We will begin our guided tour with splenic anatomy as it correlates to splenic immunologic and filtering function, which will allow us to better understand benign and malignant splenic abnormalities. The majority of spleen specimens are removed for non-malignant etiologies, and we will accordingly learn about hyperplasias, developmental abnormalities, traumatic lesions, vascular/mesenchymal lesions, and systemic disorders as manifest in the spleen. We will use our anatomic and functional understanding of splenic architecture to guide our approach to splenic malignancies.
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INTRODUCTION TO HISTIOCYTIC DISORDERS Dr. James R. Cook, Cleveland Clinic
This video provides an introduction to the disorders of histiocytes and dendritic cells, including hemophagocytic syndromes, Rosai-Dorfman disease, Langerhans cell histiocytosis, follicular dendritic cell sarcomas, interdigitating dendritic cell sarcomas, and histiocytic sarcoma.
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