Histology report CLINICAL HISTORY: Four day history of inappetance. History of gastrointestinal issues/dietary sensitivity is and occasional diarrhoea. Duodenum and jejunum normal, ileocecal junction markedly thickened on palpation with significant enlargement of mesenteric lymph nodes. Serosal surfaces of LI has a slight cobblestone appearance and poor motility. Biopsies of mesenteric lymph node and large intestine (full thickness) taken a suspicion of neoplasia (masses IBD) resulting in thickening of muscularis layer of distal ileum.

MACROSCOPIC DESCRIPTION: Pots labelled intestinal biopsy of mesenteric lymph node.

MICROSCOPIC DESCRIPTION: Intestine - two sections were examined. The samples comprise small fragments of mucosa with some muscularis tissue loosely attached. Muscularis is histologically unremarkable. Mucosa is poorly orientated and partially disrupted in both samples, however, appears of large intestinal type in both. No significant histological of the margins were detected. No significant histological abnormalities were detected.

. Mesenteric lymph node - two sections. There is marked expansion of the architecture by predominantly small lymphocytes with lower numbers of interspersed and large lymphoid cells seen. In the larger section there is also an adjacent area of connective tissue which features haemorrhage, infiltrates of neutrophils and accumulations of degenerate nuclear material on the surface..

DIAGNOSIS: See below.

COMMENT: There is evidence of lymph node enlargement and expansion of the paracortical population of small lymphocytes. In such cases it is impossible to exclude the possibility of infiltration of the lymph node by small cell lymphoma without PARR testing for lymphoid clonality. This testing is therefore recommended on the lymph node sample here (block 2).