Department of Pathology, State University of New York at Stony Brook


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Using This Tutorial for Continuing Medical Education (CME) Credit

Registration Form | CME Quiz Selection | Evaluation Form

THIS tutorial is designed to teach physicians about different types of lymphomas. It is intended to be used both by general pathologists who may participate in the tissue- or laboratory-based diagnosis of lymphomas and by general internists, primary care doctors, and other health professionals who help to care for patients with these diseases. Depending on the individual's experience, the whole tutorial should take about 5 hours to complete.

Why This Tutorial: Because lymphomas are a somewhat esoteric specialty both for pathologists and other clinicians, many physicians would like to feel better informed about their diagnosis and behavior. Especially confusing for many are such issues as lymphoma classifications, the immunophenotyping of lymphomas with its complicated system of CD numbers and antigens, lymphoma morphology, and other questions.
        Although this kind of information is available in books, many of them treat lymphomas either too superficially (because the target audience is medical students) or in too great detail (because the target audience is hematology specialists). This tutorial aims to strike a balance between these extremes. In addition, books fail to supply the copious color illustrations that are important for understanding the morphology of lymphomas. Such pictures can be supplied more easily in large numbers in a Web-based tutorial.

Objectives: The objectives of this course are to gain a useful understanding of various aspects of non-Hodgkin's lymphomas, Hodgkin's lymphomas, and plasma cell dyscrasias. Upon completion of this tutorial, participants should be able to:

  1. Discuss the epidemiology of lymphomas.
  2. Explain the behavior and prognosis of different kinds of lymphomas, including some of the biological mechanisms underlying their evolution.
  3. Classify lymphomas according to the traditional Working Formulation and the more recent REAL classification.
  4. Enumerate the techniques used to diagnose lymphomas in the laboratory, including immunoperoxidase staining, flow cytometry, and cytogenetics.
  5. Identify the morpohological distinctions between lymphomas, including what each individual type looks like and what features characterize larger classes of lymphomas such as follicular lymphomas or T-cell lymphomas.
  6. Differentiate between supergroups of lymphomas, such as non-Hodgkin's versus Hodgkin's, low-grade versus high-grade, T-cell versus B-cell.
  7. Distinguish among benign and malignant lymphoid proliferations, such as lymphomas versus reactive adenopathies, or mulitple myeloma versus monoclonal gammopathies of uncertain significance.
How the Tutorial Works: Pathologists may choose to follow their bent and concentrate on the images of lymphoma morphology. Internists and primary care doctors may choose to focus more on text-based facts. Either way, for the purposes of obtaining CME credits, the tutorial is best approached as a whole, starting with the first section on "Normal lymph nodes" and ending with "Types of (plasma cell) disease". Each section or main page contains links to the next one, in addition to links to subpages, most often to show important, additional photomicrographs with captions. (Navigating the tutorial is explained in more detail in How to use this tutorial.)

Obtaining CME Credit: To register for 5 CME credits after having studied the tutorial, doctors should follow the instructions on the Registering for CME Credit page. There is a $75 processing fee to obtain the CME credits. Just complete the registration and evaluation forms and a CME quiz (see below) within one year after the release date of this CME program to earn credit. Participants who complete and return the forms and fee will receive confirmation of credit in the mail.
         In order to confirm that a learning process has occurred, applicants are also asked to take one of two CME quizzes. One CME quiz includes morphological questions based on photomicrographs and is intended for pathologists comfortable with this sort of analysis. The other CME quiz forgoes morphology and may appeal to non-pathologists to whom all cells look alarmingly similar (Sometimes they do to pathologists too!).
         Applicants can earn CME credits for this tutorial just once, so that only one of the two CME quizzes should be chosen. Also, the quizzes for CME credits should not be confused with the so-called "big quiz" and "little quiz" referenced in the Table of Contents, which are targeted toward a more general audience.

Continuing Medical Education Credits: The School of Medicine, State University of New York at Stony Brook, is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians.
         The School of Medicine, State University of New York at Stony Brook, designates this continuing medical education for 5 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
         Credit hours are based on the estimated time to complete this self-instructional CME activity. This activity was planned and produced in accordance with ACCME Essentials for Enduring Materials

Brought to You By: The tutorial was created by Dr. David Weissmann, Assistant Professor of Pathology at the State University of New York at Stony Brook School of Medicine. Dr. Weissmann trained in anatomic and clinical pathology at The Massachusetts General Hospital in Boston and then crossed town to complete a fellowship in hematopathology at Brigham and Women's Hospital. He currently serves as a diagnostic surgical pathologist and hematopathologist at the medical center's University Hospital and teaches in the medical school. The words in the tutorial are his; and the illustrations come from specimens seen at University Hospital.
         The adaptation of this tutorial for CME was developed in conjunction with the Office of Continuing Medical Education of the School of Medicine SUNY at Stony Brook. Members of the committee include Dorothy Lane, M.D., Associate Dean for Continuing Medical Education; Judy Lum, Assistant Director of Continuing Medical Education; and Frederick Miller, M.D., Chairman of Pathology.
         John Wolf, systems analyst in the Department of Pathology, was helpful in putting this tutorial on the Internet. He is the webmaster maintaining the Department's web site, of which this tutorial is a part, on a Windows NT server using IIS4 as the web server. Questions related to problems accessing this web site should be addressed either to John Wolf or Dr. Weissmann.
         Dr. Weissmann wishes that he owned lots of stock in lucrative biomedical companies, creating all kinds of perplexing conflicts of interest. Alas, he owns none and steadfastly denies any affiliation with or financial interest in any organization(s) that may have a direct interest in the subject matter of this tutorial.

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