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Follicular lymphoma
Age, gene, sx, pathology
- Median age 60-65
- t(14;18) bcl-2
- Painless adenopathy
- Nodular pattern of growth and looks like germinal centers
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Well differentiated lymph
Age, sx, pathology
- Older pts
- Hepatospenomegaly, bone marrow involvement
- LN replaced by small, round lymphocytes with dark nuclei
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Poorly differentiated lymphocytic lymphoma (PDLL)
Age, sx, pathology
- Middle-aged or older
- Infiltration of bone marrown, liver and spleen
- Irregularl and indented dense chromatin nuclei
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Histiocytic lymphoma (B cell)
Sx, prognosis, pathology
- Nodal and extranodal involvement (skin, bone, GI, brain)
- Rare liver and spleen involvment
- Poor prognosis unless treated with chemo
- Lrg cells with prominent nucleoli
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Mixed lymphocytic-histiocytic lymphoma (nodular)
Pathology
Atypical lymphocytes with histiocytes
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Lymphoblastic lymphoma (diffuse)
Age, sx, prognosis, pathology
- Bimodal - adolescents and 70's
- Mediastinal mass (expresses T-cell markers)
- Poor prognosis
- Loculated or convoluted nuclear membrane
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Burkitt undifferentiated lymphoma
Age, cause, gene, pathology
- Children (endemic in Africa)
- EBV
- (8;14) c-myc gene
- Large lymphocytes with lipid containing vacuoles interspersed with macrophages - "starry sky pattern"
African kids like to see myc-ie and the Disney Starry Sky.
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Mantle Cell lymphoma
Age, gene, sx, pathology
- 60yo
- t(11;14) bcl-1
- Fever, night sweats, massive splenomegaly or hepatomegaly
- Expansion of mantle zone surrounding germinal centers with small atypical lymphocytes
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Mycosis fungoides
- Three phases of skin lesions: inflammation, plaque, and tumor
- Epidermal and dermal infiltration by neoplastic T cells (CD4)
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Sezary Syndrome
- Progressive pruritic erythroderma, exfoliation, and lymphadenopathy.
- Sezary cells: T-cells with cerebriform nuclei in peripheral blood
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Acute lymphocytic leukemia (ALL)
Age, sx, dx, pathology
- Childhood (peak age 4)
- Gingival petechiae, bone pain, thymic mass compressing trachea
- CD10 (CALLA), TDT positive (immature cells)
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Acute myelogenous leukemia (AML)
Age, sx, gene, pathology, Fab classification
- 20% in children, most common acute leukemia in adults
- Same sx as ALL plus lympadenopathy
- t(15;17) protein with affinity to vit A, t(1;12) in acute promyelocytic leukemia, Auer rods (peroxidase stain), myeloblasts
Fab classification: M0-M7
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Chronic myelogenous leukemia (CML)
Age, sx, gene, pathology
- Midde age
- Night sweats, wt loss, giant splenomegaly
- t(9;22) Philidelphia chromosome
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Hairy cell leukemia
Sx, prognosis, pathology
- Hepatosplenomegaly, pancytopenia
- May be curred with 2-chloro-deoxyadenosine (apoptosis inducer)
- Leukemic cells with "hair-like" projections, cells express tartrate-resistant acid phosphatase
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Adult T-cell leukemia/lymphoma
Who?, sx, pathology
- Endemic to Japan
- Hepatospleno, skin involvment, hyperCa
- Caused by Human T-cell leukemia/lymphoma virus (HTLV1)
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Myelodysplastic syndrome
- Proliferation stem cell disorders
- Presents as pancytopenia in elderly
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