Chapter 105. Malignancies of Lymphoid Cells (Part 2) ppt

Malignancies of Lymphoid Cells Part 2 Non-Hodgkin's lymphomas were separated from Hodgkin's disease by recognition of the Sternberg-Reed cells early in the twentieth century.. In 1999,

Chapter 105 Malignancies of

Lymphoid Cells

(Part 2)

Non-Hodgkin's lymphomas were separated from Hodgkin's disease by recognition of the Sternberg-Reed cells early in the twentieth century The histologic classification for non-Hodgkin's lymphomas has been one of the most contentious issues in oncology Imperfect morphologic systems were supplanted

by imperfect immunologic systems, and poor reproducibility of diagnosis has hampered progress In 1999, the World Health Organization (WHO) classification

of lymphoid malignancies was devised through a process of consensus development among international leaders in hematopathology and clinical oncology The WHO classification takes into account morphologic, clinical, immunologic, and genetic information and attempts to divide non-Hodgkin's

lymphomas and other lymphoid malignancies into clinical/pathologic entities that have clinical and therapeutic relevance This system is presented in Table 105-3 This system is clinically relevant and has a higher degree of diagnostic accuracy than those used previously The possibilities for subdividing lymphoid malignancies are extensive However, Table 105-3 presents in bold those malignancies that occur in at least 1% of patients Specific lymphoma subtypes will be dealt with in more detail below Lymphomas associated with HIV infection are discussed in Chap 182

Table 105-3 WHO Classification of Lymphoid Malignancies

Disease

Precursor B cell

neoplasm

Precursor T cell neoplasm

Nodular lymphocyte-predominant Hodgkin's disease

Precursor B

lymphoblastic

Precursor T lymphoblastic

leukemia/lymphoma

(precursor B cell acute

lymphoblastic leukemia)

lymphoma/leukemia (precursor T cell acute lymphoblastic leukemia)

Mature (peripheral) B

cell neoplasms

Mature (peripheral) T cell neoplasms

Classical Hodgkin's disease

B cell chronic

lymphocytic

leukemia/small

lymphocytic lymphoma

T cell prolymphocytic leukemia

Nodular sclerosis Hodgkin's disease

prolymphocytic leukemia

T cell granular lymphocytic leukemia

Lymphocyte-rich classic Hodgkin's disease

Lymphoplasmacytic

lymphoma

Aggressive NK cell leukemia

Mixed-cellularity Hodgkin's disease

Splenic marginal Adult T cell

Lymphocyte-zone B cell lymphoma (±

villous lymphocytes)

lymphoma/leukemia (HTLV-I+)

depletion Hodgkin's disease

Hairy cell leukemia Extranodal NK/T cell

lymphoma, nasal type

Plasma cell

myeloma/plasmacytoma

Enteropathy-type T cell lymphoma

Extranodal

marginal zone B cell

lymphoma of MALT type

Hepatosplenic γd T cell lymphoma

Mantle cell

lymphoma

Subcutaneous panniculitis-like T cell lymphoma

Follicular

lymphoma

Mycosis fungoides/Sézary syndrome

Nodal marginal zone Anaplastic large cell

B cell lymphoma (±

monocytoid B cells)

lymphoma, primary cutaneous type

Diffuse large B cell

lymphoma

Peripheral T cell lymphoma, not otherwise specified (NOS)

Burkitt's

lymphoma/Burkitt cell

leukemia

Angioimmunoblastic

T cell lymphoma

lymphoma, primary systemic type

Note: HTLV, human T cell lymphotropic virus; MALT, mucosa-associated

lymphoid tissue; NK, natural killer; WHO, World Health Organization

Malignancies in bold occur in at least 1% of patients

Source: Adapted from Harris et al