Lymphoma: Difference between revisions

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[[Image:Lymphoma macro.jpg | thumb | 200px | right | Lymphoma at [[cut-up]]. (WC/Emmanuelm)]]
'''Lymphoma''' is almost a specialty for itself.  It can be subclassified a number of ways.   
'''Lymphoma''' is almost a specialty for itself.  It can be subclassified a number of ways.   


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====Histologic terms====
====Histologic terms====
*Lymphomas = cells look discohesive, may be difficult to differentiate from poor differentiated carcinoma.
*Lymphomas = cells look discohesive, may be difficult to differentiate from poor differentiated carcinoma.
*Auer rods = Acute myeloid leukemia.
*[[Auer rods]] = [[acute myeloid leukemia]].
**Granular cytoplasmic rod (0.5-1 x4-6 micrometres).
**Granular cytoplasmic rod (0.5-1 x4-6 micrometres).
**Not pathognomonic.
*Reed-Sternberg cells = [[Hodgkin's lymphoma]].
*Reed-Sternberg cells = [[Hodgkin's lymphoma]].
**Large cell - very large nucleus.
**Large cell - very large nucleus.
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Others:
Others:
*AE1/AE3 -- to r/o carcinoma.
*[[AE1/AE3]] -ve -- to r/o carcinoma.


====T cell markers====
====T cell markers====
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==Intravascular lymphoma==
==Intravascular lymphoma==
*[[AKA]] ''angiotropic lymphoma'', ''intravascular malignant lymphomatosis'', ''malignant angioendotheliomatosis''
*Rare.
*Rare.
*Usually B-cell lineage (see below ''intravascular large B-cell lymphoma'').
*Usually B-cell lineage (see ''[[intravascular large B-cell lymphoma]]'').
**May be T-cell lineage.<ref name=pmid20337769>{{cite journal |author=Wang L, Li C, Gao T |title=Cutaneous intravascular anaplastic large cell lymphoma |journal=J Cutan Pathol |volume= |issue= |pages= |year=2010 |month=March |pmid=20337769 |doi=10.1111/j.1600-0560.2010.01538.x |url=}}</ref>
**May be T-cell lineage.<ref name=pmid20337769>{{cite journal |author=Wang L, Li C, Gao T |title=Cutaneous intravascular anaplastic large cell lymphoma |journal=J Cutan Pathol |volume= |issue= |pages= |year=2010 |month=March |pmid=20337769 |doi=10.1111/j.1600-0560.2010.01538.x |url=}}</ref>
===Intravascular large B-cell lymphoma===
====General====
*[[AKA]] ''angiotropic lymphoma'', ''intravascular malignant lymphomatosis'', ''malignant angioendotheliomatosis''.
=====Clinical=====
*Often a non-specific presentation.<ref name=pmid11579120>{{cite journal |author=Lapkuviene O, Forchetti D, Roepke JE |title=Unusual sites of involvement by hematologic malignancies. Case 1. Intravascular large B-cell lymphoma presenting with CNS symptoms |journal=J. Clin. Oncol. |volume=19 |issue=19 |pages=3988–91 |year=2001 |month=October |pmid=11579120 |doi= |url=http://jco.ascopubs.org/content/19/19/3988.full}}</ref>
**+/-Fever.
**+/-Multiple infarcts.
**+/-Non-specific skin lesions.
====Microscopic====
Features:
*Abundant atypical intravascular lymphoid cells that are:
**Large (~2-3X size of a mature lymphocyte or RBC).
**Nucleolus prominent.
Notes:
*It may be hard to find RBCs in the vessels.
*Looks sorta like a [[DLBCL]] -- but is intravascular.
=====Images=====
<gallery>
Image:Intravascular_lymphoma_-_high_mag.jpg | Intravascular lymphoma - high mag. (WC/Nephron)
Image:Intravascular_lymphoma_-_very_high_mag.jpg | Intravascular lymphoma - very high mag. (WC/Nephron)
</gallery>
www:
*[http://jco.ascopubs.org/content/19/19/3988/F1.expansion.html ILBCL (ascopubs.org)].<ref name=pmid11579120/>
*[http://theoncologist.alphamedpress.org/cgi/content/full/11/8/923/F1 ILBCL in bone marrow (alphamedpress.org)].
*[http://annonc.oxfordjournals.org/content/13/9/1503/F1.expansion.html ILBCL - various images (oxfordjournals.org)].
*[http://path.upmc.edu/cases/case473/images/fig01a.jpg ILBCL (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case473.html http://path.upmc.edu/cases/case473.html]. Accessed on: 21 January 2012.</ref>
*[http://path.upmc.edu/cases/case697.html ILBCL - several images (upmc.edu)].
====IHC====
Features:<ref name=pmid11579120/>
*CD20 +ve - '''key feature'''.
*CD3 -ve.
*CD34 -ve.


==Burkitt's lymphoma==
==Burkitt's lymphoma==
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Features:
Features:
*Intermediate size cells with:
*Intermediate size cells with:
**+/-Vesicular nuclei.
**+/-[[Vesicular nuclei]].
**Clear, moderate cytoplasm.
**Clear, moderate cytoplasm.
*"Empty" sinus; subcapsular sinuses "open".
*"Empty" sinus; subcapsular sinuses "open".
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**''Hyperviscosity syndrome''.
**''Hyperviscosity syndrome''.
**Bony destruction (seen in [[multiple myeloma]]) is absent.<ref name=Ref_PCPBoD8_325>{{Ref PCPBoD8|325}}</ref>
**Bony destruction (seen in [[multiple myeloma]]) is absent.<ref name=Ref_PCPBoD8_325>{{Ref PCPBoD8|325}}</ref>
**Over 90% of patients have the MYD88 L265P somatic mutation.<ref name=pmid=22931316>{{cite journal |vauthors=Treon SP, Xu L, Yang G, Zhou Y, Liu X, Cao Y, Sheehy P, Manning RJ, Patterson CJ, Tripsas C, Arcaini L, Pinkus GS, Rodig SJ, Sohani AR, Harris NL, Laramie JM, Skifter DA, Lincoln SE, Hunter ZR |title=MYD88 L265P somatic mutation in Waldenström's macroglobulinemia |journal=N Engl J Med |volume=367 |issue=9 |pages=826–33 |date=August 2012 |pmid=22931316 |doi=10.1056/NEJMoa1200710 |url=}}</ref>


====Clinical====
====Clinical====
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*[[AKA]] ''extranodal natural kill lymphoma''
*[[AKA]] ''extranodal natural kill lymphoma''
*[[AKA]] ''angiocentric lymphoma''.
*[[AKA]] ''angiocentric lymphoma''.
 
{{Main|Extranodal NK/T-cell lymphoma, nasal type}}
===General===
*Common in east Asia.<ref name=pmid18283711>{{Cite journal  | last1 = Suzuki | first1 = R. | last2 = Takeuchi | first2 = K. | last3 = Ohshima | first3 = K. | last4 = Nakamura | first4 = S. | title = Extranodal NK/T-cell lymphoma: diagnosis and treatment cues. | journal = Hematol Oncol | volume = 26 | issue = 2 | pages = 66-72 | month = Jun | year = 2008 | doi = 10.1002/hon.847 | PMID = 18283711 }}</ref>
*Strong association with [[EBV]].
 
===Microscopic===
Features:
*Atypical lymphoid cells:
**[[Nucleoli]].
**[[Nuclear pleomorphism]].
**Cells centered around vessels (angiocentric).
***May destroy small and medium sized arterioles.
 
Images:
*[http://path.upmc.edu/cases/case231/micro.html Extranodal NK/T-cell lymphoma, nasal type - case 1 - several images (upmc.edu)].
*[http://path.upmc.edu/cases/case310.html Extranodal NK/T-cell lymphoma, nasal type - case 2 - several images (upmc.edu)].
 
===IHC===
Features:<ref name=pmid17064952>{{Cite journal  | last1 = Al-Hakeem | first1 = DA. | last2 = Fedele | first2 = S. | last3 = Carlos | first3 = R. | last4 = Porter | first4 = S. | title = Extranodal NK/T-cell lymphoma, nasal type. | journal = Oral Oncol | volume = 43 | issue = 1 | pages = 4-14 | month = Jan | year = 2007 | doi = 10.1016/j.oraloncology.2006.03.011 | PMID = 17064952 }}</ref>
*CD2 +ve.
*CD3 +ve (cytoplasmic).
*CD56 +ve.
 
Others:<ref>URL: [http://path.upmc.edu/cases/case310.html http://path.upmc.edu/cases/case310.html]. Accessed on: 14 January 2012.</ref>
*TIA-1 +ve.
*CD7 +ve.
*EBER +ve.


==Table of lymphoma==
==Table of lymphoma==
Retrieved from "https://librepathology.org/wiki/Lymphoma"