Sanbox:Kamal

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xray showing femur fracture source:Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID: 25704


X-ray showing Humerus Fracture source:Case courtesy of Dr Benoudina Samir, Radiopaedia.org, rID: 22063


X-Ray showing Tibial Fracture source:Case courtesy of MD PhD gasssss, Radiopaedia.org, rID: 13768


==References==

Differentiating NHL

Category Disease Etiology Constitutional symptoms Rash Abdominal pain Diarrhea Mass Other Immunochemistry Histopathology Gold standard Associated findings
T cell lymphoma Precursor T-cell lymphoblastic leukemia/lymphoma[1][2]
  • Precursor T-cell Lymphomas
  • CD3
  • CD7
  • TDT
    • Blast-like cells with scant cytoplasm, convoluted nuclei, fine chromatin, indistinct nucleoli,
      • Some lymphoblasts have cytoplasmic pseudopods
  • males in their teens to early twenties
  • lymphadenopathy in cervical, supraclavicular, axillary ,and mediastinum
  • In most patients the mediastinal mass is anterior; associated with pleural effusions. Can produce such complications as superior vena cava syndrome, tracheal obstruction, and pericardial effusions
T-cell granular lymphocytic[3][4][5]
  • clonal proliferation of CD8 T cells
  • Constant immune stimulation
  • Absence of homeostatic apoptosis
  • Fatigue
  • Lymphadenopathy
  • Fever
  • Enlarged liver and/or spleen
  • Frequent infections
  • Night sweats
  • CD8
  • CD57
  • TCRαβ
  • CD3
  • CD16
  • Granzyme b
  • TIA1
 Medium / large lymphocytes with abundant cytoplasm having azurophilic granules
T-cell prolymphocytic leukemia[6]
  • Abnormal proliferation of mature T cells (post thymic)
  • CD2
  • CD3
  • CD4
  • CD5
  • CD7
  • CD56
  • TCL1
    • lymphocytes with abundant basophilic, nongranular cytoplasm, atypical nucleus
    • cytoplasmic protrusions (blebs)
Adult T cell leukemia/lymphoma[7][8][9]
  • Mature T-cell Lymphoma
  • Human T-lymphotrophic virus 1 infection
  • Hepatospleanomagaly
  • Hypercalcemia
  • Skin lesions
  • Lytic bone lesions
  • Elevated LDH
  • T-cell deficiency leading immunodeficiency causing opportunistic infection
 +
  • Adult T-cell leukemia cells are typically CD2, CD4, CD5, and CD8 positive
  • Charecterstic leukemia cells with sharp nuclear indentations and a prominent nucleoli
  • "Cloverleaf" or "flower" cells
 Hypercalcemia
Anaplastic large cell lymphoma[10][11][12][13]
  • Mature T-cell Lymphoma
 + +
  • Strongly immunoreactive for CD30, Anaplastic lymphoma kinase (ALK), EMA, and vimentin
  • Nucleoli tend to be more prominent
  • The cytoplasm may be either basophilic or eosinophilic and the cell might have many nuclei with dispersed or clumped chromatin
 Painless swelling in the neck, axilla, groin, thorax, and abdomen
Cutaneous T-cell lymphoma Mycosis fungoides / Sézary syndrome[14][15][16] + +
  • Cutaneous manifestations
 Beta F1+, CD2-/+, CD3+, CD3- (CD4-positive variant), CD4+ (CD4-positive variant), CD4-, CD5-, CD7+/-, CD8+, CD8- (CD4-positive variant), Granzyme B+, and perforin+
  • polymorphous inflammatory infiltrate in the dermis that contains small numbers of frankly atypical lymphoid cells
  • These cells may line up individually along the epidermal basal layer
  • The presence of spongiosis is highly suggestive of mycosis fungoides
Peripheral T-cell lymphoma Subcutaneous panniculitis-like T-cell lymphoma[17][18][19]
  • Mature T-cell Lymphoma
Hepatosplenic T-cell lymphoma[20][21][22]
  • Mature T-cell Lymphoma
  • Inflammatory bowel disease
    • Organ transplant patients (reciever)
    • Immunosuppresent medications
    • Thiopurines
    • Infliximab
    • Cyclophosphamide
    • Vincristine
    • Doxorubicin
 + +
  • CD2, CD3, CD7, CD16 , CD56 or CD57, TIA1, Granzyme m, Fas ligand,
  • Intermediate sized tumor cells with clear cytoplasm, oval nuclei, slightly dispersed condensed chromatin, inconspicuous nucleoli
Enteropathy-type intestinal T-cell lymphoma[23][24][25]
  • Mature T-cell Lymphoma
 + + CD3+, CD4-, CD5-, CD7+, CD30+, CD56+, CD103+, CD8+/-, and TCR beta+/-
    • lymphomatous infiltrate with neoplastic large cells
    • May have pleomorphic, multinucleated cells
    • Adjacent mucosa shows villous atrophy, crypt hyperplasia, increased inflammatory cells
    • lymphocytosis
Extranodal T-cell lymphoma, nasal type[26][27][28]
  • Mature T-cell Lymphoma
  • Cytoplasmic CD3 epsilon, Granzyme B, perforin, CD2, CD56
  • medium sized tumor cells and polymorphic infiltrate of non-neoplastic inflammatory cells
  • lymphoma cells may be admixed with a polymorphic infiltrate of non-neoplastic inflammatory cells
Angioimmunoblastic T-cell lymphoma[29][30][31]
  • Mature T-cell Lymphoma
Peripheral T-cell lymphoma, unspecified[32][33]
  • Mature T-cell Lymphoma
    • Fatigue
    • Lymphadenopathy (swollen )
    • Thirst
    • Nausea and vomiting
    • Fever
    • Skin and bone abnormalities
    • Enlarged liver and/or spleen
    • Frequent infections
    • CD2, CD3, TCR β F1; variable CD4, CD5 and CD7
      • Occasional CD56 and cytotoxic granule expression
    • Clear cytoplasm, resemble Reed-Sternberg cells, with irregular, pleomorphic, hyperchromatic or nuclei
    • A lot of mitotic figures; very broad cytologic spectrum
  1. ↑ Shelly D, Gujral S (2017). "Early T-Cell Precursor Acute Lymphoblastic Leukaemia/Lymphoma: Immunohistochemical Evaluation of Four Lymph Node Biopsies". J Clin Diagn Res. 11 (7): EL01–EL02. doi:10.7860/JCDR/2017/29352.10164. PMC 5583929. PMID 28892922.
  2. ↑ You MJ, Medeiros LJ, Hsi ED (2015). "T-lymphoblastic leukemia/lymphoma". Am J Clin Pathol. 144 (3): 411–22. doi:10.1309/AJCPMF03LVSBLHPJ. PMID 26276771.
  3. ↑ Rose, M. G. (2004). "T-Cell Large Granular Lymphocyte Leukemia and Related Disorders". The Oncologist. 9 (3): 247–258. doi:10.1634/theoncologist.9-3-247. ISSN 1083-7159.
  4. ↑ Liu EB, Chen HS, Zhang PH, Li ZQ, Sun Q, Yang QY; et al. (2012). "[Hematopathologic features of T-cell large granular lymphocytic leukemia]". Zhonghua Bing Li Xue Za Zhi. 41 (4): 229–33. doi:10.3760/cma.j.issn.0529-5807.2012.04.004. PMID 22800517.
  5. ↑ Osuji N, Matutes E, Catovsky D, Lampert I, Wotherspoon A (2005). "Histopathology of the spleen in T-cell large granular lymphocyte leukemia and T-cell prolymphocytic leukemia: a comparative review". Am J Surg Pathol. 29 (7): 935–41. PMID 15958859.
  6. ↑ Graham RL, Cooper B, Krause JR (2013). "T-cell prolymphocytic leukemia". Proc (Bayl Univ Med Cent). 26 (1): 19–21. PMC 3523759. PMID 23382603.
  7. ↑ Matutes E (2007). "Adult T-cell leukaemia/lymphoma". J. Clin. Pathol. 60 (12): 1373–7. doi:10.1136/jcp.2007.052456. PMC 2095573. PMID 18042693.
  8. ↑ Matutes E (2007) Adult T-cell leukaemia/lymphoma. J Clin Pathol 60 (12):1373-7. DOI:10.1136/jcp.2007.052456 PMID: 18042693
  9. ↑ Shimoyama M (1991). "Diagnostic criteria and classification of clinical subtypes of adult T-cell leukaemia-lymphoma. A report from the Lymphoma Study Group (1984-87)". Br J Haematol. 79 (3): 428–37. PMID 1751370.
  10. ↑ Al-Ahmad, Selma; Maertens, Vincent; Libeer, Christophe; Schelfhout, Vera; Vanhoenacker, Filip; Boeckx, Nancy; Vandevenne, Marleen (2017). "The masquerading presentation of a systemic anaplastic large cell lymphoma, ALK positive: a case report and review of the literature". Acta Clinica Belgica. 72 (6): 454–460. doi:10.1080/17843286.2017.1312057. ISSN 1784-3286.
  11. ↑ Yu L, Yan LL, Yang SJ (2014). "Sarcomatoid variant of ALK- anaplastic large cell lymphoma involving multiple lymph nodes and both lungs with production of proinflammatory cytokines: report of a case and review of literature". Int J Clin Exp Pathol. 7 (8): 4806–16. PMC 4152041. PMID 25197351.
  12. ↑ de Campos FPF, Zerbini MCN, Felipe-Silva A, Simões AB, Lovisolo SM, da Fonseca LG; et al. (2014). "Unusual clinical presentation of anaplastic large cell lymphoma". Autops Case Rep. 4 (1): 21–27. doi:10.4322/acr.2014.004. PMC 5470561. PMID 28652989.
  13. ↑ Watanabe M, Ogawa Y, Itoh K; et al. (January 2008). "Hypomethylation of CD30 CpG islands with aberrant JunB expression drives CD30 induction in Hodgkin lymphoma and anaplastic large cell lymphoma". Lab. Invest. 88 (1): 48–57. doi:10.1038/labinvest.3700696. PMID 17965727.
  14. ↑ Foss, Francine M.; Girardi, Michael (2017). "Mycosis Fungoides and Sezary Syndrome". Hematology/Oncology Clinics of North America. 31 (2): 297–315. doi:10.1016/j.hoc.2016.11.008. ISSN 0889-8588.
  15. ↑ Campbell, J. J.; Clark, R. A.; Watanabe, R.; Kupper, T. S. (2010). "Sezary syndrome and mycosis fungoides arise from distinct T-cell subsets: a biologic rationale for their distinct clinical behaviors". Blood. 116 (5): 767–771. doi:10.1182/blood-2009-11-251926. ISSN 0006-4971.
  16. ↑ Vonderheid, Eric C.; Bernengo, Maria Grazia; Burg, Günter; Duvic, Madeleine; Heald, Peter; Laroche, Liliane; Olsen, Elise; Pittelkow, Mark; Russell-Jones, Robin; Takigawa, Masahiro; Willemze, Rein (2002). "Update on erythrodermic cutaneous T-cell lymphoma: Report of the international society for cutaneous lymphomas". Journal of the American Academy of Dermatology. 46 (1): 95–106. doi:10.1067/mjd.2002.118538. ISSN 0190-9622.
  17. ↑ Subcutaneous panniculitis-like T-cell lymphoma. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf56e3e27c3994bd52df/. Accessed on March 08, 2016
  18. ↑ Subcutaneous panniculitis-like T-cell lymphoma. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf56e3e27c3994bd52df/. Accessed on March 08, 2016
  19. ↑ Parveen Z, Thompson K (2009). "Subcutaneous panniculitis-like T-cell lymphoma: redefinition of diagnostic criteria in the recent World Health Organization-European Organization for Research and Treatment of Cancer classification for cutaneous lymphomas". Arch Pathol Lab Med. 133 (2): 303–8. doi:10.1043/1543-2165-133.2.303. PMID 19195975.
  20. ↑ van de Meeberg MM, Derikx LA, Sinnige HA, Nooijen P, Schipper DL, Nissen LH (2016). "Hepatosplenic T-cell lymphoma in a 47-year-old Crohn's disease patient on thiopurine monotherapy". World J Gastroenterol. 22 (47): 10465–10470. doi:10.3748/wjg.v22.i47.10465. PMC 5175260. PMID 28058028.
  21. ↑ Shi, Yang; Wang, Endi (2015). "Hepatosplenic T-Cell Lymphoma: A Clinicopathologic Review With an Emphasis on Diagnostic Differentiation From Other T-Cell/Natural Killer–Cell Neoplasms". Archives of Pathology & Laboratory Medicine. 139 (9): 1173–1180. doi:10.5858/arpa.2014-0079-RS. ISSN 0003-9985.
  22. ↑ Alsohaibani FI, Abdulla MA, Fagih MM (2011). "Hepatosplenic T-cell lymphoma". Indian J Hematol Blood Transfus. 27 (1): 39–42. doi:10.1007/s12288-010-0051-1. PMC 3102508. PMID 22379294.
  23. ↑ Delabie, J.; Holte, H.; Vose, J. M.; Ullrich, F.; Jaffe, E. S.; Savage, K. J.; Connors, J. M.; Rimsza, L.; Harris, N. L.; Muller-Hermelink, K.; Rudiger, T.; Coiffier, B.; Gascoyne, R. D.; Berger, F.; Tobinai, K.; Au, W. Y.; Liang, R.; Montserrat, E.; Hochberg, E. P.; Pileri, S.; Federico, M.; Nathwani, B.; Armitage, J. O.; Weisenburger, D. D. (2011). "Enteropathy-associated T-cell lymphoma: clinical and histological findings from the International Peripheral T-Cell Lymphoma Project". Blood. 118 (1): 148–155. doi:10.1182/blood-2011-02-335216. ISSN 0006-4971.
  24. ↑ Bautista-Quach MA, Ake CD, Chen M, Wang J (September 2012). "Gastrointestinal lymphomas: Morphology, immunophenotype and molecular features". J Gastrointest Oncol. 3 (3): 209–25. doi:10.3978/j.issn.2078-6891.2012.024. PMC 3418529. PMID 22943012.
  25. ↑ Enteropathy-associated T-cell lymphoma. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf56e3e27c3994bd5315/. Accessed on January 26, 2016
  26. ↑ Extranodal Natural-Killer/T-Cell Lymphoma, Nasal Type. Hindawi Publishing Corporation. http://www.hindawi.com/journals/ah/2010/627401/. Accessed on February 19, 2016
  27. ↑ Extranodal NK-/T-cell lymphoma, nasal type. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf56e3e27c3994bd530f/. Accessed on February 02, 2016
  28. ↑ Extranodal Natural-Killer/T-Cell Lymphoma, Nasal Type. Hindawi Publishing Corporation. http://www.hindawi.com/journals/ah/2010/627401/. Accessed on February 18, 2016
  29. ↑ Swerdlow, S.H.; Campo, E.; Harris, N.L.; Jaffe, E.S.; Pileri, S.A.; Stein, H.; Thiele, J.; Vardiman, J.W (2008). "11 Mature T- and NK-cell neoplasms: Angioimmunoblastic T-cell lymphoma". WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC WHO Classification of Tumours. 2 (4th ed.). IARC. ISBN 9283224310.
  30. ↑ [1] Quintanilla-Martinez L, Fend F, Moguel LR, Spilove L, Beaty MW, Kingma DW, Raffeld M, Jaffe ES. "Peripheral T-cell lymphoma with Reed-Sternberg-like cells of B-cell phenotype and genotype associated with Epstein-Barr virus infection." Am J Surg Pathol. 1999 Oct;23(10):1233-40. PMID: 10524524
  31. ↑ Angioimmunoblastic T-cell lymphoma. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf56e3e27c3994bd52dc/ Accessed on November 27, 2015
  32. ↑ Lemonnier F, Couronné L, Parrens M, Jaïs JP, Travert M, Lamant L, Tournillac O, Rousset T, Fabiani B, Cairns RA, Mak T, Bastard C, Bernard OA, de Leval L, Gaulard P (August 2012). "Recurrent TET2 mutations in peripheral T-cell lymphomas correlate with TFH-like features and adverse clinical parameters". Blood. 120 (7): 1466–9. doi:10.1182/blood-2012-02-408542. PMID 22760778.
  33. ↑ Jha, KunalKishor; Gupta, SureshK; Saluja, Harpreet; Subedi, Nuwadatta (2017). "Peripheral T-cell lymphoma, not otherwise specified". Journal of Family Medicine and Primary Care. 6 (2): 427. doi:10.4103/jfmpc.jfmpc_323_16. ISSN 2249-4863.

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