Non-Hodgkin lymphoma pathophysiology: Difference between revisions

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{{Non-Hodgkin lymphoma}}
{{Non-Hodgkin lymphoma}}
{{CMG}}; {{AE}} {{AS}]
==Overview==
==Pathophysiology==


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===B cell lymphomas===
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto"
! Name
! Size of cells
! Site
! Histomorphology
! IHC
! [[Translocations]]
! Clinical
! Prevalence
! DDx
|-
| [[Follicular lymphoma]]
| small (centrocytes)
| lymph node, germinal center
| abundant atypical follicles (lack GC polarity, lack polar mantle zone), effaced sinuses, scattered large cells (centroblasts)
| CD10+, bcl-6+<ref name=Ref_Lester95>{{Ref Lester|95}}</ref>
| t(14,18)
| usually indolent, may transform to DLBCL
| very common
| DLBCL, other small cell lymphomas
|-
| [[Mantle cell lymphoma]]
| small, monomorphic
| lymph node, mantle zone
| monomorphic lymphoid, abundant mitoses. +/-scattered epithelioid histiocytes, sclerosed blood vessels
| CD5+, CD23-, CD43+, cyclin D1+<ref name=Ref_Lester95>{{Ref Lester|95}}</ref>
| t(11;14)(q13;q32)<ref>URL: [http://atlasgeneticsoncology.org/Anomalies/t1114ID2021.html http://atlasgeneticsoncology.org/Anomalies/t1114ID2021.html]. Accessed on: 10 August 2010.</ref>
| indolent ???
| uncommon
| other [[small cell lymphomas]], [[PTGC]], [[Castleman disease]], [[Burkitt's lymphoma]]
|-
| Extranodal marginal zone lymphoma (MALT lymphoma)
| small
| mucosa-associated lymphoid tissue, GI tract + elsewhere
| +/- lymphepithelial lesion (cluster of 3+ cells in epithelium)
| CD21+, CD11c+, CD5-, CD23-<ref name=Ref_Lester95>{{Ref Lester|95}}</ref>
| ???
| indolent ???
| common
| other small cell lymphomas, neuroendocrine tumours
|-
| Precursor B-cell lymphoblastic lymphoma/ leukemia
| small
| lymph node ???, bone marrow
| nuclei slightly large than resting lymphocytes, scant basophilic cytoplasm, irregular nuclear membrane, no nucleoli, stippled chromatin<ref name=Ref_PCPBoD8_315>{{Ref PCPBoD8|315}}</ref>
| CD10+, CD5-, TdT+, CD99+<ref name=Ref_Lester95>{{Ref Lester|95}}</ref>
| +/-t(12;21)<ref name=Ref_PCPBoD8_317>{{Ref PCPBoD8|317}}</ref>
| aggressive ???
| uncommon
| [[small cell lymphomas]]
|-
| [[Hairy cell leukemia]]
| small
| bone marrow, peripheral blood
| perinuclear clearing, clear cytoplasm, central nucleus
| CD25+, CD103+, CD5-<ref>URL: [http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022&rendertype=table&id=A34029 http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022&rendertype=table&id=A34029]. Accessed on: 20 August 2010.</ref>
| translocations ?
| splenomegaly, no lymphadenopathy, pancytopenia, good prognosis with Tx
| uncommon
| small cell leukemias/lymphomas (e.g. [[SMZL]])
|-
| [[Burkitt's lymphoma]]
| medium, monomorphic
| lymph node, germinal center (???)
| tingible-body macrophages ("starry sky" appearance), round nucleus, small nucleoli, mitoses +++
| CD10+, BCL6+, BCL2-
| t(8;14) (q24;q32)
| rapid growth, may be associated with [[EBV]], [[HIV]]/AIDS
| uncommon
| DLBCL, mantle cell lymphoma
|-
| [[Diffuse large B cell lymphoma]]
| large cells (>2x RBC, often larger), variable size
| lymph node usually, germinal center
| sheets of large discohesive cells; if only nodular = follicular lymphoma
| MIB1 >40%
| none / like follicular lymphoma t(14,18) / c-MYC (like Burkitt lymphoma)
| poor prognosis
| very common
| Burkitt lymphoma, [[ALCL]], [[Hodgkin lymphoma]]
|-
| [[Primary mediastinal B-cell lymphoma]]
| large (>2x RBC, often larger), variable size
| mediastinum
| histomorphology ?
| IHC ?
| translocations ?
| predominantly young adults, better prognosis than [[DLBCL]]
| uncommon
| DLBCL
|-
| B cell small lymphocytic lymphoma /<br>chronic lymphocytic leukemia
| small
| lymph node (???)
| proliferation centres
| CD5+, CD23+, CD43+, cyclin D1-
| trisomy 12; deletions of 11q, 13q, 17p<ref>{{Ref PCPBoD8|318}}</ref>
| good prognosis / indolent course
| common
| other [[small cell lymphomas]]
|- <!--
| Name
| size of cells ?
| site ?
| histomorphology ?
| IHC ?
| translocations ?
| clinical ?
| prevalence ?
| DDx ? -->
|}


==References==
==References==

Revision as of 18:48, 22 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: {{AS}]

Overview

Pathophysiology

B cell lymphomas

Name Size of cells Site Histomorphology IHC Translocations Clinical Prevalence DDx
Follicular lymphoma small (centrocytes) lymph node, germinal center abundant atypical follicles (lack GC polarity, lack polar mantle zone), effaced sinuses, scattered large cells (centroblasts) CD10+, bcl-6+[1] t(14,18) usually indolent, may transform to DLBCL very common DLBCL, other small cell lymphomas
Mantle cell lymphoma small, monomorphic lymph node, mantle zone monomorphic lymphoid, abundant mitoses. +/-scattered epithelioid histiocytes, sclerosed blood vessels CD5+, CD23-, CD43+, cyclin D1+[1] t(11;14)(q13;q32)[2] indolent ??? uncommon other small cell lymphomas, PTGC, Castleman disease, Burkitt's lymphoma
Extranodal marginal zone lymphoma (MALT lymphoma) small mucosa-associated lymphoid tissue, GI tract + elsewhere +/- lymphepithelial lesion (cluster of 3+ cells in epithelium) CD21+, CD11c+, CD5-, CD23-[1] ??? indolent ??? common other small cell lymphomas, neuroendocrine tumours
Precursor B-cell lymphoblastic lymphoma/ leukemia small lymph node ???, bone marrow nuclei slightly large than resting lymphocytes, scant basophilic cytoplasm, irregular nuclear membrane, no nucleoli, stippled chromatin[3] CD10+, CD5-, TdT+, CD99+[1] +/-t(12;21)[4] aggressive ??? uncommon small cell lymphomas
Hairy cell leukemia small bone marrow, peripheral blood perinuclear clearing, clear cytoplasm, central nucleus CD25+, CD103+, CD5-[5] translocations ? splenomegaly, no lymphadenopathy, pancytopenia, good prognosis with Tx uncommon small cell leukemias/lymphomas (e.g. SMZL)
Burkitt's lymphoma medium, monomorphic lymph node, germinal center (???) tingible-body macrophages ("starry sky" appearance), round nucleus, small nucleoli, mitoses +++ CD10+, BCL6+, BCL2- t(8;14) (q24;q32) rapid growth, may be associated with EBV, HIV/AIDS uncommon DLBCL, mantle cell lymphoma
Diffuse large B cell lymphoma large cells (>2x RBC, often larger), variable size lymph node usually, germinal center sheets of large discohesive cells; if only nodular = follicular lymphoma MIB1 >40% none / like follicular lymphoma t(14,18) / c-MYC (like Burkitt lymphoma) poor prognosis very common Burkitt lymphoma, ALCL, Hodgkin lymphoma
Primary mediastinal B-cell lymphoma large (>2x RBC, often larger), variable size mediastinum histomorphology ? IHC ? translocations ? predominantly young adults, better prognosis than DLBCL uncommon DLBCL
B cell small lymphocytic lymphoma /
chronic lymphocytic leukemia 		small lymph node (???) proliferation centres CD5+, CD23+, CD43+, cyclin D1- trisomy 12; deletions of 11q, 13q, 17p[6] good prognosis / indolent course common other small cell lymphomas

References

  1. ↑ 1.0 1.1 1.2 1.3 Template:Ref Lester
  2. ↑ URL: http://atlasgeneticsoncology.org/Anomalies/t1114ID2021.html. Accessed on: 10 August 2010.
  3. ↑ Template:Ref PCPBoD8
  4. ↑ Template:Ref PCPBoD8
  5. ↑ URL: http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022&rendertype=table&id=A34029. Accessed on: 20 August 2010.
  6. ↑ Template:Ref PCPBoD8

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