Non-Hodgkin lymphoma pathophysiology: Difference between revisions
Preeti Singh (talk | contribs) No edit summary |
Preeti Singh (talk | contribs) No edit summary |
||
Line 52: | Line 52: | ||
|- | |- | ||
| | | | ||
|[[Diffuse large B-cell lymphoma]] | |[[Diffuse large B-cell lymphoma]]<ref name="Shipp2002">{{cite journal |doi=10.1038/nm0102-68 |pmid=11786909 |title=Diffuse large B-cell lymphoma outcome prediction by gene-expression profiling and supervised machine learning |journal=Nature Medicine |volume=8 |issue=1 |pages=68–74 |year=2002 |last1=Shipp |first1=Margaret A. |last2=Ross |first2=Ken N. |last3=Tamayo |first3=Pablo |last4=Weng |first4=Andrew P. |last5=Kutok |first5=Jeffery L. |last6=Aguiar |first6=Ricardo C.T. |last7=Gaasenbeek |first7=Michelle |last8=Angelo |first8=Michael |last9=Reich |first9=Michael |last10=Pinkus |first10=Geraldine S. |last11=Ray |first11=Tane S. |last12=Koval |first12=Margaret A. |last13=Last |first13=Kim W. |last14=Norton |first14=Andrew |last15=Lister |first15=T. Andrew |last16=Mesirov |first16=Jill |last17=Neuberg |first17=Donna S. |last18=Lander |first18=Eric S. |last19=Aster |first19=Jon C. |last20=Golub |first20=Todd R. }}</ref><ref name="Rosenwald2002">{{cite journal |doi=10.1056/NEJMoa012914 |pmid=12075054 |title=The Use of Molecular Profiling to Predict Survival after Chemotherapy for Diffuse Large-B-Cell Lymphoma |journal=New England Journal of Medicine |volume=346 |issue=25 |pages=1937–47 |year=2002 |last1=Rosenwald |first1=Andreas |last2=Wright |first2=George |last3=Chan |first3=Wing C. |last4=Connors |first4=Joseph M. |last5=Campo |first5=Elias |last6=Fisher |first6=Richard I. |last7=Gascoyne |first7=Randy D. |last8=Muller-Hermelink |first8=H. Konrad |last9=Smeland |first9=Erlend B. |last10=Giltnane |first10=Jena M. |last11=Hurt |first11=Elaine M. |last12=Zhao |first12=Hong |last13=Averett |first13=Lauren |last14=Yang |first14=Liming |last15=Wilson |first15=Wyndham H. |last16=Jaffe |first16=Elaine S. |last17=Simon |first17=Richard |last18=Klausner |first18=Richard D. |last19=Powell |first19=John |last20=Duffey |first20=Patricia L. |last21=Longo |first21=Dan L. |last22=Greiner |first22=Timothy C. |last23=Weisenburger |first23=Dennis D. |last24=Sanger |first24=Warren G. |last25=Dave |first25=Bhavana J. |last26=Lynch |first26=James C. |last27=Vose |first27=Julie |last28=Armitage |first28=James O. |last29=Montserrat |first29=Emilio |last30=López-Guillermo |first30=Armando |display-authors=29 }}</ref><ref name="pmid27271843">{{cite journal| author=Korkolopoulou P, Vassilakopoulos T, Milionis V, Ioannou M| title=Recent Advances in Aggressive Large B-cell Lymphomas: A Comprehensive Review. | journal=Adv Anat Pathol | year= 2016 | volume= 23 | issue= 4 | pages= 202-43 | pmid=27271843 | doi=10.1097/PAP.0000000000000117 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27271843 }}</ref> | ||
| | |Classified into 2 subtypes based on [[gene expression]] profiles: | ||
*Germinal centre B-cell-like (GCB) | *Germinal centre B-cell-like (GCB) | ||
*Activated B-cell-like (ABC). | *Activated B-cell-like (ABC). |
Revision as of 04:02, 24 December 2018
Non-Hodgkin lymphoma Microchapters |
Differentiating Non-Hodgkin's Lymphoma |
---|
Treatment |
Case Studies |
Non-Hodgkin lymphoma pathophysiology On the Web |
American Roentgen Ray Society Images of Non-Hodgkin lymphoma pathophysiology |
Risk calculators and risk factors for Non-Hodgkin lymphoma pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Non Hodgkin's Lymphoma represents a heterogeneous group of diseases with varied clinical presentation and histological appearance.It arises from cell of the lymphoid system, tumors are mainly derived from B lymphocytes, but are also from T lymphocytes, or natural killer cells. Lymphomas rise from different stages of B and T cell differentiation. Aberrations in the tightly controlled steps of B cell development can lead to oncogenesis. These aberrations are mainly seen in form of chromosomal translocation.
Pathophysiology
Pathogenesis
- Lymphomas can arise from different stages of B cell development:
- B cell development starts in the primary lymphoid tissue, the bone marrow and subsequent maturation takes place in secondary lymphoid tissue (spleen and lymph nodes).
- At the germinal centers of secondary lymphoid tissue B cells encounter antigens via T cells and then undergo affinity maturation to produce immunoglobulins of high affinity.
- It supports rapid B-cell proliferation for immunoglobulin affinity maturation and production of antibody diversity through two processes know as somatic hypermutation (SHM) and immunoglobulin class switching.
- Both of these processes require rapid cell turnover and multiple double stranded DNA breaks, which is error-prone.
- Somatically acquired genetic alterations ( mainly translocations) of these processes is probably the underlying cause of lymphomagenesis.
- The major subtypes of non-hodgkin lymphoma include the following:
- Mature B-cell neoplasms:
- Diffuse large B cell lymphoma
- Follicular lymphoma
- Burkitt lymphoma
- Mantle cell lymphoma
- Hairy cell leukemia
- Extranodal marginal zone lymphoma
- Splenic marginal zone lymphoma
- Plasma cell myeloma
- Mature T and NK neoplasms:
- Mature B-cell neoplasms:
Genetics
Different subtypes of non Hodgkin lymphoma and their genetic involvements::
Pathophysiology | Symptoms | History | Physical Examination | Laboratory Findings | ||||
---|---|---|---|---|---|---|---|---|
Immunochemistry | Blood work | Biospy | ||||||
Diffuse large B-cell lymphoma[1][2][3] | Classified into 2 subtypes based on gene expression profiles:
|
|
|
|
|
Centroblastic
Immunoblastic::
Anaplastic:
| ||
Follicular lymphoma | ||||||||
Burkitt lymphoma |
|
|
|
| ||||
B cell lymphoma | Mantle cell lymphoma |
|
|
|
|
|
CBC
|
|
Nodal marginal zone B-cell lymphoma |
|
|
|
|
| |||
Splenic marginal zone lymphoma |
|
| ||||||
Hairy cell leukemia |
|
|
|
| ||||
Plasma cell myeloma | ||||||||
T cell lymphoma | Mycosis fungoides / Sézary syndrome |
|
|
|
||||
T-cell granular lymphocytic leukemia |
|
Symptoms of T-cell large granular lymphocyte leukemia may include the following: |
|
|
| |||
Subcutaneous panniculitis-like T-cell lymphoma |
- ↑ Shipp, Margaret A.; Ross, Ken N.; Tamayo, Pablo; Weng, Andrew P.; Kutok, Jeffery L.; Aguiar, Ricardo C.T.; Gaasenbeek, Michelle; Angelo, Michael; Reich, Michael; Pinkus, Geraldine S.; Ray, Tane S.; Koval, Margaret A.; Last, Kim W.; Norton, Andrew; Lister, T. Andrew; Mesirov, Jill; Neuberg, Donna S.; Lander, Eric S.; Aster, Jon C.; Golub, Todd R. (2002). "Diffuse large B-cell lymphoma outcome prediction by gene-expression profiling and supervised machine learning". Nature Medicine. 8 (1): 68–74. doi:10.1038/nm0102-68. PMID 11786909.
- ↑ Rosenwald, Andreas; Wright, George; Chan, Wing C.; Connors, Joseph M.; Campo, Elias; Fisher, Richard I.; Gascoyne, Randy D.; Muller-Hermelink, H. Konrad; Smeland, Erlend B.; Giltnane, Jena M.; Hurt, Elaine M.; Zhao, Hong; Averett, Lauren; Yang, Liming; Wilson, Wyndham H.; Jaffe, Elaine S.; Simon, Richard; Klausner, Richard D.; Powell, John; Duffey, Patricia L.; Longo, Dan L.; Greiner, Timothy C.; Weisenburger, Dennis D.; Sanger, Warren G.; Dave, Bhavana J.; Lynch, James C.; Vose, Julie; Armitage, James O.; Montserrat, Emilio; et al. (2002). "The Use of Molecular Profiling to Predict Survival after Chemotherapy for Diffuse Large-B-Cell Lymphoma". New England Journal of Medicine. 346 (25): 1937–47. doi:10.1056/NEJMoa012914. PMID 12075054.
- ↑ Korkolopoulou P, Vassilakopoulos T, Milionis V, Ioannou M (2016). "Recent Advances in Aggressive Large B-cell Lymphomas: A Comprehensive Review". Adv Anat Pathol. 23 (4): 202–43. doi:10.1097/PAP.0000000000000117. PMID 27271843.
Associated Conditions
Conditions associated with [disease name] include:
- [Condition 1]
- [Condition 2]
- [Condition 3]
Gross Pathology
On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
Microscopic Pathology
On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
References
Genetics
The development of Non-Hodgkin lymphoma is the result of multiple genetic mutations such as:[1][2]
- Mutations of the B-cell receptor genes and NFKB pathway
- RNA splicing mutations in the small lymphocytic lymphoma
- Genetic mutations in histone formation:[3]
- MLL2
- MEF2B
- EZH2
- CREBBP
- EP300
- MLL2
Gross Pathology
On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
Microscopic Pathology
On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
References
- ↑ Pasqualucci L, Trifonov V, Fabbri G, Ma J, Rossi D, Chiarenza A; et al. (2011). "Analysis of the coding genome of diffuse large B-cell lymphoma". Nat Genet. 43 (9): 830–7. doi:10.1038/ng.892. PMC 3297422. PMID 21804550.
- ↑ Lohr JG, Stojanov P, Lawrence MS, Auclair D, Chapuy B, Sougnez C; et al. (2012). "Discovery and prioritization of somatic mutations in diffuse large B-cell lymphoma (DLBCL) by whole-exome sequencing". Proc Natl Acad Sci U S A. 109 (10): 3879–84. doi:10.1073/pnas.1121343109. PMC 3309757. PMID 22343534.
- ↑ Green MR, Gentles AJ, Nair RV, Irish JM, Kihira S, Liu CL; et al. (2013). "Hierarchy in somatic mutations arising during genomic evolution and progression of follicular lymphoma". Blood. 121 (9): 1604–11. doi:10.1182/blood-2012-09-457283. PMC 3587323. PMID 23297126.