Non-Hodgkin lymphoma (differentiating types of NHL): Difference between revisions

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! colspan="2" align="center" style="background:#DCDCDC;" + |B-lymphoblastic leukemia/lymphoma  
! colspan="2" align="center" style="background:#DCDCDC;" + |B-lymphoblastic leukemia/lymphoma<ref name="pmid11075849">{{cite journal |vauthors=Lin P, Jones D, Dorfman DM, Medeiros LJ |title=Precursor B-cell lymphoblastic lymphoma: a predominantly extranodal tumor with low propensity for leukemic involvement |journal=Am. J. Surg. Pathol. |volume=24 |issue=11 |pages=1480–90 |date=November 2000 |pmid=11075849 |doi= |url=}}</ref><ref name="pmid30410844">{{cite journal |vauthors=Javed Z, Hanif F |title=A Rare Presentation of Precursor B-cell Lymphoblastic Lymphoma in a Child |journal=Cureus |volume=10 |issue=8 |pages=e3238 |date=August 2018 |pmid=30410844 |pmc=6209516 |doi=10.7759/cureus.3238 |url=}}</ref><ref name="pmid25548762">{{cite journal |vauthors=Kim JY, Om SY, Shin SJ, Kim JE, Yoon DH, Suh C |title=Case series of precursor B-cell lymphoblastic lymphoma |journal=Blood Res |volume=49 |issue=4 |pages=270–4 |date=December 2014 |pmid=25548762 |pmc=4278010 |doi=10.5045/br.2014.49.4.270 |url=}}</ref>
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* Precursor B-cell Lymphoma
* Precursor B-cell Lymphoma
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! colspan="2" align="center" style="background:#DCDCDC;" + |B cell chronic lymphocytic leukemia/small lymphocytic lymphoma<ref name="pmid11075849">{{cite journal |vauthors=Lin P, Jones D, Dorfman DM, Medeiros LJ |title=Precursor B-cell lymphoblastic lymphoma: a predominantly extranodal tumor with low propensity for leukemic involvement |journal=Am. J. Surg. Pathol. |volume=24 |issue=11 |pages=1480–90 |date=November 2000 |pmid=11075849 |doi= |url=}}</ref><ref name="pmid30410844">{{cite journal |vauthors=Javed Z, Hanif F |title=A Rare Presentation of Precursor B-cell Lymphoblastic Lymphoma in a Child |journal=Cureus |volume=10 |issue=8 |pages=e3238 |date=August 2018 |pmid=30410844 |pmc=6209516 |doi=10.7759/cureus.3238 |url=}}</ref><ref name="pmid25548762">{{cite journal |vauthors=Kim JY, Om SY, Shin SJ, Kim JE, Yoon DH, Suh C |title=Case series of precursor B-cell lymphoblastic lymphoma |journal=Blood Res |volume=49 |issue=4 |pages=270–4 |date=December 2014 |pmid=25548762 |pmc=4278010 |doi=10.5045/br.2014.49.4.270 |url=}}</ref>
! colspan="2" align="center" style="background:#DCDCDC;" + |B cell chronic lymphocytic leukemia/small lymphocytic lymphoma
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* Mature B-cell Lymphoma
* Mature B-cell Lymphoma

Revision as of 21:18, 18 January 2019

Non-Hodgkin lymphoma Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Preeti Singh, M.B.B.S.[2]

Overview

Non-Hodgkin lymphoma (differentiating types of NHL)

Differentiating different types of Non-Hodgkin lymphoma. Gold standard for differentiation different types of Non-Hodgkin lymphoma is Biopsy.

Category Disease Etiology Clinical manifestations Paraclinical findings Associated findings
Lab findings
Symptoms Signs CBC Immunochemistry Histopathology
Constitutional symptoms Rash Abdominal pain Diarrhea Mass Other WBC Hb Plt
Hodgkin's Lymphoma[1][2][3][4][5]
  • Activation of (NF-kB)
  • Mutations in JAK-STAT pathway
  • NF-kB leads to activation of many genes like:
- ± -
  • Painless lymphadenopathy with a rubbery consistency.
  • Mostly above the diaphram
  • Effacement of the lymph node architecture by Reed-Sternberg cells .
  • Reed-Sternberg cell is a large often bi-nucleated cells with prominent nucleoli and an unusual immuno phenotype.
Non-Hodgkin's Lymphoma
B Cell Lymphoma Diffuse large B cell lymphoma[6][7][8][9][10][11].
  • Mature B-cell Lymphoma
  • 8q24/MYC translocations
  • Hypermutated immunoglobulin genes
  • Mutation of BCL6, MYC, PAX5, PIM1, RhoH /TTFn, TP53 genes
  • Translocations involving c-MYC, BCL6, and IgH gene.
  • Fever
  • Night sweats
  • weight loss
- + +
  • Extranodal involvement of GI tract, lungs, and CNS
Nl to ↓
  • CD20
  • CD3
  • CD5
  • CD45
  • CD10
  • BCL-2
  • BCl-6
  • MYC
  • IRF-4/ MUM-1
  • Ki-67

Centroblastic

Immunoblastic

  • > 90% immunoblasts
  • Trapezoid shaped large lymphoid cells with significant basophilic cytoplasm

Anaplastic

  • Very large cells with a round, oval, or polygonal shape that may resemble Reed-Sternberg cells
_
Mantle cell lymphoma[12][13][14][15][16]
  • Fatigue
  • Night sweats
  • Weight Loss
Abdominal distention +
  • Palpable masses in skin, breast, and salivary glands
  • Generalized lymphadenopathy
  • Extranodal involvement of GI tract, lungs, and CNS
  • Mental Retardation
  • Lymphocytosis > 4000/µL
Nl to ↓
  • CD5+
  • B-cell antigen positive
  • Overexpression of Cyclin D1
  • Germinal centers filled by small-to-medium atypical lymphocytes
  • Nodular appearance
_
B-lymphoblastic leukemia/lymphoma[17][18][19]
  • Precursor B-cell Lymphoma
  • Unknown
  • Inherited mutations of PAX5, ETV6, and TP53
+
  • Painless mass at extranodal sites mainly of the skin, bone and lymphnode.
Nl to ↓
  • CD20+
  • CD10+
  • Consists of small to medium-sized lymphoid cells with blastic nuclear chromatin and a high mitotic rate.
  • Down syndrome
Follicular lymphoma
  • Mature B-cell Lymphoma
  • Reciprocal translocation t(14;18)
  • Overexpression of BCL2
Only in 20% of patients: + + ±
  • Painless peripheral adenopathy in the cervical, axillary, inguinal, and/or femoral regions
  • Asymptomatic large abdominal mass
Nl to ↓
  • CD21
  • CD23
  • Nodular growth pattern
  • Most common clinically indolent NHL
  • Peripheral nerve compression
Burkitt lymphoma
  • Mature B-cell Lymphoma
  • Translocation of chromosome 8 myc locus such as:
    • t(8;14)
    • t(2;8)
    • t(8;22)
  • Round and small nucleoli
  • basophilic cytoplasm
  • "Starry-sky pattern"
B cell chronic lymphocytic leukemia/small lymphocytic lymphoma
  • Mature B-cell Lymphoma
Marginal zone lymphoma Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type
  • Mature B-cell Lymphoma
Splenic marginal zone lymphoma
  • Mature B-cell Lymphoma
  • Clonal rearrangements of the immunoglobulin genes (heavy and light chains)
    • Deletion 7q21-32
    • Translocations of the CDK6 gene located on 7q21
  • Small lymphocytes
  • Transformed blasts
  • Epithelial histocytes
  • Plasmacytic differentiation of neoplastic cells
Nodal marginal zone B-cell lymphoma
  • Mature B-cell Lymphoma
  • Stimulation of antigen receptor by autoantigen and co-stimulatory molecule CD40
+
  • Hemorrhage
  • Dyspepsia
  • Follicular cells in reactive zone
  • Centrocyte like cells in marginal zone lymphoma
  • Chronic infectious conditions or autoimmune processes, such as
    • H pylori gastritis
  • Hashimoto thyroiditis
  • Sjögren syndrome
Lymphoplasmacytic lymphoma (Waldenstrom’s macroglobulinemia)
  • Mature B-cell Lymphoma
Hairy cell leukemia
  • Production of cytokines, such as TNF alpha and IL-2R, provide important stimuli for malignant B cells proliferation in hairy cell leukemia.
    • The p38-MAPK-JNK cascade
    • The MEK-ERK cascade
    • The Phosphatidylinositol 3 kinase (PI3K)-AKT cascade
  • Tartrate-resistant acid phosphatase positive
  • CBC
  • Small cells with "fried egg"-like appearance
  • Well-demarcated thread-like cytoplasmic extensions
  • Clear cytoplasm
  • Central round nucleus
  • Peri-nuclear clearing ("water-clear rim" appearance)
Category Disease Etiology Constitutional symptoms Rash Abdominal pain Diarrhea Mass Other WBC Hb Plt Immunochemistry Histopathology Associated findings
T cell lymphoma Precursor T-cell lymphoblastic leukemia/lymphoma
  • Precursor T-cell Lymphomas
Adult T cell leukemia/lymphoma
  • Mature T-cell Lymphoma
Anaplastic large cell lymphoma
  • Mature T-cell Lymphoma
Cutaneous T-cell lymphoma Mycosis fungoides / Sézary syndrome
  • Cutaneous manifestations
Peripheral T-cell lymphoma Subcutaneous panniculitis-like T-cell lymphoma
  • Mature T-cell Lymphoma
Hepatosplenic gamma-delta T-cell lymphoma
  • Mature T-cell Lymphoma
Enteropathy-type intestinal T-cell lymphoma
  • Mature T-cell Lymphoma
Extranodal T-cell lymphoma, nasal type
  • Mature T-cell Lymphoma
Angioimmunoblastic T-cell lymphoma
  • Mature T-cell Lymphoma
Peripheral T-cell lymphoma, unspecified
  • Mature T-cell Lymphoma

References

  1. Mauch PM, Kalish LA, Kadin M, Coleman CN, Osteen R, Hellman S (March 1993). "Patterns of presentation of Hodgkin disease. Implications for etiology and pathogenesis". Cancer. 71 (6): 2062–71. PMID 8443755.
  2. Gobbi PG, Cavalli C, Gendarini A, Crema A, Ricevuti G, Federico M, Di Prisco U, Ascari E (December 1985). "Reevaluation of prognostic significance of symptoms in Hodgkin's disease". Cancer. 56 (12): 2874–80. PMID 4052959.
  3. Buri C, Körner M, Schärli P, Cefai D, Uguccioni M, Mueller C, Laissue JA, Mazzucchelli L (March 2001). "CC chemokines and the receptors CCR3 and CCR5 are differentially expressed in the nonneoplastic leukocytic infiltrates of Hodgkin disease". Blood. 97 (6): 1543–8. PMID 11238088.
  4. Peh SC, Looi LM, Pallesen G (March 1997). "Epstein-Barr virus (EBV) and Hodgkin's disease in a multi-ethnic population in Malaysia". Histopathology. 30 (3): 227–33. PMID 9088951.
  5. Andriko JA, Aguilera NS, Nandedkar MA, Abbondanzo SL (April 1997). "Childhood Hodgkin's disease in the United States: an analysis of histologic subtypes and association with Epstein-Barr virus". Mod. Pathol. 10 (4): 366–71. PMID 9110300.
  6. Colomo, L.; López-Guillermo, A; Perales, M; Rives, S; Martínez, A; Bosch, F; Colomer, D; Falini, B; Montserrat, E; Campo, E (2002). "Clinical impact of the differentiation profile assessed by immunophenotyping in patients with diffuse large B-cell lymphoma". Blood. 101 (1): 78–84. doi:10.1182/blood-2002-04-1286. PMID 12393466.
  7. Hans, C. P.; Weisenburger, D. D.; Greiner, T. C.; Gascoyne, R. D.; Delabie, J; Ott, G; Müller-Hermelink, H. K.; Campo, E; Braziel, R. M.; Jaffe, E. S.; Pan, Z; Farinha, P; Smith, L. M.; Falini, B; Banham, A. H.; Rosenwald, A; Staudt, L. M.; Connors, J. M.; Armitage, J. O.; Chan, W. C. (2004). "Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray". Blood. 103 (1): 275–82. doi:10.1182/blood-2003-05-1545. PMID 14504078.
  8. Muris, JJF; Meijer, Cjlm; Vos, W; Van Krieken, Jhjm; Jiwa, NM; Ossenkoppele, GJ; Oudejans, JJ (2006). "Immunohistochemical profiling based on Bcl-2, CD10 and MUM1 expression improves risk stratification in patients with primary nodal diffuse large B cell lymphoma". The Journal of Pathology. 208 (5): 714–23. doi:10.1002/path.1924. PMID 16400625.
  9. 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.
  10. Swerdlow SH, et al (editors). WHO classification of tumours of haematopoietic and lymphoid tissues. 4th edition. 2008. International Agency for Research on Cancer (IARC), Lyon, Franc
  11. Tilly H, et al. Diffuse large B-cell lymphoma (DLBCL): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2015; 26: v116-v125
  12. Itziar Salaverria, Cristina Royo, Alejandra Carvajal-Cuenca, Guillem Clot, Alba Navarro, Alejandra Valera, Joo Y. Song, Renata Woroniecka, Grzegorz Rymkiewicz, Wolfram Klapper, Elena M. Hartmann, Pierre Sujobert, Iwona Wlodarska, Judith A. Ferry, Philippe Gaulard, German Ott, Andreas Rosenwald, Armando Lopez-Guillermo, Leticia Quintanilla-Martinez, Nancy L. Harris, Elaine S. Jaffe, Reiner Siebert, Elias Campo & Silvia Bea (2013). "CCND2 rearrangements are the most frequent genetic events in cyclin D1(-) mantle cell lymphoma". Blood. 121 (8): 1394–1402. doi:10.1182/blood-2012-08-452284. PMID 23255553. Unknown parameter |month= ignored (help)
  13. Markus Tiemann, Carsten Schrader, Wolfram Klapper, Martin H. Dreyling, Elias Campo, Andrew Norton, Francoise Berger, Philip Kluin, German Ott, Stephano Pileri, Ennio Pedrinis, Alfred C. Feller, Hartmut Merz, Dirk Janssen, Martin L. Hansmann, Han Krieken, Peter Moller, Harald Stein, Michael Unterhalt, Wolfgang Hiddemann & Reza Parwaresch (2005). "Histopathology, cell proliferation indices and clinical outcome in 304 patients with mantle cell lymphoma (MCL): a clinicopathological study from the European MCL Network". British journal of haematology. 131 (1): 29–38. doi:10.1111/j.1365-2141.2005.05716.x. PMID 16173960. Unknown parameter |month= ignored (help)
  14. L. H. Argatoff, J. M. Connors, R. J. Klasa, D. E. Horsman & R. D. Gascoyne (1997). "Mantle cell lymphoma: a clinicopathologic study of 80 cases". Blood. 89 (6): 2067–2078. PMID 9058729. Unknown parameter |month= ignored (help)
  15. Markus Tiemann, Carsten Schrader, Wolfram Klapper, Martin H. Dreyling, Elias Campo, Andrew Norton, Francoise Berger, Philip Kluin, German Ott, Stephano Pileri, Ennio Pedrinis, Alfred C. Feller, Hartmut Merz, Dirk Janssen, Martin L. Hansmann, Han Krieken, Peter Moller, Harald Stein, Michael Unterhalt, Wolfgang Hiddemann & Reza Parwaresch (2005). "Histopathology, cell proliferation indices and clinical outcome in 304 patients with mantle cell lymphoma (MCL): a clinicopathological study from the European MCL Network". British journal of haematology. 131 (1): 29–38. doi:10.1111/j.1365-2141.2005.05716.x. PMID 16173960. Unknown parameter |month= ignored (help)
  16. Julie M. Vose (2017). "Mantle cell lymphoma: 2017 update on diagnosis, risk-stratification, and clinical management". American journal of hematology. 92 (8): 806–813. doi:10.1002/ajh.24797. PMID 28699667. Unknown parameter |month= ignored (help)
  17. Lin P, Jones D, Dorfman DM, Medeiros LJ (November 2000). "Precursor B-cell lymphoblastic lymphoma: a predominantly extranodal tumor with low propensity for leukemic involvement". Am. J. Surg. Pathol. 24 (11): 1480–90. PMID 11075849.
  18. Javed Z, Hanif F (August 2018). "A Rare Presentation of Precursor B-cell Lymphoblastic Lymphoma in a Child". Cureus. 10 (8): e3238. doi:10.7759/cureus.3238. PMC 6209516. PMID 30410844.
  19. Kim JY, Om SY, Shin SJ, Kim JE, Yoon DH, Suh C (December 2014). "Case series of precursor B-cell lymphoblastic lymphoma". Blood Res. 49 (4): 270–4. doi:10.5045/br.2014.49.4.270. PMC 4278010. PMID 25548762.