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Non-Hodgkin Lymphoma

Non-Hodgkin Lymphoma. Dr. Raid Jastania Dec 2006. By the end of this session you should be able to: Classify Non-Hodgkin lymphoma

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Non-Hodgkin Lymphoma

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  1. Non-Hodgkin Lymphoma Dr. Raid Jastania Dec 2006

  2. By the end of this session you should be able to: • Classify Non-Hodgkin lymphoma • Know the clinical and pathological features of common Non-Hodgkin B-cell lymphomas (ALL, CLL, Mantle cell lymphoma, Follicular lymphoma, Marginal zone lymphoma, DLBCL, and Burkitt lymphoma)

  3. Classification of Non-Hodgkin Lymphoma

  4. Precursor B cell Acute lymphoblastic lymphoma Peripheral B cell Small lymphocytic lymphoma SLL, Chronic lymphocytic leukemia CLL Mantle cell lymphoma Follicular lymphoma Marginal zone lymphoma Diffuse large B cell lymphom Burkitt lymphoma Precursor T cell Acute lymphoblastic lymphoma Peripheral T cell Anaplastic large T cell lymphoma Peripheral T cell lymphoma Classification of Non-Hodgkin Lymphoma (selected common entities)

  5. B cell • Precursor Naïve Mantle Germinal center Marginal zone Morphology • Blast Small mature Large transformed plasma cell Markers • CD34/TdT CD5 CD20/CD10 CD20 only Homing • BM Peripheral LN LN/extralymphatic Symptoms • BM suppression Leukemia LN involve mass Patterns

  6. Acute lymphoblastic lymphoma/leukemia (ALL) • Clinical: children, young adults, leukemic, mediastianl mass (T cell ALL), Bone marrow involvement, high grade • Pathology: medium size Blasts, uniform • Immuno: TdT, CD 34, CD10, (CD20 or CD3)

  7. Small lymphocytic lymphoma SLL, Chronic lymphocytic leukemia CLL • Clinical: low grade, asymptomatic, nodal and leukemic, elderly 7th, 8th decade • Pathology: small cells, vague nodularity, proliferation centers • Immuno: CD20, CD23, CD5 • Can transform to large cell lymphoma (Richter transformation)

  8. Mantle cell lymphoma • Clinical: Variable (low grade to aggressive) >50 year, nodal, GI tract • Pathology: small uniform cells • Immuno: CD20, CD5, CyclinD1 • T(11;14) cyclinD1 • Transformation to large cell lymphoma is very rare

  9. Follicular lymphoma • Clinical: Low grade, Nodal, > 40 years • Pathology: large malignant follicles, mixture of small (centrocytes) and large cells (centroblasts) • Immuno: CD20, CD10, Bcl-2 • T(14;18) Bcl-2 over expression • 30% transform to large cell lymphoma

  10. Marginal zone lymphoma • Clinical: nodal or extranodal (MALT), low grade • Pathology: mixture of small, large lymphocytes and plasma cells • Immuno: CD20 only • Can transform to large cell lymphoma • Treatment

  11. Diffuse large B-cell lymphoma • Heterogenous group: Denovo, or transformed low grade lymphoma (FL) • Nodal or extranodal, Intermediate grade • Pathology: Sheets of large cells, mitosis, apoptosis • Immuno: CD20, most CD10+

  12. Burkitt lymphoma • Clinical: 3 types • 1. Endemic: African EBV • 2. Sporadic: North America • 3. Immunosuppressed (HIV) • Aggressive tumor • Pathology: medium size, high mitosis, apoptosis, Starry sky pattern • Immuno: CD20, CD10 • T(8;14) C-myc over expression

  13. Test

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