Sandbox:Preeti: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 47: Line 47:
|-
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" + |
! align="center" style="background:#4479BA; color: #FFFFFF;" + |
! colspan="2" |Hodgkin's Lymphoma
! colspan="2" align="center" style="background:#DCDCDC;" + |Hodgkin's Lymphoma
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
Line 79: Line 79:
|-
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" + |B Cell Lymphoma
! align="center" style="background:#4479BA; color: #FFFFFF;" + |B Cell Lymphoma
! colspan="2" |Precursor B-cell lymphoblastic leukemia/lymphoma
! colspan="2" align="center" style="background:#DCDCDC;" + |Precursor B-cell lymphoblastic leukemia/lymphoma
|
|
* Precursor B-cell Lymphoma
* Precursor B-cell Lymphoma
Line 111: Line 111:
|-
|-
!
!
| colspan="2" |[[Follicular lymphoma]]
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Follicular lymphoma]]
|
|
* Mature B-cell Lymphoma
* Mature B-cell Lymphoma
* Reciprocal translocation t(14;18)(q32;q21)
* Reciprocal translocation t(14;18)(q32;q21)
|
|
Line 136: Line 135:
|
|
* [[Seizures]]
* [[Seizures]]
*[[Chest pain]]
*[[Chest pain]]
*[[Bone pain]]
*[[Bone pain]]
Line 155: Line 153:
|-
|-
!
!
| colspan="2" |Mantle cell lymphoma
! colspan="2" align="center" style="background:#DCDCDC;" + |Mantle cell lymphoma
|
|
* [[CD5 (protein)|CD5]] positive antigen in pregerminal center of B-cell
* [[CD5 (protein)|CD5]] positive antigen in pregerminal center of B-cell
Line 213: Line 211:
|-
|-
!
!
| colspan="2" |Diffuse large B cell lymphoma
! colspan="2" align="center" style="background:#DCDCDC;" + |Diffuse large B cell lymphoma
|
|
* Mature B-cell Lymphoma
* Mature B-cell Lymphoma
Line 247: Line 245:
|
|
|
|
====Centroblastic====
'''Centroblastic'''
*Medium-to-large-sized [[Lymphocyte|lymphocytes]]
*Medium-to-large-sized [[Lymphocyte|lymphocytes]]
*Monomorphic
*Monomorphic
====Immunoblastic====
'''Immunoblastic'''
*> 90% immunoblasts
*> 90% immunoblasts
*Trapezoid shaped large lymphoid cells with significant [[basophilic]] cytoplasm
*Trapezoid shaped large lymphoid cells with significant [[basophilic]] cytoplasm
====Anaplastic:====
'''Anaplastic'''
*Very large cells with a round, oval, or polygonal shape that may resemble Reed-Sternberg cells  
*Very large cells with a round, oval, or polygonal shape that may resemble Reed-Sternberg cells  
|
|
Line 292: Line 290:
|-
|-
!
!
! colspan="2" |[[Burkitt lymphoma]]
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Burkitt lymphoma]]
|
|
* Mature B-cell Lymphoma
* Mature B-cell Lymphoma
Line 314: Line 312:
* [[Proptosis]]
* [[Proptosis]]
* Jaw mass
* Jaw mass
* [[Abdominal mass|Abdominal masses]]  
* [[Abdominal mass|Abdominal masses]]  
* [[Ascites]]
* [[Ascites]]
* [[Lymphadenopathy|Peripheral lymphadenopathy]]
* [[Lymphadenopathy|Peripheral lymphadenopathy]]
|
|
Line 353: Line 349:
|-
|-
!
!
| colspan="2" |B cell chronic lymphocytic leukemia/small lymphocytic lymphoma
! colspan="2" align="center" style="background:#DCDCDC;" + |B cell chronic lymphocytic leukemia/small lymphocytic lymphoma
|
|
* Mature B-cell Lymphoma
* Mature B-cell Lymphoma
Line 384: Line 380:
|-
|-
!
!
| rowspan="3" |Marginal zone lymphoma
! rowspan="3" align="center" style="background:#DCDCDC;" + |Marginal zone lymphoma
|Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type
! align="center" style="background:#DCDCDC;" + |Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type
|
|
* Mature B-cell Lymphoma
* Mature B-cell Lymphoma
Line 416: Line 412:
|-
|-
|
|
|[[Splenic marginal zone lymphoma]]
! align="center" style="background:#DCDCDC;" + |[[Splenic marginal zone lymphoma]]
|
|
* Clonal rearrangements of the [[immunoglobulin]] genes (heavy and light chains) .
* Clonal rearrangements of the [[immunoglobulin]] genes (heavy and light chains)
** Deletion 7q21-32
** Deletion 7q21-32
** Translocations of the CDK6 gene located at 7q21.  
** Translocations of the CDK6 gene located at 7q21.  
Line 445: Line 441:
* [[CD79a]]
* [[CD79a]]
|
|
* [[B-cells]] replace the normal [[white pulp]] of the [[spleen]].
* [[B-cells]] replace the normal [[white pulp]] of the [[spleen]]
* The neoplastic cells compromise
* The neoplastic cells compromise
** Small [[lymphocytes]]  
** Small [[lymphocytes]]  
Line 462: Line 458:
|-
|-
|
|
|[[Nodal marginal zone B-cell lymphoma]]  
! align="center" style="background:#DCDCDC;" + |[[Nodal marginal zone B-cell lymphoma]]  
|
|
* Arise from memory B cells. Include
* Arise from memory B cells. Include
Line 510: Line 506:
|-
|-
|
|
| colspan="2" |Lymphoplasmacytic lymphoma (Waldenstrom’s macroglobulinemia)
! colspan="2" align="center" style="background:#DCDCDC;" + |Lymphoplasmacytic lymphoma (Waldenstrom’s macroglobulinemia)
|
|
* Mature B-cell Lymphoma
* Mature B-cell Lymphoma
Line 541: Line 537:
|-
|-
|
|
| colspan="2" |[[Hairy cell leukemia]]
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hairy cell leukemia]]
|
|
* Production of [[Cytokine|cytokines]], such as [[TNF alpha]] and IL-2R, provide important stimuli for [[malignant]] [[B cell|B cells]] proliferation in hairy cell leukemia.
* Production of [[Cytokine|cytokines]], such as [[TNF alpha]] and IL-2R, provide important stimuli for [[malignant]] [[B cell|B cells]] proliferation in hairy cell leukemia.
Line 603: Line 599:
|-
|-
|
|
| colspan="2" |Precursor T-cell lymphoblastic leukemia/lymphoma
! colspan="2" align="center" style="background:#DCDCDC;" + |Precursor T-cell lymphoblastic leukemia/lymphoma
|
|
* '''Precursor T-cell Lymphomas'''
* '''Precursor T-cell Lymphomas'''
Line 635: Line 631:
|-
|-
|
|
| colspan="2" |Adult T cell leukemia/lymphoma
! colspan="2" align="center" style="background:#DCDCDC;" + |Adult T cell leukemia/lymphoma
|
|
|
|
Line 665: Line 661:
|-
|-
|T cell lymphoma
|T cell lymphoma
| colspan="2" |Anaplastic large cell lymphoma
! colspan="2" align="center" style="background:#DCDCDC;" + |Anaplastic large cell lymphoma
|
|
|
|
Line 695: Line 691:
|-
|-
|
|
|Cutaneous T-cell lymphoma
! align="center" style="background:#DCDCDC;" + |Cutaneous T-cell lymphoma
|[[Mycosis fungoides]] / [[Sézary syndrome]]
! align="center" style="background:#DCDCDC;" + |[[Mycosis fungoides]] / [[Sézary syndrome]]
|
|
* The [[tumor]] [[Cell (biology)|cells]] originate from [[memory T cells]] or [[skin]] homing [[CD4+ T cells]] expressing [[cutaneous]] [[lymphocyte]] [[antigen]] (CLA) and [[chemokine]] [[receptors]] [[CCR4]]<nowiki/>and CCR7.
* The [[tumor]] [[Cell (biology)|cells]] originate from [[memory T cells]] or [[skin]] homing [[CD4+ T cells]] expressing [[cutaneous]] [[lymphocyte]] [[antigen]] (CLA) and [[chemokine]] [[receptors]] [[CCR4]]<nowiki/>and CCR7.
Line 706: Line 702:
|
|
* [[Epidermis (skin)|Epidermal]] [[atrophy]] or poikiloderma
* [[Epidermis (skin)|Epidermal]] [[atrophy]] or poikiloderma
* Generalized [[itching]]([[pruritus]])
* Generalized [[itching]]([[pruritus]])
* [[Pain]] in the affected area of the skin.
* [[Pain]] in the affected area of the skin.
Line 721: Line 716:
|
|
|
|
* Cutaneous manifestaions
* Cutaneous manifestations
|
|
|
|
Line 740: Line 735:
|-
|-
|
|
| rowspan="6" |Peripheral T-cell lymphoma
! rowspan="6" align="center" style="background:#DCDCDC;" + |Peripheral T-cell lymphoma
|Subcutaneous panniculitis-like T-cell lymphoma
! align="center" style="background:#DCDCDC;" + |Subcutaneous panniculitis-like T-cell lymphoma
|
|
|
|
Line 771: Line 766:
|-
|-
|
|
|Hepatosplenic gamma-delta T-cell lymphoma
! align="center" style="background:#DCDCDC;" + |Hepatosplenic gamma-delta T-cell lymphoma
|
|
|
|
Line 801: Line 796:
|-
|-
|
|
|Enteropathy-type intestinal T-cell lymphoma
! align="center" style="background:#DCDCDC;" + |Enteropathy-type intestinal T-cell lymphoma
|
|
|
|
Line 831: Line 826:
|-
|-
|
|
|Extranodal T-cell lymphoma, nasal type
! align="center" style="background:#DCDCDC;" + |Extranodal T-cell lymphoma, nasal type
|
|
|
|
Line 861: Line 856:
|-
|-
|
|
|Angioimmunoblastic T-cell lymphoma
! align="center" style="background:#DCDCDC;" + |Angioimmunoblastic T-cell lymphoma
|
|
|
|
Line 891: Line 886:
|-
|-
|
|
|Peripheral T-cell lymphoma, unspecified
! align="center" style="background:#DCDCDC;" + |Peripheral T-cell lymphoma, unspecified
|
|
|
|

Revision as of 18:56, 31 December 2018


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

Category Disease Etiology Mechanism Clinical manifestations Paraclinical findings Gold standard Associated findings
Lab findings Imaging
Demography History Symptoms Signs CBC PBS LFT PT/PTT Immunochemistry Histopathology Other
Inherited Acquired Constitutional symptoms Rash Abdominal pain Diarrhea V/S Mass LAP Hepatosplenomegaly Arthritis Other WBC Hb Plt
HL
Hodgkin's Lymphoma
NHL
B Cell Lymphoma Precursor B-cell lymphoblastic leukemia/lymphoma
  • Precursor B-cell Lymphoma
Follicular lymphoma
  • Mature B-cell Lymphoma
  • Reciprocal translocation t(14;18)(q32;q21)
+ +
  • Painless swelling in the neck, axilla, groin, thorax and abdomen
  • Central and peripheral lymphadenopathy
+
Mantle cell lymphoma
  • Stage IV disease
  • B symptoms,
  • Generalized lymphadenopathy
  • Abdominal distention
  • Fatigue
  • Night sweats
  • Weight Loss
  • Extranodal involvement of gastrointtestinal (GI) tract, lungs, and central nervous system (CNS)
  • Generalized lymphadenopathy
  • Hepato-splenomegaly
  • Mental Retardation
  • Less commonly
    • Palpable masses in skin, breast, and salivary glands
CBC
  • Anemia and cytopenias are secondary to bone marrow infiltration
  • Lymphocytosis > 4000/µL
  • Elevated LDH
  • CD5+
  • B-cell antigen positive
    • CD19
    • CD20
    • CD22
  • Cyclin D1 is overexpressed.
  • Germinal centers filled by small-to-medium atypical lymphocytes.
  • Nodular appearance may be evident from expansion of the mantle zone in 30-50% of patients early in the disease.
Diffuse large B cell lymphoma
  • 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
Nl to ↓

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
  • Hypergammaglobulinemia
Category Disease Etiology Inherited Acquired Demography History Constitutional symptoms Rash Abdominal pain Diarrhea V/S Mass LAP Hepatosplenomegaly Arthritis Other WBC Hb Plt PBS LFT PT/PTT Immunochemistry Histopathology Other lab findings Imaging Gold standard Associated findings
Burkitt lymphoma
  • Mature B-cell Lymphoma
  • Translocation of chromosome 8 myc locus such as:
    • t(8;14)
    • t(2;8)
    • t(8;22)
  • Medium-sized (~1.5-2x the size of a RBC) with uniform size ("monotonous") -- key feature (i.e. tumor nuclei size similar to that of histiocytes or endothelial cells)
  • Round nucleus
  • Small nucleoli
  • basophilic cytoplasm
  • Brisk mitotic rate and apoptotic activity
  • Cellular outline usually appears squared off
  • "Starry-sky pattern":
    • The stars in the pattern are tingible-body macrophages (macrophages containing apoptotic tumor cells)
    • The tumour cells are the sky
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
  • Clonal rearrangements of the immunoglobulin genes (heavy and light chains)
    • Deletion 7q21-32
    • Translocations of the CDK6 gene located at 7q21.
  • B-cells replace the normal white pulp of the spleen
  • The neoplastic cells compromise
  • Sinus invasion
  • Epithelial histocytes
  • Plasmacytic differentiation of neoplastic cells.
  • Splenic Hilar Lymph Nodes
  • Bone Marrow Biopsy
    • Splenic marginal zone lymphoma in bone marrow displays a nodular pattern with morphology similar to what is observed in the splenic hilar lymph nodes.
Nodal marginal zone B-cell lymphoma
  • Arise from memory B cells. Include
    • Splenic marginal zone lymphoma
    • Nodal marginal zone lymphoma
    • Extranodal marginal zone lymphoma.
  • Stimulation of antigen receptor by autoantigen and co-stimulatory molecule CD40.
  • Depends largely on its location
  • Gastric marginal zone lymphoma
    • Dyspepsia
    • Abdominal pain
    • Hemorrhage
  • Chronic infectious conditions or autoimmune processes, such as
    • H pylori gastritis
    • Hashimoto thyroiditis
    • Sjögren syndrome.
  • AE1/AE3
  • B-cell markers CD20, CD79a, CD10, CD23, and bcl-2 are expressed
  • Follicular cells in reactive zone
  • Centrocyte like cells in marginal zone lymphoma
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)
Precursor T-cell lymphoblastic leukemia/lymphoma
  • Precursor T-cell Lymphomas
Adult T cell leukemia/lymphoma
T cell lymphoma Anaplastic large cell lymphoma
Cutaneous T-cell lymphoma Mycosis fungoides / Sézary syndrome
  • Cutaneous manifestations
Peripheral T-cell lymphoma Subcutaneous panniculitis-like T-cell lymphoma
Hepatosplenic gamma-delta T-cell lymphoma
Enteropathy-type intestinal T-cell lymphoma
Extranodal T-cell lymphoma, nasal type
Angioimmunoblastic T-cell lymphoma
Peripheral T-cell lymphoma, unspecified