Sandbox:Preeti: Difference between revisions

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*[[Weight loss]]
*[[Weight loss]]
*[[Night sweats]]
*[[Night sweats]]
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* Central and peripheral lymphadenopathy
* Central and peripheral lymphadenopathy
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! colspan="2" align="center" style="background:#DCDCDC;" + |Mantle cell lymphoma
! colspan="2" align="center" style="background:#DCDCDC;" + |Mantle cell lymphoma
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* Mature B-cell Lymphoma
* [[CD5 (protein)|CD5]] positive antigen in pregerminal center of B-cell
* [[CD5 (protein)|CD5]] positive antigen in pregerminal center of B-cell
* [[Chromosomal translocation]] at '''t(11:14)'''
* [[Chromosomal translocation]] at '''t(11:14)'''
** Over-express [[cyclin D1]]
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* Stage IV disease
* B symptoms,
* Generalized lymphadenopathy
* Abdominal distention
* Fatigue  
* Fatigue  
* Night sweats  
* Night sweats  
* Weight Loss
* Weight Loss
* Extranodal involvement of gastrointtestinal (GI) tract, lungs, and central nervous system (CNS)
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| align="center" style="background:#F5F5F5;" + |Abdominal distention
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* Palpable masses in skin, breast, and salivary glands
| align="center" style="background:#F5F5F5;" + |Generalized lymphadenopathy
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* Generalized lymphadenopathy
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* Hepato-splenomegaly
* Extranodal involvement of GI tract, lungs, and CNS
* Mental Retardation
* Mental Retardation
* Less commonly
** Palpable masses in skin, breast, and salivary glands
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| align="center" style="background:#F5F5F5;" + |CBC
* Anemia and cytopenias are secondary to bone marrow infiltration
* Lymphocytosis > 4000/µL  
* Lymphocytosis > 4000/µL  
* Elevated LDH
*  
*  
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| align="center" style="background:#F5F5F5;" + |Nl to ↓
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* CD5<sup>+</sup>  
* CD5<sup>+</sup>  
* B-cell antigen positive  
* B-cell antigen positive
** CD19
* Overexpression of Cyclin D1  
** CD20
** CD22
* Cyclin D1 is overexpressed.
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* Germinal centers filled by small-to-medium atypical lymphocytes.
* 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.
* Nodular appearance
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| align="center" style="background:#F5F5F5;" + |Elevated LDH
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* [[Proptosis]]
* Jaw mass
* Jaw mass
* [[Abdominal mass|Abdominal masses]]  
* [[Abdominal mass|Abdominal masses]]  
* [[Ascites]]
* [[Lymphadenopathy|Peripheral lymphadenopathy]]
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* [[Swollen lymph nodes]] in the neck, axilla, or groin
* [[Swollen lymph nodes]] in the neck, axilla, or groin
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* [[Ascites]]
* [[Proptosis]]
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* [[CD19]]
* [[CD19]]
* [[CD20]],
* [[CD20]]
* [[CD22]]
* [[CD22]]
* [[CD10]]
* [[CD10]]
* BCL6.
* BCL6  
* BCL2 and TdT.
* BCL2 and TdT
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:* 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 and small nucleoli
:* Round nucleus
:* Small nucleoli
:* [[basophilic]] cytoplasm
:* [[basophilic]] cytoplasm
:* Brisk mitotic rate and [[apoptotic]] activity
:* "Starry-sky pattern"
:* 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''
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! align="center" style="background:#DCDCDC;" + |[[Splenic marginal zone lymphoma]]
! align="center" style="background:#DCDCDC;" + |[[Splenic marginal zone lymphoma]]
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* Mature B-cell 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 on 7q21  
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* [[CD79a]]
* [[CD79a]]
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* [[B-cells]] replace the normal [[white pulp]] of the [[spleen]]
* Small [[lymphocytes]]  
* The neoplastic cells compromise
* Transformed blasts
** Small [[lymphocytes]]  
** Transformed blasts
* S[[Sinus|inus]] invasion
* Epithelial histocytes
* Epithelial histocytes
* Plasmacytic differentiation of neoplastic cells.
* Plasmacytic differentiation of neoplastic cells
* '''Splenic Hilar Lymph Nodes'''
** Involved hilar [[lymph nodes]] adjacent to the [[spleen]] show an effaced architecture without preservation of the [[marginal zone]] seen in the spleen
* '''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]].
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! align="center" style="background:#DCDCDC;" + |[[Nodal marginal zone B-cell lymphoma]]  
! align="center" style="background:#DCDCDC;" + |[[Nodal marginal zone B-cell lymphoma]]  
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* Arise from memory B cells. Include
* Mature B-cell Lymphoma
** Splenic marginal zone lymphoma
* Stimulation of antigen receptor by autoantigen and co-stimulatory molecule CD40
** Nodal marginal zone lymphoma
** Extranodal marginal zone lymphoma.
* Stimulation of antigen receptor by autoantigen and co-stimulatory molecule CD40.
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* 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.
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* Hemorrhage
* Dyspepsia
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* AE1/AE3  
* AE1/AE3  
* B-cell markers CD20, CD79a, CD10, CD23, and bcl-2 are expressed
* Expression of B-cell markers CD20, CD79a, CD10, CD23, and bcl-2
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* Follicular cells in reactive zone
* Follicular cells in reactive zone
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Chronic infectious conditions or autoimmune processes, such as
* ''H pylori'' gastritis
* Hashimoto thyroiditis
* Sjögren syndrome
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Revision as of 19:14, 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
  • 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
Elevated LDH
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)
  • 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
  • AE1/AE3
  • Expression of B-cell markers CD20, CD79a, CD10, CD23, and bcl-2
  • 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)
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