Category
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Disease
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Etiology
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Mechanism
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Clinical manifestations
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Paraclinical findings
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Gold standard
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Associated findings
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Lab findings
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Imaging
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Demography
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History
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Symptoms
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Signs
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CBC
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PBS
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LFT
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PT/PTT
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Immunochemistry
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Histopathology
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Other
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Inherited
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Acquired
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Constitutional symptoms
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Rash
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Abdominal pain
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Diarrhea
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V/S
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Mass
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LAP
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Hepatosplenomegaly
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Arthritis
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Other
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WBC
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Hb
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Plt
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HL
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Hodgkin's Lymphoma
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NHL
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B Cell Lymphoma
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Precursor B-cell lymphoblastic leukemia/lymphoma
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- Precursor B-cell Lymphoma
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Follicular lymphoma
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- Mature B-cell Lymphoma
- Reciprocal translocation t(14;18)(q32;q21)
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- Painless swelling in the neck, axilla, groin, thorax and abdomen
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- Central and peripheral lymphadenopathy
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Mantle cell lymphoma
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- 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)
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- Generalized lymphadenopathy
- Hepato-splenomegaly
- Mental Retardation
- Less commonly
- Palpable masses in skin, breast, and salivary glands
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CBC
- Anemia and cytopenias are secondary to bone marrow infiltration
- Lymphocytosis > 4000/µL
- Elevated LDH
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- CD5+
- B-cell antigen positive
- Cyclin D1 is overexpressed.
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- 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.
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Diffuse large B cell lymphoma
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- 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.
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- Fever
- Night sweats
- weight loss
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↓
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↓
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Nl to ↓
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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
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Category
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Disease
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Etiology
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Inherited
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Acquired
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Demography
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History
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Constitutional symptoms
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Rash
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Abdominal pain
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Diarrhea
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V/S
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Mass
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LAP
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Hepatosplenomegaly
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Arthritis
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Other
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WBC
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Hb
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Plt
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PBS
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LFT
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PT/PTT
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Immunochemistry
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Histopathology
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Other lab findings
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Imaging
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Gold standard
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Associated findings
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Burkitt lymphoma
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- Mature B-cell Lymphoma
- Translocation of chromosome 8 myc locus such as:
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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 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
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B cell chronic lymphocytic leukemia/small lymphocytic lymphoma
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Marginal zone lymphoma
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Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type
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Splenic marginal zone lymphoma
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- Clonal rearrangements of the immunoglobulin genes (heavy and light chains)
- Deletion 7q21-32
- Translocations of the CDK6 gene located at 7q21.
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- 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.
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Nodal marginal zone B-cell lymphoma
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- 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.
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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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- AE1/AE3
- B-cell markers CD20, CD79a, CD10, CD23, and bcl-2 are expressed
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- Follicular cells in reactive zone
- Centrocyte like cells in marginal zone lymphoma
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Lymphoplasmacytic lymphoma (Waldenstrom’s macroglobulinemia)
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Hairy cell leukemia
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- 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
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- Tartrate-resistant acid phosphatase positive
- CBC
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- 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)
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Precursor T-cell lymphoblastic leukemia/lymphoma
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- Precursor T-cell Lymphomas
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Adult T cell leukemia/lymphoma
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T cell lymphoma
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Anaplastic large cell lymphoma
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Cutaneous T-cell lymphoma
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Mycosis fungoides / Sézary syndrome
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Peripheral T-cell lymphoma
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Subcutaneous panniculitis-like T-cell lymphoma
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Hepatosplenic gamma-delta T-cell lymphoma
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Enteropathy-type intestinal T-cell lymphoma
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Extranodal T-cell lymphoma, nasal type
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Angioimmunoblastic T-cell lymphoma
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Peripheral T-cell lymphoma, unspecified
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