Sanbox:Kamal

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xray showing femur fracture source:Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID: 25704


X-ray showing Humerus Fracture source:Case courtesy of Dr Benoudina Samir, Radiopaedia.org, rID: 22063


X-Ray showing Tibial Fracture source:Case courtesy of MD PhD gasssss, Radiopaedia.org, rID: 13768


==References==

Differentiating NHL

Category Disease Etiology Constitutional symptoms Rash Abdominal pain Diarrhea Mass Other WBC Hb Plt Immunochemistry Histopathology Gold standard Associated findings
T cell lymphoma Precursor T-cell lymphoblastic leukemia/lymphoma
  • Precursor T-cell Lymphomas
T-cell granular lymphocytic
T-cell prolymphocytic leukemia
Adult T cell leukemia/lymphoma[1][2][3]
  • Mature T-cell Lymphoma
  • Human T-lymphotrophic virus 1 infection
  • Hepatospleanomagaly
  • Hypercalcemia
  • Skin lesions
  • Lytic bone lesions
  • Elevated LDH
  • T-cell deficiency leading immunodeficiency causing opportunistic infection
 +
  • Anemia
  • Thrombocytopenia
  • Elevated lymphocyte count
  • Adult T-cell leukemia cells are typically CD2, CD4, CD5, and CD8 positive
  • Charecterstic leukemia cells with sharp nuclear indentations and a prominent nucleoli
  • "Cloverleaf" or "flower" cells
 Hypercalcemia
Anaplastic large cell lymphoma[4][5][6][7]
  • Mature T-cell Lymphoma
 + +
  • Strongly immunoreactive for CD30, Anaplastic lymphoma kinase (ALK), EMA, and vimentin
  • Nucleoli tend to be more prominent
  • The cytoplasm may be either basophilic or eosinophilic and the cell might have many nuclei with dispersed or clumped chromatin
Cutaneous T-cell lymphoma Mycosis fungoides / Sézary syndrome[8][9][10] + +
  • Cutaneous manifestations
 Beta F1+, CD2-/+, CD3+, CD3- (CD4-positive variant), CD4+ (CD4-positive variant), CD4-, CD5-, CD7+/-, CD8+, CD8- (CD4-positive variant), Granzyme B+, and perforin+
  • polymorphous inflammatory infiltrate in the dermis that contains small numbers of frankly atypical lymphoid cells
  • These cells may line up individually along the epidermal basal layer
  • The presence of spongiosis is highly suggestive of mycosis fungoides
Peripheral T-cell lymphoma Subcutaneous panniculitis-like T-cell lymphoma[11][12][13]
  • Mature T-cell Lymphoma
Hepatosplenic T-cell lymphoma[14][15][16]
  • Mature T-cell Lymphoma
  • Inflammatory bowel disease
    • Organ transplant patients (reciever)
    • Immunosuppresent medications
    • Thiopurines
    • Infliximab
    • Cyclophosphamide
    • Vincristine
    • Doxorubicin
 + +
  • CD2, CD3, CD7, CD16 , CD56 or CD57, TIA1, Granzyme m, Fas ligand,
  • Intermediate sized tumor cells with clear cytoplasm, oval nuclei, slightly dispersed condensed chromatin, inconspicuous nucleoli
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
  1. ↑ Matutes E (2007). "Adult T-cell leukaemia/lymphoma". J. Clin. Pathol. 60 (12): 1373–7. doi:10.1136/jcp.2007.052456. PMC 2095573. PMID 18042693.
  2. ↑ Matutes E (2007) Adult T-cell leukaemia/lymphoma. J Clin Pathol 60 (12):1373-7. DOI:10.1136/jcp.2007.052456 PMID: 18042693
  3. ↑ Shimoyama M (1991). "Diagnostic criteria and classification of clinical subtypes of adult T-cell leukaemia-lymphoma. A report from the Lymphoma Study Group (1984-87)". Br J Haematol. 79 (3): 428–37. PMID 1751370.
  4. ↑ Al-Ahmad, Selma; Maertens, Vincent; Libeer, Christophe; Schelfhout, Vera; Vanhoenacker, Filip; Boeckx, Nancy; Vandevenne, Marleen (2017). "The masquerading presentation of a systemic anaplastic large cell lymphoma, ALK positive: a case report and review of the literature". Acta Clinica Belgica. 72 (6): 454–460. doi:10.1080/17843286.2017.1312057. ISSN 1784-3286.
  5. ↑ Yu L, Yan LL, Yang SJ (2014). "Sarcomatoid variant of ALK- anaplastic large cell lymphoma involving multiple lymph nodes and both lungs with production of proinflammatory cytokines: report of a case and review of literature". Int J Clin Exp Pathol. 7 (8): 4806–16. PMC 4152041. PMID 25197351.
  6. ↑ de Campos FPF, Zerbini MCN, Felipe-Silva A, Simões AB, Lovisolo SM, da Fonseca LG; et al. (2014). "Unusual clinical presentation of anaplastic large cell lymphoma". Autops Case Rep. 4 (1): 21–27. doi:10.4322/acr.2014.004. PMC 5470561. PMID 28652989.
  7. ↑ Watanabe M, Ogawa Y, Itoh K; et al. (January 2008). "Hypomethylation of CD30 CpG islands with aberrant JunB expression drives CD30 induction in Hodgkin lymphoma and anaplastic large cell lymphoma". Lab. Invest. 88 (1): 48–57. doi:10.1038/labinvest.3700696. PMID 17965727.
  8. ↑ Foss, Francine M.; Girardi, Michael (2017). "Mycosis Fungoides and Sezary Syndrome". Hematology/Oncology Clinics of North America. 31 (2): 297–315. doi:10.1016/j.hoc.2016.11.008. ISSN 0889-8588.
  9. ↑ Campbell, J. J.; Clark, R. A.; Watanabe, R.; Kupper, T. S. (2010). "Sezary syndrome and mycosis fungoides arise from distinct T-cell subsets: a biologic rationale for their distinct clinical behaviors". Blood. 116 (5): 767–771. doi:10.1182/blood-2009-11-251926. ISSN 0006-4971.
  10. ↑ Vonderheid, Eric C.; Bernengo, Maria Grazia; Burg, Günter; Duvic, Madeleine; Heald, Peter; Laroche, Liliane; Olsen, Elise; Pittelkow, Mark; Russell-Jones, Robin; Takigawa, Masahiro; Willemze, Rein (2002). "Update on erythrodermic cutaneous T-cell lymphoma: Report of the international society for cutaneous lymphomas". Journal of the American Academy of Dermatology. 46 (1): 95–106. doi:10.1067/mjd.2002.118538. ISSN 0190-9622.
  11. ↑ Subcutaneous panniculitis-like T-cell lymphoma. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf56e3e27c3994bd52df/. Accessed on March 08, 2016
  12. ↑ Subcutaneous panniculitis-like T-cell lymphoma. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf56e3e27c3994bd52df/. Accessed on March 08, 2016
  13. ↑ Parveen Z, Thompson K (2009). "Subcutaneous panniculitis-like T-cell lymphoma: redefinition of diagnostic criteria in the recent World Health Organization-European Organization for Research and Treatment of Cancer classification for cutaneous lymphomas". Arch Pathol Lab Med. 133 (2): 303–8. doi:10.1043/1543-2165-133.2.303. PMID 19195975.
  14. ↑ van de Meeberg MM, Derikx LA, Sinnige HA, Nooijen P, Schipper DL, Nissen LH (2016). "Hepatosplenic T-cell lymphoma in a 47-year-old Crohn's disease patient on thiopurine monotherapy". World J Gastroenterol. 22 (47): 10465–10470. doi:10.3748/wjg.v22.i47.10465. PMC 5175260. PMID 28058028.
  15. ↑ Shi, Yang; Wang, Endi (2015). "Hepatosplenic T-Cell Lymphoma: A Clinicopathologic Review With an Emphasis on Diagnostic Differentiation From Other T-Cell/Natural Killer–Cell Neoplasms". Archives of Pathology & Laboratory Medicine. 139 (9): 1173–1180. doi:10.5858/arpa.2014-0079-RS. ISSN 0003-9985.
  16. ↑ Alsohaibani FI, Abdulla MA, Fagih MM (2011). "Hepatosplenic T-cell lymphoma". Indian J Hematol Blood Transfus. 27 (1): 39–42. doi:10.1007/s12288-010-0051-1. PMC 3102508. PMID 22379294.

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