Page 352 - Concise Pathology for Exam Preparation ( PDFDrive )

12 Haematology 337

(a) B-cell neoplasms
(i) Precursor B-cell neoplasm: Precursor B-lymphoblastic leukaemia/lymphoma
(B-ALL)
(ii) Mature (peripheral) B-cell neoplasms
- B-cell chronic lymphocytic leukaemia/small lymphocytic lymphoma
- Lymphoplasmacytic lymphoma
- Splenic marginal zone lymphoma (6 villous lymphocytes)
- Hairy cell leukaemia
- Plasma cell myeloma/plasmacytoma
- Extranodal marginal zone B-cell lymphoma of MALT type
- Mantle cell lymphoma
- Follicular lymphoma
- Nodal marginal zone B-cell lymphoma (6 monocytoid B cells)
- Diffuse large B-cell lymphoma (NOS)
- Diffuse large B cell lymphoma associated with chronic inflammation
- Primary effusion lymphoma
- Burkitt’s lymphoma
(b) T-cell and NK-cell neoplasms
(i) Precursor T-cell neoplasm: Precursor T-lymphoblastic lymphoma/leukaemia
(ii) Mature (peripheral) T-cell neoplasms
- T-cell prolymphocytic leukaemia
- T-cell granular lymphocytic leukaemia
- Chronic lymphoproliferative disorder of NK cells
- Adult T-cell lymphoma/leukaemia (HTLV11)
- Extranodal NK/T-cell lymphoma and nasal type
- Enteropathy-type T-cell lymphoma
- Primary cutaneous T cell lymphoproliferative disorder
- Mycosis fungoides/Sézary syndrome
- Anaplastic large cell lymphoma
- Peripheral T-cell lymphoma; unspecified (NOS)
- Angioimmunoblastic T-cell lymphoma

Q. Write in detail about the gross and microscopic pathology of NHL.
Ans. Diagnosis made reliably on lymph node biopsy; FNAC not adequate for typing of NHL.

Gross
1. Lymph nodes are enlarged and matted.
2. Common groups involved are cervical, supraclavicular and axillary.
3. Cut surface is grey-white and fish-flesh like

Histopathology

Precursor B-cell and T-cell leukaemia/lymphoma (acute lymphoblastic leukaemia/
lymphoma):
• Group of neoplasms composed of immature precursor B (Pre-B) or T (Pre-T) cells, referred
to as lymphoblasts.
• Eighty-five percent of ALLs are precursor B-cell tumours that are aggressive and mani-
fest as childhood acute leukaemia with symptoms relating to pancytopenia secondary to
marrow involvement.
• Less common precursor T-cell ALLs (15% of childhood leukaemias) are also aggressive
and manifest in adolescence with a thymic mass with variable splenic, hepatic and bone
marrow involvement.

Morphology
• Normal tissue architecture is completely effaced by lymphoblasts having scanty cytoplasm
and nuclei slightly larger than a small lymphocyte.

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