Page 442 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

426 PART 6 ■ Neoplastic Disorders

FIGURE 22.9 Non-Ho gkin ly pho s o

B cell origin i use l rge B cell ly pho .
(Fro An erson SC. Anderson’s Atlas o

Hematology, Phil elphi , PA: Wolters Kluwer

He lth/Lippincott Willi s & Wilkins, 2003.)

Laboratory Characteristics LYMPHOMAS

Circul ting tu or cells in the peripher l bloo re ore

not ble th n the ppe r nce o the bone rrow. In the M lign nt ly pho expresses itsel s isor er o the

peripher l bloo (Fig. 22.10), tu or cells h ve hyperlob te ly ph no es. It is ch r cterize by the inf ltr tion o bnor-

nuclei, so eti es with cloverle sh pe. Neopl stic cells l ly phocytes n estruction o the nor l rchitecture

re CD4+ but o en l ck CD7. Cells re CD25+ n positive o the no e. T is results in the inv sion n estruction o the

or FoxP3, phenotype ch r cteristic o regul tory cells. ly ph no e c psule n subc psul r sinuses n the inf ltr -

tion o the peric psul r t by l rge nu bers o the cells th t

estroye the rchitecture o the ly ph no es. Eventu lly,

NOTE: This is a good time to complete Review Questions this isor er progresses to ll o the ly phoi tissues o the

related to the preceding content. g strointestin l tr ct.

Factors Associated w ith Lymphoid

Neoplasms

Acquire n inherite genetic ctors c n be ssoci te with

the evelop ent o ly phoi neopl s (Box 22.3). Acquire

genetic ctors such s lter tions o protooncogenes n

tu or suppressor genes h ve been ssoci te with evelop-

ent o ture ly phoi neopl s s. A ition l t rgets or

genetic ge re genes th t in uence poptosis. An ex ple

is the Bcl-2 gene on chro oso e 18 in ollicul r ly pho .

Bec use o ecre se poptosis, ly phocytes ccu ul te

within ly ph no e. Low-gr e ollicul r ly pho ppe rs

to rise ro cell persistence not uncontrolle cell proli er tion.

Inherite genetic ctors ssoci te with inherite i u-

no ef ciency, such s Wiskott-Al rich syn ro e, re ssoci-

te with n incre se inci ence o lign nt ly pho .

In ition, environ ent l ctors such s Epstein-B rr
FIGURE 22.10 A ult -cell leuke i /ly pho (A LL). T is is-

e se is ch r cterize by proli er tion o lign nt ly phocytes virus (EBV) is irectly ssoci te with the or o Burkitt’s
(here, in the bone rrow) with extre ely irregul r, knobby nuclei ly pho prev lent in A ric n boys, so e c ses o en e ic

(arrows). T e itotic r te ong the lign nt cells is ch r cter- Burkitt’s ly pho , n Ho gkin ly pho . An in ec-

istic lly high (arrowheads). (Reprinte ro Str yer DS, Rubin E. tious gent ssoci te with NHL is Helicobacter pylori. T is
Rubin’s P thology, 7th e ., Phil elphi , PA: Lippincott Willi s & is pp rent in the high inci ence o g stric ly pho o

Wilkins, 2014, with per ission.) mucosa-associated lymphoid tissue (MALT).