Page 443 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

CHAPTER 22 ■ Lymphoid and Plasma Cell Neoplasms 427

types. R re or s o ly pho inclu e Burkitt’s ly pho

BOX 22.3 n ycosis ungoi es, v ri nt o Séz ry syn ro e.

T e two conte por ry ly pho cl ssif c tion sys-

te s re the Revise Europe n-A eric n Ly pho
Examples of Lymphoid Neoplasms (REAL) Cl ssif c tion n the Worl He lth Org niz tion

(WHO) Cl ssif c tion o u ours o the H e topoietic
B-CELL NEOPLASMS

Precursor B-cell neopl s n Ly phoi issues, ourth e ition. T ere re pproxi-
tely 30 i erent ly pho bnor lities, inclu ing

■ Precursor B-ly phobl stic leuke i /ly pho (pre- entities ef ne by co bin tion o orphologic l, i un-

cursor B-cell cute ly phobl stic leuke i ) ophenotypic l, genetic, n clinic l e tures (see bles 22.6

M ture (peripher l) B-cell neopl s s with leuke ic n 22.7). T e i port nce o the v rious e tures i ers

present tion epen ing on the i erent types o ly pho s.
Te REAL n WHO cl ssif c tions inclu e Ho gkin is-

■ Chronic ly phocytic leuke i /B-cell SLL e se n NHL. T e ter Ho gkin ly pho is pre erre

■ B-cell proly phocytic leuke i bec use o the origin o the Reed-Sternberg cell in l ost ll

■ H iry cell leuke i c ses o Ho gkin ise se s the B ly phocytes. T e WHO

■ Pl s cell neopl s s cl ssif c tion lso inclu es pl s cell neopl s s within the

M ture (peripher l) B-cell neopl s s no e b se c tegory o B-cell neopl s s. Sep r te sections o the WHO
cl ssif c tion inclu e i uno ef ciency- ssoci te ly pho-

■ Di use l rge B-cell ly pho proli er tive isor ers, cute yeloi leuke i s, yelo ys-

■ Burkitt ly pho /leuke i pl stic syn ro es, n chronic yeloproli er tive isor ers.

Within the group o NHLs, ly phobl stic neopl s s re
T- AND NK-CELL NEOPLASMS

Precursor -cell neopl s sep r te ro ture B- n -cell neopl s s. Both the
ture B- n -cell neopl s s re subcl ssif e into those

■ Precursor -ly phobl stic leuke i /ly pho (pre- th t re s ollows:

cursor -cell cute ly phobl stic leuke i )
■ Pre o in ntly isse in te or leuke ic t present tion
M ture (peripher l) -cell neopl s s with leuke ic ■ Pri rily extr no l

present tion ■ Pre o in ntly ly ph no e–b se entities

■ -cell proly phocytic leuke i As v nces re e in he top thology, ch nges will

■ A ult -cell ly pho /leuke i (H LV 1+) be incorpor te into the WHO cl ssif c tion syste . Precise

■ Mycosis ungoi es/Séz ry syn ro e i gnostic subcl ssif c tion is i port nt to inister e ec-

tive ther py.
HODGKIN LYMPHOMA (HODGKIN DISEASE)

■ No ul r ly phocyte pre o in nt Ho gkin ly pho Epidemiology

■ Cl ssic l Ho gkin ly pho
Ly pho s h ve been escribe in ll r ces n ethnic

groups. Ly pho is the thir ost co on or o c n-

cer ong chil ren ollowing leuke i s n br in tu ors.
Classi cations
Ho gkin ly pho or Ho gkin’s ise se, ost co only

Di gnosis n subcl ssif c tion o ly pho h ve ch nge ects chil ren ge 15 n ol er. T ree subtypes o Ho gkin

r tic lly over ti e. Cl ssic lly, the jor or s o lig- ly pho exist in chil ren. T e subtype, No ul r sclerosis

n nt ly pho s re ivi e into Ho gkin n non-Ho gkin (NS ects 70% o chil ren who re i gnose with Ho gkin

TABLE 22.6 Immunohistological Features of Selected B-Cell Neoplasms

Surface Membrane Marker

Type of Neoplasm SIg CD5 CD10 CD23 CD43

Chronic lymphocytic leukemia + + − + +

Hairy cell leukemia + − − − +

Burkitt lymphoma + − + − −

SIg, surface immunoglobulin.

Source: Handin RI, et al. (eds.), Blood: Principles and Practice of Hematology, 2nd ed, Philadelphia, PA: Lippincott Williams & Wilkins, 2003:75.