Bone Marrow Pathology

Barbara J. Bain, David M. Clark, Bridget S. Wilkins

• Publisher: Wiley-Blackwell
• Year: 2019
• ISBN:
  9781119398912
• Edition: 5
• Topic: Medicina
• Subtopic: Hematología

Bone Marrow Pathology has been extensively revised to reflect the significant advances which have occurred in the application of cytogenetics and in particular, molecular genetics in the diagnosis, classification and understanding of haematological disorders. This comprehensive book not only provides information on all common disease entities, but also covers rare disorders in which bone marrow examination is useful. It is designed as a practical resource with "problems and pitfalls" highlighted throughout to aid laboratory diagnosis.

SIX
LYMPHOPROLIFERATIVE DISORDERS

In this chapter we shall discuss acute and chronic leukaemias of lymphoid lineage and Hodgkin and non‐Hodgkin lymphomas. The disease entities will be classified according to the 2016 revision of the 2008 World Health Organization (WHO) classification of lymphoid neoplasms [1]. The 2016 revision of the WHO classification of B‐, T‐ and natural killer (NK)‐lineage neoplasms (excluding Hodgkin lymphoma) is summarized in Tables 6.1 and 6.2 and that of Hodgkin lymphoma in Table 6.3. In the 2016 WHO revision, immunodeficiency‐associated lymphoproliferative disorders are classified separately.

Table 6.1 Summary of the 2016 WHO classification of B‐lineage neoplasms [2,3]. Provisional entities are italicized.

B‐cell precursor neoplasms

B‐lymphoblastic leukaemia/lymphoma, NOS

B‐lymphoblastic leukaemia/lymphoma with recurrent genetic abnormalities

Mature B‐cell neoplasms

Chronic lymphocytic leukaemia/small lymphocytic lymphoma

Monoclonal B‐cell lymphocytosis

B‐cell prolymphocytic leukaemia

Splenic marginal zone lymphoma^*

Hairy cell leukaemia

Splenic B‐cell lymphoma/leukaemia, unclassifiable

Splenic diffuse red pulp small B‐cell lymphoma

Hairy cell leukaemia variant

Lymphoplasmacytic lymphoma

IgM monoclonal gammopathy of undetermined significance

Heavy chain diseases

Plasma cell neoplasms (including plasma cell leukaemia and non‐IgM monoclonal gammopathy of undetermined significance)

Extranodal marginal zone lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma)

Nodal marginal zone B‐cell lymphoma

Follicular lymphoma

Paediatric‐type follicular lymphoma

Primary cutaneous follicle centre lymphoma

Mantle cell lymphoma

Diffuse large B‐cell lymphoma, NOS

T‐cell/histiocyte‐rich large B‐cell lymphoma

Primary diffuse large B‐cell lymphoma of the central nervous system

Primary cutaneous diffuse large B‐cell lymphoma, leg type

EBV‐positive diffuse large B‐cell lymphoma, NOS

EBV‐positive mucocutaneous ulcer

Diffuse large B‐cell lymphoma associated with chronic inflammation

Lymphomatoid granulomatosis

Primary mediastinal (thymic) large B‐cell lymphoma

Intravascular large B‐cell lymphoma

Large B‐cell lymphoma with IRF4 rearrangement

ALK‐positive large B‐cell lymphoma

Plasmablastic lymphoma

Primary effusion lymphoma

HHV8‐associated lymphoproliferative disorders

Multicentric Castleman disease

HHV8‐positive diffuse large B‐cell lymphoma, NOS

HHV8‐positive germinotropic lymphoproliferative disorder

Burkitt lymphoma

Burkitt‐like lymphoma with 11q aberration

High grade B‐cell lymphoma

High grade B‐cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements

High grade B‐cell lymphoma, NOS

B‐cell lymphoma, unclassifiable, with features intermediate between DLBCL and classic Hodgkin lymphoma

^*Includes splenic lymphoma with villous lymphocytes.

DLBCL, diffuse large B‐cell lymphoma; EBV, Epstein–Barr virus, HHV8, human herpesvirus 8; Ig, immunoglobulin; NOS, not otherwise specified.

Table 6.2 Summary of the 2016 WHO classification of T‐cell and NK‐cell neoplasms [2]. Provisional entities are italicized. (Reproduced with permission of IARC.)

T‐cell and NK‐cell precursor neoplasms

T‐lymphoblastic leukaemia/lymphoma

Early T‐cell precursor lymphoblastic leukaemia

NK‐lymphoblastic leukaemia/lymphoma

Mature T‐cell and NK‐cell neoplasms

T‐cell prolymphocytic leukaemia

T‐cell large granular lymphocytic leukaemia

Chronic lymphoproliferative disorders of NK lineage

Aggressive NK‐cell leukaemia

Systemic EBV‐positive T‐cell lymphoma of childhood

Adult T‐cell leukaemia/lymphoma

Extranodal NK/T‐cell lymphoma, nasal type

Intestinal T‐cell lymphoma including enteropathy‐associated T‐cell lymphoma

Hepatosplenic T‐cell lymphoma

Subcutaneous panniculitis‐like T‐cell lymphoma

Mycosis fungoides

Sézary syndrome

Primary cutaneous CD30‐positive T‐cell lymphoproliferative disorders

Primary cutaneous peripheral T‐cell lymphomas, rare subtypes

Angioimmunoblastic T‐cell lymphoma and other nodal lymphomas of T follicular helper cell origin

Anaplastic large cell lymphoma, ALK‐positive

Anaplastic large cell lymphoma, ALK‐negative

Breast‐implant‐associated anaplastic large cell lymphoma

Peripheral T‐cell lymphoma, not otherwise specified

EBV, Epstein–Barr virus; NK, natural killer.

Table 6.3 Summary of the 2016 WHO classification of Hodgkin lymphoma [2]. (Reproduced with permission of IARC.)

Category	Specific histological characteristics^*
Nodular lymphocyte‐predominant Hodgkin lymphoma	Typical Reed–Sternberg cells are infrequent or absent; LP (lymphocyte predominant) cells are present; prominent proliferation of lymphocytes, histiocytes or both; usually nodular pattern in lymph nodes
Classic Hodgkin lymphoma
Nodular sclerosis classic Hodgkin lymphoma	Typical Reed–Sternberg cells often very infrequent; lacunar cell varian...