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Bone Marrow Pathology
Barbara J. Bain, David M. Clark, Bridget S. Wilkins
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eBook - ePub
Bone Marrow Pathology
Barbara J. Bain, David M. Clark, Bridget S. Wilkins
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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.
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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... |