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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 nonâHodgkin 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 Bâ, Tâ and natural killer (NK)âlineage 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, immunodeficiencyâassociated lymphoproliferative disorders are classified separately.
Table 6.1 Summary of the 2016 WHO classification of Bâlineage neoplasms [2,3]. Provisional entities are italicized.
Bâcell precursor neoplasms |
Bâlymphoblastic leukaemia/lymphoma, NOS |
Bâlymphoblastic leukaemia/lymphoma with recurrent genetic abnormalities |
Mature Bâcell neoplasms |
Chronic lymphocytic leukaemia/small lymphocytic lymphoma |
Monoclonal Bâcell lymphocytosis |
Bâcell prolymphocytic leukaemia |
Splenic marginal zone lymphoma* |
Hairy cell leukaemia |
Splenic Bâcell lymphoma/leukaemia, unclassifiable |
Splenic diffuse red pulp small Bâcell lymphoma |
Hairy cell leukaemia variant |
Lymphoplasmacytic lymphoma |
IgM monoclonal gammopathy of undetermined significance |
Heavy chain diseases |
Plasma cell neoplasms (including plasma cell leukaemia and nonâIgM monoclonal gammopathy of undetermined significance) |
Extranodal marginal zone lymphoma of mucosaâassociated lymphoid tissue (MALT lymphoma) |
Nodal marginal zone Bâcell lymphoma |
Follicular lymphoma |
Paediatricâtype follicular lymphoma |
Primary cutaneous follicle centre lymphoma |
Mantle cell lymphoma |
Diffuse large Bâcell lymphoma, NOS |
Tâcell/histiocyteârich large Bâcell lymphoma |
Primary diffuse large Bâcell lymphoma of the central nervous system |
Primary cutaneous diffuse large Bâcell lymphoma, leg type |
EBVâpositive diffuse large Bâcell lymphoma, NOS |
EBVâpositive mucocutaneous ulcer |
Diffuse large Bâcell lymphoma associated with chronic inflammation |
Lymphomatoid granulomatosis |
Primary mediastinal (thymic) large Bâcell lymphoma |
Intravascular large Bâcell lymphoma |
Large Bâcell lymphoma with IRF4 rearrangement |
ALKâpositive large Bâcell lymphoma |
Plasmablastic lymphoma |
Primary effusion lymphoma |
HHV8âassociated lymphoproliferative disorders |
Multicentric Castleman disease |
HHV8âpositive diffuse large Bâcell lymphoma, NOS |
HHV8âpositive germinotropic lymphoproliferative disorder |
Burkitt lymphoma |
Burkittâlike lymphoma with 11q aberration |
High grade Bâcell lymphoma |
High grade Bâcell lymphoma with MYC and BCL2 and/or BCL6 rearrangements |
High grade Bâcell lymphoma, NOS |
Bâcell lymphoma, unclassifiable, with features intermediate between DLBCL and classic Hodgkin lymphoma |
*Includes splenic lymphoma with villous lymphocytes.
DLBCL, diffuse large Bâcell lymphoma; EBV, EpsteinâBarr virus, HHV8, human herpesvirus 8; Ig, immunoglobulin; NOS, not otherwise specified.
Table 6.2 Summary of the 2016 WHO classification of Tâcell and NKâcell neoplasms [2]. Provisional entities are italicized. (Reproduced with permission of IARC.)
Tâcell and NKâcell precursor neoplasms |
Tâlymphoblastic leukaemia/lymphoma |
Early Tâcell precursor lymphoblastic leukaemia |
NKâlymphoblastic leukaemia/lymphoma |
Mature Tâcell and NKâcell neoplasms |
Tâcell prolymphocytic leukaemia |
Tâcell large granular lymphocytic leukaemia |
Chronic lymphoproliferative disorders of NK lineage |
Aggressive NKâcell leukaemia |
Systemic EBVâpositive Tâcell lymphoma of childhood |
Adult Tâcell leukaemia/lymphoma |
Extranodal NK/Tâcell lymphoma, nasal type |
Intestinal Tâcell lymphoma including enteropathyâassociated Tâcell lymphoma |
Hepatosplenic Tâcell lymphoma |
Subcutaneous panniculitisâlike Tâcell lymphoma |
Mycosis fungoides |
SĂ©zary syndrome |
Primary cutaneous CD30âpositive Tâcell lymphoproliferative disorders |
Primary cutaneous peripheral Tâcell lymphomas, rare subtypes |
Angioimmunoblastic Tâcell lymphoma and other nodal lymphomas of T follicular helper cell origin |
Anaplastic large cell lymphoma, ALKâpositive |
Anaplastic large cell lymphoma, ALKânegative |
Breastâimplantâassociated anaplastic large cell lymphoma |
Peripheral Tâcell lymphoma, not otherwise specified |
EBV, EpsteinâBarr 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 lymphocyteâpredominant Hodgkin lymphoma | Typical ReedâSternberg 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 ReedâSternberg cells often very infrequent; lacunar cell varian... |