Chapter 105. Malignancies of Lymphoid Cells (Part 2)

Non-Hodgkins lymphomas were separated from Hodgkins disease by recognition of the Sternberg-Reed cells early in the twentieth century. The histologic classification for non-Hodgkins lymphomas has been one of the most contentious issues in oncology. Imperfect morphologic systems were supplanted by imperfect immunologic systems, and poor reproducibility of diagnosis has hampered progress. In 1999, the World Health Organization (WHO) classification of lymphoid malignancies was devised through a process of consensus development among international leaders in hematopathology and clinical oncology. The WHO classification takes into account morphologic, clinical, immunologic, and genetic information and attempts to divide non-Hodgkinslymphomas and other lymphoid malignancies...
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Chapter 105. Malignancies of Lymphoid Cells (Part 2) Chapter 105. Malignancies of Lymphoid Cells (Part 2) Non-Hodgkins lymphomas were separated from Hodgkins disease byrecognition of the Sternberg-Reed cells early in the twentieth century. Thehistologic classification for non-Hodgkins lymphomas has been one of the mostcontentious issues in oncology. Imperfect morphologic systems were supplantedby imperfect immunologic systems, and poor reproducibility of diagnosis hashampered progress. In 1999, the World Health Organization (WHO) classificationof lymphoid malignancies was devised through a process of consensusdevelopment among international leaders in hematopathology and clinicaloncology. The WHO classification takes into account morphologic, clinical,immunologic, and genetic information and attempts to divide non-Hodgkinslymphomas and other lymphoid malignancies into clinical/pathologic entities thathave clinical and therapeutic relevance. This system is presented in Table 105-3.This system is clinically relevant and has a higher degree of diagnostic accuracythan those used previously. The possibilities for subdividing lymphoidmalignancies are extensive. However, Table 105-3 presents in bold thosemalignancies that occur in at least 1% of patients. Specific lymphoma subtypeswill be dealt with in more detail below. Lymphomas associated with HIV infectionare discussed in Chap. 182. Table 105-3 WHO Classification of Lymphoid Malignancies B Cell T Cell Hodgkins Disease Precursor B cell Precursor T cell Nodularneoplasm neoplasm lymphocyte- predominant Hodgkins disease Precursor B Precursor Tlymphoblastic lymphoblasticleukemia/lymphoma lymphoma/leukemia(precursor B cell acute (precursor T cell acutelymphoblastic leukemia) lymphoblastic leukemia) Mature (peripheral) B Mature (peripheral) T Classicalcell neoplasms cell neoplasms Hodgkins disease B cell chronic T cell prolymphocytic Nodularlymphocytic leukemia sclerosis Hodgkinsleukemia/small diseaselymphocytic lymphoma B cell T cell granular Lymphocyte-prolymphocytic leukemia lymphocytic leukemia rich classic Hodgkins disease Lymphoplasmacytic Aggressive NK cell Mixed-lymphoma leukemia cellularity Hodgkins disease Splenic marginal Adult T cell Lymphocyte-zone B cell lymphoma (± lymphoma/leukemia (HTLV- depletion Hodgkinsvillous lymphocytes) I+) disease Hairy cell leukemia Extranodal NK/T cell lymphoma, nasal type Plasma cell Enteropathy-type Tmyeloma/plasmacytoma cell lymphoma Extranodal Hepatosplenic γd Tmarginal zone B cell cell lymphomalymphoma of MALT type Mantle cell Subcutaneouslymphoma panniculitis-like T cell lymphoma Follicular Mycosislymphoma fungoides/Sézary syndrome Nodal marginal zone Anaplastic large cellB cell lymphoma (± lymphoma, primary cutaneousmonocytoid B cells) type Diffuse large B cell Peripheral T celllymphoma lymphoma, not otherwise specified (NOS) Burkitts Angioimmunoblasticlymphoma/Burkitt cell T cell lymphomaleukemia Anaplastic large cell lymphoma, primary systemic type Note: HTLV, human T cell lymphotropic virus; MALT, mucosa-associatedlymphoid ti ...