XI. Non- Hodgkin's lymphoma cont'd

 

Table 2: International Lymphoma Study Group Classification (including provisional WHO categories)

B-Cell Neoplasms

T/NK-Cell Lymphoma

Hodgkin's Lymphoma

Precursor B-cell lymphoblastic leukemia/lymphoma

Precursor T cell lymphoblastic leukemia/lymphoma

Lymphocyte predominance, nodular

 

 

 

Peripheral B-cell neoplasms

Peripheral T-cell and NK-cell neoplasms

Classical HL

B-cell CLL/SLL

Predominantly leukemic/disseminated

Lymphocyte rich classical HL

B-cell prolymphocytic leukemia

T-cell prolymphocytic leukemia

Nodular sclerosis

Lymphoplasmacytic lymphoma

T-cell large granular lymphocytic (LGL)

Mixed cellularity

Mantle cell lymphoma

leukemia

Lymphocyte depletion

Follicular lymphoma

NK cell leukemia

Unclassifiable classical HL

Extranodal marginal zone B-cell lymphoma, MALT type (+/- monocytoid B cells)

Adult T-cell leukemia/lymphoma

 

Splenic marginal zone B-cell lymphoma (+/-villous lymphocytes)

Predominantly nodal

 

Hairy cell leukemia

Angioimmunoblastic T-cell lymphoma

 

Diffuse large B-cell lymphoma

Peripheral T-cell lymphoma unspecified

 

Burkitt lymphoma

Anaplastic large cell lymphoma, T/null-cell

 

Plasma cell myeloma

Predominantly extranodal

 

Plasmacytoma

Mycosis fungoides

 

 

Sezary syndrome

 

 

Primary cutaneous (CD30+ T-cell lymphoproliferative disorders)

 

 

Subcutaneous panniculitis-like T-cell lymphoma

 

 

NK/T cell lymphoma, nasal and nasal-type

 

 

Enteropathy-type intestinal T-cell lymphoma

 

 

Hepatosplenic T-cell lymphoma

 

 

gd (gamma/delta)

 

 

ab (alpha/beta)

 

 

 

 

 

 

 

Table X: Indolent B cell lymphomas+imitator

 

Follicular Lymphoma (Grade I)

Small lymphocytic lymphoma/CLL

Marginal zone Lymphoma

Mantle cell Lymphoma

Frequency (% all lymphomas)

22%

7

8

6

Age of onset-median

59

65

61

63

Stage at Presentation

Stage III/IV (Disseminated)

Stage IV

Stage I

Stage III/IV

Response to Therapy

Good to most treatments, but incurable short of transplant

Similar to Follicular lymphoma

Frequently curable

Poor response to all therapies to date

5 yr survival

72%

51

74

27

Predominant site presentation

Nodal

Marrow/Nodal

Extranodal

Marrow/nodal

Pattern of nodal Infiltration

Follicular

Diffuse

Diffuse

Diffuse or "mantle zone"

Benign cell Equivalent

Germinal center small cleaved cell

Virgin B cell

Marginal zone Lymphocyte

Mantle cell

Dominant cell type

Small cleaved cell in most cases, but can be large cell

Small lymphocytes with round nucleus

Mix of small lymphocytes, plasma cells

Small cell with irregular nucleus, similar to cleaved

Immuno phenotype

Positive: CD19 CD10, Bcl2+

Negative: CD5

Positive: CD19 CD5,CD23

Negative: CD10

Positive: CD19 Bcl2

Negative: CD10, CD5

Positive: CD19 CD5, Bcl2

Negative: CD23, CD10

Molecular Pathogenesis

t(14;18) Bcl2/JH

Trisomy 12

Trisomy 3 t(11;18)

t(11;14) Bcl1/JH

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