Chapter 36

Mature Lymphoid Neoplasms

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 Chapter Overview

 Morphologic and immunophenotypic features of

lymph nodes
 Lymph node processing
 Reactive lymphadenopathies
 Lymphomas

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 Normal Lymph Node Features

 Function of lymphoid tissue

 Location of lymph nodes
 Histologic components of lymph node
 Cortex
 Paracortex
 Medullary cords and sinuses

Continued
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Normal Lymph Node Features (Cont.)

Continued
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Normal Lymph Node Features (Cont.)

 Cortex
 Primary follicles
 Secondary follicles
• Germinal center
• Mantle zone
 Paracortex
 Cellular contents
 Medulla
 Cords
 Sinuses

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Normal Lymph Node Features (Cont.)

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Normal Lymph Node Features (Cont.)

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 Lymph Node Processing

 Transport of specimen
 Processing of specimen
 3-mm thick sections
 Cultures
 Touch imprints
 Paraffin embedding
 Immunophenotyping

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 Reactive Lymphadenopathies

 Classification based on patterns

 Follicular
 Paracortical
 Sinusoidal
 Mixed

Continued
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 Reactive Lymphadenopathies (Cont.)

 Follicular patterns
 Incidence
 Disease correlations
 Paracortical patterns
 Disease correlations
 Cellular features

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 Reactive Lymphadenopathies (Cont.)

 Sinusoidal patterns
 Disease correlations and cellular features
 Mixed patterns
 Disease correlations
 Lymph node features

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 Lymphomas

 Incidence
 Risk factors
 Classification

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 Mature B-Cell Lymphomas
 Features
 Subtypes
 Chronic lymphocytic leukemia/Small lymphocytic lymphoma
(CLL/SLL)
 Prolymphocytic leukemia
 Hairy cell leukemia
 Mantle cell lymphoma
 Follicular lymphoma
 Extranodal marginal zone lymphoma of mucosa-associated
lymphoid tissue
 Plasma cell neoplasms
 Diffuse large B-cell lymphoma
 Burkitt lymphoma
Continued
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 Mature B-Cell Lymphomas (Cont.)

 CLL and SLL

 Definition
 Origin
 Morphology
• Atypical CLL (aCLL)
 Diagnosis
 Prognosis
• IGVH
• FISH
• Next generation sequencing

Continued
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Mature B-Cell Lymphomas (Cont.)

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Mature B-Cell Lymphomas (Cont.)

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 Mature B-Cell Lymphomas (Cont.)

 Prolymphocytic leukemia (PLL)

 Definition
 Morphology and immunophenotype
 Clinical features
 Prognosis
• TP53

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Mature B-Cell Lymphomas (Cont.)

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 Mature B-Cell Lymphomas (Cont.)

 Hairy cell leukemia

 Definition
 Morphology and immunophenotype
 Clinical features
 Prognosis

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Mature B-Cell Lymphomas (Cont.)

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 Mature B-Cell Lymphomas (Cont.)

 Mantle cell lymphoma

 Definition
 Sites of involvement
 Morphology and immunophenotype
 Clinical features
 Prognosis

Continued
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Mature B-Cell Lymphomas (Cont.)

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Mature B-Cell Lymphomas (Cont.)

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 Mature B-Cell Lymphomas (Cont.)

 Follicular lymphoma
 Definition
 Sites of involvement
 Morphology and immunophenotype
 Clinical features
 Prognosis

Continued
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Mature B-Cell Lymphomas (Cont.)

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 Mature B-Cell Lymphomas (Cont.)

 Extranodal marginal zone lymphoma of mucosa-

associated lymphoid tissue
 Definition and subtypes
 Features of extranodal subtype
• Cell types
• Disease associations
• Role of antigenic stimulation
 Morphology and immunophenotyping
 Clinical features
 Prognosis
Continued
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Mature B-Cell Lymphomas (Cont.)

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 Mature B-Cell Lymphomas (Cont.)

 Plasma cell neoplasms

 Definition
• Monoclonal gammopathy
• MGUS
 Morphology and immunophenotype
• Plasma cell leukemia
 Clinical features
 Prognosis

Continued
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Mature B-Cell Lymphomas (Cont.)

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Mature B-Cell Lymphomas (Cont.)

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 Mature B-Cell Lymphomas (Cont.)

 Diffuse large B-cell lymphoma

 Definition
 Incidence
 Morphology and immunophenotype
 Clinical features
 Prognosis

Continued
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Mature B-Cell Lymphomas (Cont.)

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 Mature B-Cell Lymphomas (Cont.)

 Burkitt lymphoma
 Definition
 WHO variants
 Morphology and immunophenotype
 Clinical features
 Prognosis

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Mature B-Cell Lymphomas (Cont.)

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 Mature T-Cell and Natural Killer Cell
Lymphomas
 Incidence
 Features
 Subtypes
 Mycosis fungoides and Sézary syndrome
 Peripheral T-cell lymphoma, unspecified
 Anaplastic large cell lymphoma

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 Mature T-Cell and Natural Killer Cell
Lymphomas (Cont.)
 Mycosis fungoides and Sézary syndrome
 Definition
 Incidence
 Morphology and immunophenotype
 Clinical features
 Prognosis

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 Mature T-Cell and Natural Killer Cell
Lymphomas (Cont.)
 Peripheral T-cell lymphoma, unspecified
 Definition
 Morphology and immunophenotype
 Clinical features
 Prognosis

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 Mature T-Cell and Natural Killer Cell
Lymphomas (Cont.)
 Anaplastic large cell lymphoma
 Definition
 Morphology and immunophenotype
 Clinical features
 Prognosis

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Mature T-Cell and Natural Killer Cell
Lymphomas (Cont.)

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 Hodgkin Lymphoma

 Two broad categories

 Nodular lymphocyte–predominant
 Classical Hodgkin lymphoma
 Incidence

Continued
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 Hodgkin Lymphoma (Cont.)

 Nodular lymphocyte–predominant
 Definition
 Morphology and immunophenotype
 Clinical features
 Prognosis

Continued
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Hodgkin Lymphoma (Cont.)

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 Hodgkin Lymphoma (Cont.)
 Classical Hodgkin lymphoma
 Definition
 Incidence
 Morphology and immunophenotype
 Subtypes
• Nodular sclerosis
• Mixed cellularity
• Lymphocyte rich
• Lymphocyte depleted
 Clinical features
 Prognosis and treatment

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Hodgkin Lymphoma (Cont.)

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Hodgkin Lymphoma (Cont.)

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 Chapter Review

 What is the predominant cell found in each

component of the lymph node?
 What are the four patterns seen in reactive
lymphadenopathies?
 What are some of the risk factors for
development of lymphomas?
 What are the subtypes of mature B-cell
lymphomas?
 What cell is diagnostic for Hodgkin lymphomas?

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