Lymphoid neoplasms

Lymphocytic neoplasms

Updated: 05/17/2020

© Jun Wang, MD, PhD


Terminology
  • Lymphoma: Proliferations forming discrete tissue masses
  • Leukemia: Widespread involvement of the bone marrow and usually the peripheral blood
  • Any "lymphoma" can present with or evolve to a leukemic picture, and any "leukemia" can occasionally present with a mass lesion
  • Other hematology terms
Important risk factors
  • Immunodeficiency (primary or secondary)
  • Autoimmune disorders
  • Viruses (HIV, KSHV/HHV8, HTLV-1)
  • H. pylori infection
  • Radiation
  • Chemotherapy
Diagnostic approaches
  • Complete history, especially those with possible epidemic characters, such as Burkitt lymphoma
  • CBC, Bone marrow
  • Morphology/immunohistochemistry
  • Immunofluorescence flow cytometry
  • Cytogenetic studies
  • Molecular studies
Commonly used markers
  • All lymphomas: CD45
  • B-cell neoplasms: CD5, CD10, CD19, CD20, CD79a, CD23, bcl2, bcl6, cyclin D1, light chains
  • T-cells: CD2, CD3, CD4, CD8, CD5
  • Hodgkin lymphoma: CD15, CD30
  • Plasma cell neoplasms: CD38, CD138, light chains
Key diagnostic considerations
  • Cell count
  • Morphology/immunohistochemistry
  • Flow cytometry profiles
  • Molecular abnormality
Some lymphocytic neoplasms
B-cell acute lymphoblastic leukemia/lymphoma
T-cell acute lymphoblastic leukemia/lymphoma
  • Mature B-cell neoplasms, including plasma cell neoplasms
Chronic lymphocytic leukemia/Small lymphocytic lymphoma
Follicular lymphoma
Mantle cell lymphoma
Marginal zone lymphoma
Hairy cell leukemia
Diffuse large B cell lymphoma 
Primary effusion lymphoma
Burkitt lymphoma
Multiple myeloma
Plasmacytoma
Monoclonal gammopathy of undetermined significance (MGUS)
Lymphoplasmacytic lymphoma
  • Mature T-cell and NK-cell neoplasms
Anaplastic large-cell lymphoma (ALK Positive)
Peripheral T-cell lymphoma, not otherwise specified
Adult T-cell leukemia/lymphoma
Large granular lymphocytic leukemia
Extranodal NK/T cell lymphoma, nasal type
Mycosis fungoides
  • Posttransplantation lymphoproliferative disorders (PTLDs)

 

Practice questions I

Practice questions II

Practice question III

Practice question IV

 

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