HEMA 2 LEC - Mature B Cell Lymphomas Part 1 Flashcards
Type of lymphoma
• Derived from various stages of B cell differentiation
MATURE B CELL LYMPHOMAS
Type of lymphoma
All produce monoclonal light chain Ig, clonal Ig gene rearrangements, or both
MATURE B CELL LYMPHOMAS
Type of lymphoma
Most common subtypes: follicular lymphoma and B cell lymphoma
MATURE B CELL LYMPHOMAS
• Accumulation of small lymphoid cells in PB, BM, lymphoid organs
Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
type of lymphocytic leukemia or lymphoma presents mostly in PB and BM
CLL
type of lymphocytic leukemia or lymphoma presents mostly in LN
SLL
Morphology
• Soccer-ball : small lymphoid cells with coarse chromatin, absent or subtle nucleoli, scant cytoplasm
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CLL
Morphology
Prolymphocytes (up to 55% of cells)
CLL
Morphology
Lymphoid cells with cleaved nuclei
CLL
FAB CLassification of CLL
>90% small mature lymphocytes,
Typical CLL
- Smudge cells (disintegrated lymphoid cells) – unique feature
- BM: nodular, diffuse, interstitial infiltrates of small lymphoid cells
CLL
- Effacement of normal nodal architecture by a diffuse proliferation of small, round lymphoid cells (Pathognomonic)
- Pseudofollicles/growth or proliferation centers
SLL
Used to distinguish CLL/SLL from mantle cell lymphoma: (5)
CD23, LEF1, absence of FMC7, cyclin D1, SOX11
What condition
• Monoclonal B-cell lymphocytosis:
• Asymptomatic at diagnosis, 1st indication: lymphocytosis
CLL/SLL
Two Divisions of CLL:
indolent, median survival: 24 years
Mutated IVGH (Ig heavy chain)
Two Divisions of CLL:
aggressive, median survival: 8 years
Unmutated IVGH
5% of patients of CLL/SLL patients develop _____ high-grade diffuse large B cell lymphoma with survival of
Richter syndrome
> 55% of circulating lymphoid cells have prolymphocyte morphology
prolymphocytic leukemia
Pathognomonic cell of B cell PLL:
prolymphocyte of medium size, round nucleus, distinct punched out nucleolus
LN involvement more common in what type of PLL (B or T cell)
T cell
how to distinguish B CELL PLL from CLL/SLL
To distinguish from CLL/SLL: cell size (2x normal) and prominent central nucleolus (PUNCHED OUT)
- BM: interstitial and/or nodular proliferation of prolymphocytes
- Infiltrated white and red splenic pulp
B CELL PLL
- BM: small to medium size neoplastic cells with round or irregular nuclei, resembling Sezary cells
- Cytoplasmic blebbing
T CELL PLL