LYMPHOPROLIFERATIVE DISORDERS. Dr Mere Kende MBBS, MMED (Path), MACTM, MACRRM, MAACB Lecturer: SMHS, UPNG
|
|
- Veronica Davis
- 6 years ago
- Views:
Transcription
1 LYMPHOPROLIFERATIVE DISORDERS Dr Mere Kende MBBS, MMED (Path), MACTM, MACRRM, MAACB Lecturer: SMHS, UPNG
2 Outline What are lymphoproliferative Disorders? Examples of LPD Classification Causes Clinical Features Investigation Principles of Treatment Complications Prognosis References
3 What are Lympho-proliferative Disorders Diseases resulting from abnormal division, development, proliferation or differentiation of lymphocyte cell series (B-cells & T-cells) Immunodeficiency and Growth of Cancer Cells (lymphomas & some leukaemias
4 Hemopoiesis
5 Normal Hemopoiesis SCF= Stem Cell Factor Tpo= Thrombopoietin Epo= Erythropoietin IL= Interleukin GM-CSF= Granulocyte Macrophage-CSF M-CSF= Macrophage-CSF G-CSF= Granulocyte-CSF SDF-1= Stromal cell-derived factor-1 FLT-3 ligand= FMS-like tyrosine kinase 3 ligand TNF-a = Tumour necrosis factoralpha TGFβ = Transforming GF beta
6 Examples of Lympho-Proliferative Disorders / Diseases Lymphomas (Hodgkins, Non-Hodgkin s) Leukaemias (ALL/CLL) Paraproteinaemias (multiple myeloma) Autoimmune LPD Hypergammaglobulinemia
7 Classification Historically, LYMPHOMA - Rappaport, Kiel, or Working Formulation systems; ACUTE LEUKAEMIA - French-American-British (FAB) system; HODGKIN S DISEASE - Rye classification. WHO CLASSIFICATION - brings together all lymphoid neoplasms into a single framework. All these are limited value clinically Classification based on clinical manifestations and natural history of diseases is more clinically useful (next Table).
8 Clinical Classification - Lymphoid Neoplasm CLL (mainly B-cells) ALL (mainly T-cell) Hodgkin s Disease (B-cells) Indolent lymphomas (mainly B-cells, (NHL) Aggressive Lymphomas (B & T cell, NHL) Plasma Cell Disorders (100% B-cells) Harrison s Manual of Medicine 17 th Edition
9 Relative Frequencies of Lymphoid Malignancies Harrison s Manual of Medicine 17 th Edition
10 LPD-Malignancy Malignancy of cells of lymphoid or immune cell origins include lymphomas and leukaemias Neoplasms of lymphocytes usually represent malignant counterparts of cells at discrete stages of normal lymphocyte differentiation. Lymphoid Leukaemia (leukaemia): Bone Marrow & Peripheral blood involvement dominate the clinical picture Lymphoma: Lymph nodes and other extranodal sites involved predominantly.
11 Some lymphoid malignancies can only present as leukemia, while others almost always present as lymphomas. Others can present as either leukemia or lymphoma. Clinical pattern can change over the course of the illness. Eg lymphoma can subsequently develop into leukemia over the course of the illness.
12 The distinction between lymphoma and leukemia is sometimes blurred; eg: Small lymphocytic lymphoma and CLL are tumors of the same cell type; if the absolute number of peripheral blood lymphocytes is >5 109/L, then its called leukemia.
13 Aetiology Unknown (majority) Inherited risk factors SCID, Wiskott-Aldrich syndrome, Ataxia telangiectasis, & Chediak- Higashi Syndrome Genetic /Chromosomal abnormalities Translocations: - t(8;14) in Burkitt s lymphoma, t(14;18) in follicular lymphoma, t(11;14) in mantle cell lymphoma, t(2;5) in anaplastic large cell lymphoma Mutations: bcl-6 on 3q27 in diffuse large cell lymphoma, and others
14 Aetiology Acquired Infections (HIV, EBV) Drugs (immunosupressants) Infective/Viruses: Epstein-Barr virus (EBV),Human herpesvirus 8 (HHV-8) (both herpes family viruses), and human T-lymphotropic virus type I (HTLV-I, a retrovirus) may cause some lymphoid tumors.
15 Infective Cause EBV & Burkitt s lymphoma HHV-8 causes a rare entity, body cavity lymphoma, mainly in pts with AIDS. HTLV-I is associated with adult T cell leukemia/ lymphoma (Japanese). Immune Deficiency- Inherited or acquired : Lymphoma is 17 times more common in HIV infected than in HIVnoninfected people.
16 Helicobacter pylori infection & MALT Lymphomas- Gastric mucosa-associated lymphoid tissue (MALT) lymphoma Treated infection produces durable remissions in about half of pts with gastric MALT lymphoma. MALT lymphomas of other sites are associated with either infection (ocular adnexae, Chlamydia psittaci; small intestine, Campylobacter jejuni; skin, Borrelia) or autoimmunity (salivary gland, Sjogren s syndrome; thyroid gland, Hashimoto s thyroiditis).
17 Drugs Drugs Immunosupressants (tacrolimus) Anti-transplant Rejection Drugs (cyclosporin) HIV Drugs Other causes Lymphoma occurs with increased incidence in farmers and meat workers; Hodgkin s disease is increased in wood worker
18 Clinical Features of LPDs Incidental lymphocytosis (CLL) Non-specific complaints (night sweats/fever/weight loss Lymphadenopathy (lymphoma) Hepatomeglay & Splenomegaly (CML) Recurrent Infections Anaemia (leukaemia/lymphoma/myeloma) Thrombocytopenia Autoimmune hemolysis (CLL) Kidney Failure/Bone Fractures (Multiple Myeloma) Hypercalcemia (MM)
19 Neck Lymphoma
20 Burkitt s Lymphoma
21 Chest Lymphoma
22 Multiple Myeloma- Skull punched out lesions Skull/Lumbar spine
23 CML Severe Splenomegaly
24 Microangipathic Hemolysis Red cell fragmentation
25 Hemoglobinuria
26 Lymphomas Hodgkin s (Disease) Lymphomas Non-Hodgkins Lymphomas
27 Hodgkin s Disease Hodgkin's disease is a group of cancers characterized by Reed Sternberg cells in an appropriate reactive cellular background. The malignant cell is derived from B lymphocytes of germinal center origin
28 Hodgkin s Disease RSC is present near the center of the field; large cell -bilobed nucleus, prominent nucleoli giving an "owl's eyes" appearance. Rest are normal lymphocytes, neutrophils, and eosinophils that form a pleiomorphic cellular infiltrate.
29 Reedsternberg Giant Cells
30 Hodgkin s Lymphoma-Subtypes; nodular sclerosis (75% ) mixed cellularity (20%), & lymphocyte depletion (5%) lymphocyte predominance
31 Nodular Sclerosing Type RSG cells, with characteristic background infiltrate composed of eosinophils, lymphocytes, plasma cells, and histiocytes. Variable degree of fibrosis is also present
32 Mixed Cellularity Type Mixed Cellularity type accounts for 20% to 25% of cases of Classical Hodgkin s Lymphoma. Reed- Sternberg cells are present in a background of eosinophils, plasma cells, lymphocytes, and atypical mononuclear cells. Fibrosis is usually absent
33 Lymphocyte depleted A Reed-Sternberg cell is seen in a background of eosinophils, lymphocytes, and macrophages. Lymphocytedepleted is the most aggressive type of Hodgkin s lymphoma, commonly associated with advanced stages at presentation
34 Lymphocyte Predominant (nodular) In Nodular Lymphocytepredominant Hodgkin s Lymphoma, classic Reed- Sternberg cells, eosinophils, plasma cells, and areas of fibrosis are absent. Instead, numerous L&H cells with multilobed, folded nucleus with small nucleoli are present in a background rich in lymphocytes
35 Clinical Findings 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Hodgkin s Lymphoma Bimodal Peak Age Age in Years
36 Clinical Findings Whites > blacks B-cell origin Common presentation: a painless mass in the neck Constitutional symptoms such as fever, weight loss, or drenching night sweats, or because of generalized pruritus. Arises within single lymph node areas and spread in an orderly fashion to nearby lymph glands. Later vascular invasion widespread hematogenous dissemination. DDx : reactive lymphocytosis (EBV, cat-scratch disease, or drug reactions (eg, phenytoin).
37 Staging Nomenclature (Ann Arbor) : stage I, one lymph node region involved; (neck/throat/thymus) stage II, involvement of two lymph node areas on one side of the diaphragm; (neck, mediastinal & hilar) stage III, stage IV, lymph node regions involved on both sides of the diaphragm; and (chest & abdomen) disseminated disease with bone marrow or liver involvement.
38 Sub-classified Stage A--no constitutional symptoms Asymptomatic eg IA, IIB, IIIB etc Stage B---eg IB, IIB symptomatic 10% weight loss over 6 months, fever, or night sweats are present.
39 Hodgkins Lymphomas Essentials of Diagnosis Painless lymphadenopathy. Constitutional symptoms may or may not be present. Pathologic diagnosis by lymph node biopsy
40 Diagnosis-Hodgkin s Disease
41 Investigation Biopsy CXR/CT CHEST Abdominal USS Bone Marrow biopsy
42 Histopathology Staging- Cytogenetics-
43 Treatment Radiation therapy - used as initial treatment only for patients with low-risk stage IA and IIA disease. Combination chemotherapy: Most patients with Hodgkin's disease (including all with stage IIIB and IV disease) are best treated with using doxorubicin (Adriamycin), bleomycin, vincristine, and dacarbazine (ABVD). New shorter and more intensive regimens are being studied, but have not yet proved superior to ABVD.
44 Prognosis Stage IA or IIA disease treated by radiotherapy is excellent, with 10-year survival rates in excess of 80%. Patients with disseminated disease (IIIB, IV) have 5-year survival rates of 50 60%. Poorer results - Older patients lymphocyte depletion or mixed cellularity on histologic examination. Better result - lymphocyte-predominant form of the disease with cure seen in > 70% of those with disseminated disease and with limited treatment needed for those with early-stage disease. Relapse- after initial chemotherapy high-dose chemotherapy with autologous stem cell transplantation.
45 Non-Hodgkin s Disease Heterogeneous group of cancers of lymphocytes. Variable clinical presentation and course from indolent to rapidly progressive. Burkitt's lymphoma, Best studied characteristic cytogenetic abnormality of translocation between the long arms of chromosomes 8 and 14 Translocated protooncogene c-myc from its normal position on chromosome 8 to the heavy chain locus on chromosome 14.
46 Burkitts Lymphoma
47 Burkitts Lymphoma
48 Aetiology Unknown Elderly>young Males>females Risk factors: chemicals/organ transplant/hiv infection/inherited immune deficiency
49 Cells committed to B cell differentiation are likely to have enhanced expression of this heavy chain locus, and it is likely that over-expression of c-myc (in its new anomalous position) is related to malignant transformation. Follicular lymphomas, the t(14,18) translocation is characteristic and results in over-expression of bcl- 2, resulting in protection against apoptosis, the usual mechanism of cell death.
50
51 The normal nodal architecture is effaced by nodular expansions of tumor cells. Nodules vary in size and contain predominantly small lymphocytes with cleaved nuclei along with variable numbers of larger cells with vesicular chromatin and prominent nucleoli. Follicular Lymphoma
52 Diffuse B-cell lymphoma The neoplastic cells are heterogeneous but predominantly large cells with vesicular chromatin and prominent nucleoli.
53 Burkitts Lymphoma Homogenous, Mediumsized B cells, frequent mitotic figures Reactive macrophages - pale cytoplasm in a background of bluestaining tumor cells give the tumor starry sky appearance.
54 Burkitt s Lymphoma
55 Adult T-cell Lymphoma (leukaemia) Peripheral blood smear showing leukemia cells with typical "flower-shaped" nucleus
56 NHL Indolent Versus Aggressive
57 INDOLENT LYMPHOMAS Median Survival ~ 10years: Median Age: 55 years The majority of pts dying from follicular lymphoma have undergone histological transformation to diffuse large B cell lymphoma.
58 Follicular Lymphoma
59 Aggressive NHL Median Survival ~if untreated 6 months, Nearly all untreated pts are dead within 1 year Diffuse large B cell lymphoma is the most common (35-45%) Aggressive NHL acount for 60% of all lymphoid tumors. 85% are B-cell origin and 15% T cells origin
60 Clinical Findings Symptoms and Signs Painless lymphadenopathy, which may be isolated or widespread. Involved lymph nodes may be present in the retroperitoneum, mesentery, and pelvis. Usually (85%) disseminated at the time of diagnosis, and bone marrow and liver involvement is frequent. Patients with aggressive NHL have more common B or constitutional symptoms such as fever, drenching night sweats, or weight loss. (10-45%) Symptoms: Fever, sweats, weight loss occur more commonly with Hodgkin s Disease
61 Examination Lymphadenopathy: may be isolated, or extranodal sites of disease (skin, gastrointestinal tract) may be found. Patients with Burkitt's lymphoma are noted to have abdominal pain or abdominal fullness because of the predilection of the disease for the abdomen.
62 Staging Once a pathologic diagnosis is established, the patient is staged based on clinical and investigation findings Chest radiograph and CT scan of the abdomen and pelvis, bone marrow biopsy, and In selected cases with high-risk morphology a lumbar puncture are performed.
63 Investigation Peripheral blood: Usually Normal Blood Chemistry: LDH is a useful for prognosis and risk stratification of treatment Bone Marrow: Manifested as paratrabecular lymphoid aggregates/nodule of cleaved lymphocytes is consistent with Follicular NHL. CSF Cytology: Some high-grade lymphomas involve the meninges.
64 Investigation Tissue Biopsy: Needle aspiration may yield suspicious results, but a lymph node biopsy (or biopsy of involved extranodal tissue) is required for diagnosis and staging. Molecular profiling: Exam gene expression; t(14;18) is present in 85% of cases, resulting in the over-expression of bcl-2, a protein involved in prevention of programmed cell death CXR: May show a mediastinal mass in lymphoblastic lymphoma.
65 Treatment Follicular Lymphoma 15% of pts have localized disease- majority curable with radiation therapy 85% Disseminated Chemotherapy (with cyclophosphamide,doxorubicin, vincristine, & prednisone (CHOP) + rituximab). Nucleoside analogues (fludarabine, cladribine), Radiation therapy, Biologic agents [interferon (IFN) α,) monoclonal antibodies (rituximab, anti-cd20] 90% of pts are responsive to treatment; complete responses are seen 50-70%
66 Aggressive Lymphomas Localized four cycles of CHOP combination chemotherapy ± involved-field radiation therapy. About 85% of these pts are cured. CHOP + rituximab appears to be even more effective than CHOP + radiation therapy. More advanced disease- controversial Six cycles of CHOP + rituximab is the treatment of choice for advanced-stage disease.
67 Harrison s Manual of Medicine 17 th Edition
68 Leukaemias Acute lymphoblastic (ALL) Chronic lymphocytic (CLL)
69 Tianem Mountain Road, Huan China
70 References Current Medical Diagnosis & Treatment 2008 Harrison s Principle of Internal Medicine 17 th Edition
Non-Hodgkin lymphomas (NHLs) Hodgkin lymphoma )HL)
Non-Hodgkin lymphomas (NHLs) Hodgkin lymphoma )HL) Lymphoid Neoplasms: 1- non-hodgkin lymphomas (NHLs) 2- Hodgkin lymphoma 3- plasma cell neoplasms Non-Hodgkin lymphomas (NHLs) Acute Lymphoblastic Leukemia/Lymphoma
More informationLarge cell immunoblastic Diffuse histiocytic (DHL) Lymphoblastic lymphoma Diffuse lymphoblastic Small non cleaved cell Burkitt s Non- Burkitt s
Non Hodgkin s Lymphoma Introduction 6th most common cause of cancer death in United States. Increasing in incidence and mortality. Since 1970, the incidence of has almost doubled. Overview The types of
More informationLymphoma: What You Need to Know. Richard van der Jagt MD, FRCPC
Lymphoma: What You Need to Know Richard van der Jagt MD, FRCPC Overview Concepts, classification, biology Epidemiology Clinical presentation Diagnosis Staging Three important types of lymphoma Conceptualizing
More informationLEUKAEMIA and LYMPHOMA. Dr Mubarak Abdelrahman Assistant Professor Jazan University
LEUKAEMIA and LYMPHOMA Dr Mubarak Abdelrahman Assistant Professor Jazan University OBJECTIVES Identify etiology and epidemiology for leukemia and lymphoma. Discuss common types of leukemia. Distinguish
More information7 Omar Abu Reesh. Dr. Ahmad Mansour Dr. Ahmad Mansour
7 Omar Abu Reesh Dr. Ahmad Mansour Dr. Ahmad Mansour -Leukemia: neoplastic leukocytes circulating in the peripheral bloodstream. -Lymphoma: a neoplastic process in the lymph nodes, spleen or other lymphatic
More informationLymphatic system component
Introduction Lymphatic system component Statistics Overview Lymphoma Non Hodgkin s Lymphoma Non- Hodgkin's is a type of cancer that originates in the lymphatic system. It is estimated to be the sixth most
More informationLYMPHOMA Joginder Singh, MD Medical Oncologist, Mercy Cancer Center
LYMPHOMA Joginder Singh, MD Medical Oncologist, Mercy Cancer Center Lymphoma is cancer of the lymphatic system. The lymphatic system is made up of organs all over the body that make up and store cells
More informationLymphoma/CLL 101: Know your Subtype. Dr. David Macdonald Hematologist, The Ottawa Hospital
Lymphoma/CLL 101: Know your Subtype Dr. David Macdonald Hematologist, The Ottawa Hospital Function of the Lymph System Lymph Node Lymphocytes B-cells develop in the bone marrow and influence the immune
More informationFOLLICULARITY in LYMPHOMA
FOLLICULARITY in LYMPHOMA Reactive Follicular Hyperplasia Follicular Hyperplasia irregular follicles Follicular Hyperplasia dark and light zones Light Zone Dark Zone Follicular hyperplasia MIB1 Follicular
More informationA CASE OF PRIMARY THYROID LYMPHOMA. Prof Dr.Dilek Gogas Yavuz Marmara University School of Medicine Endocrinology and Metabolism Istanbul, Turkey
A CASE OF PRIMARY THYROID LYMPHOMA Prof Dr.Dilek Gogas Yavuz Marmara University School of Medicine Endocrinology and Metabolism Istanbul, Turkey 38 year old female She recognized a mass in her right neck
More informationWhat is a hematological malignancy? Hematology and Hematologic Malignancies. Etiology of hematological malignancies. Leukemias
Hematology and Hematologic Malignancies Cancer of the formed elements of the blood What is a hematological malignancy? A hematologic malignancy is a malignancy (or cancer) of any of the formed elements
More informationNon-Hodgkin lymphoma
Non-Hodgkin lymphoma Non-Hodgkin s lymphoma Definition: - clonal tumours of mature and immature B cells, T cells or NK cells - highly heterogeneous, both histologically and clinically Non-Hodgkin lymphoma
More informationMECHANISMS OF HUMAN DISEASE: LABORATORY SESSIONS LYMPHOMA. April 16, 2008
MECHANISMS OF HUMAN DISEASE: LABORATORY SESSIONS LYMPHOMA April 16, 2008 FACULTY COPY GOAL: Learn the appearance of normal peripheral blood elements and lymph nodes. Recognize abnormal peripheral blood
More informationUnderstanding your diagnosis. Dr Graham Collins Consultant Haemtologist Oxford University Hospitals
Understanding your diagnosis Dr Graham Collins Consultant Haemtologist Oxford University Hospitals Common questions I get asked What is lymphoma? What subtype do I have and what does that mean? What are
More informationLow grade High grade , immune suppression chronic persistent inflammation viruses B-symptoms
We've one category for lymphoid neoplasm which is the lymphoma in contrast to that of myeloid which has three categories; acute myeloid leukemias, myeloproliferative & myelodysplastic disorders. Lymphoma
More informationHodgkin's Lymphoma. Symptoms. Types
Hodgkin's lymphoma (Hodgkin's disease) usually develops in the lymphatic system, a part of the body's immune system. This system carries disease-fighting white blood cells throughout the body. Lymph tissue
More informationHAEMATOLOGICAL MALIGNANCY
HAEMATOLOGICAL MALIGNANCY Reference Compulsory reading Haematology at Glance 2 nd ed. Atul Mehta & Victor Hoffbrand Chapters: 20 to 31 Pages: 46 to 69 Pathogenesis of Haematological Malignancy Figure (a)
More informationLYMPHOMAS an overview of some subtypes of NHLs
One of the confusing aspects of the lymphoid neoplasms concerns the use of the descriptive terms "leukemia" and "lymphoma." LYMPHOMAS an overview of some subtypes of NHLs Leukemia is used for lymphoid
More informationNON HODGKINS LYMPHOMA: INDOLENT Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary)
NON HODGKINS LYMPHOMA: INDOLENT Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary) Reviewed by Dr. Michelle Geddes (Staff Hematologist, University of Calgary) and Dr.
More informationBurkitt lymphoma. Sporadic Endemic in Africa associated with EBV Translocations involving MYC gene on chromosome 8
Heme 8 Burkitt lymphoma Sporadic Endemic in Africa associated with EBV Translocations involving MYC gene on chromosome 8 Most common is t(8;14) Believed to be the fastest growing tumor in humans!!!! Morphology
More informationLymphomas and multiple myeloma 12/23/2018 1
60 Lymphomas and multiple myeloma 12/23/2018 1 Lymphomas Lymphoma is cancer of the lymphatic system. Lymphomas are subdivided into two main categories: Hodgkin's lymphoma (HL) and non- Hodgkin's lymphoma
More informationAggressive Lymphomas - Current. Dr Kevin Imrie Physician-in-Chief, Sunnybrook Health Sciences Centre
Aggressive Lymphomas - Current Dr Kevin Imrie Physician-in-Chief, Sunnybrook Health Sciences Centre Conflicts of interest I have no conflicts of interest to declare Outline What does aggressive lymphoma
More informationLymphoma and Myeloma Kris3ne Kra4s, M.D.
Lymphoma and Myeloma Kris3ne Kra4s, M.D. Hematologic Malignancies Leukemia Malignancy of hematopoie3c cells Starts in bone marrow, can spread to blood, nodes Myeloid or lymphoid Acute or chronic Lymphoma
More information, , 2011 HODGKIN LYMPHOMA
European Federation of Cytology Societies 4tu Annual Tutorial in Cytopathology Trieste, June 6-10, 2011 HODGKIN LYMPHOMA Classification The World Health Organization Classification of Lymphomas (2001)
More informationWHO Classification. B-cell chronic lymphocytic leukemia/small T-cell granular lymphocytic leukemia
Blood Malignancies-II Prof. Dr. Herman Hariman, a Ph.D, SpPK (KH). Prof. Dr. Adikoesoema Aman, SpPK (KH) Dept. of Clinical Pathology, School of Medicine, University of North Sumatra WHO classification
More informationLymphoma: The Basics. Dr. Douglas Stewart
Lymphoma: The Basics Dr. Douglas Stewart Objectives What is lymphoma? How common is it? Why does it occur? How do you diagnose it? How do you manage it? How do you follow patients after treatment? What
More informationWBCs Disorders 1. Dr. Nabila Hamdi MD, PhD
WBCs Disorders 1 Dr. Nabila Hamdi MD, PhD ILOs Compare and contrast ALL, AML, CLL, CML in terms of age distribution, cytogenetics, morphology, immunophenotyping, laboratory diagnosis clinical features
More informationDifferential diagnosis of hematolymphoid tumors composed of medium-sized cells. Brian Skinnider B.C. Cancer Agency, Vancouver General Hospital
Differential diagnosis of hematolymphoid tumors composed of medium-sized cells Brian Skinnider B.C. Cancer Agency, Vancouver General Hospital Lymphoma classification Lymphoma diagnosis starts with morphologic
More informationNeoplastic proliferation arising from white blood cells. Introductory remarks. Classification
Neoplastic proliferation arising from white blood cells Lymphoproliferative and myeloproliferative diseases and syndromes Oliver Rácz, 2012-2017 1 Introductory remarks Leukemia and lymphoma are old descriptive
More informationThe Lymphomas. An overview..
The Lymphomas An overview.. Peter Anglin MD, FRCPC, MBA Stronach Regional Cancer Centre Newmarket, ON The lymphomas are an important part of the history of medicine 1666 Magpighi publishes first recorded
More informationLymphatic System Disorders
Lymphatic System Disorders Lymphomas Malignant neoplasms involving lymphocyte proliferation in lymph nodes Specific causes not identified // Higher risk in adults who received radiation during childhood
More informationHENATOLYMPHOID SYSTEM THIRD YEAR MEDICAL STUDENTS- UNIVERSITY OF JORDAN AHMAD T. MANSOUR, MD. Parts 2 and 3
HENATOLYMPHOID SYSTEM THIRD YEAR MEDICAL STUDENTS- UNIVERSITY OF JORDAN AHMAD T. MANSOUR, MD Parts 2 and 3 NEOPLASTIC LYMPHOID DISEASES Introduction o The bone marrow is the source of all cells in the
More informationHIV and Malignancy Alaka Deshpande, Himanshu Soni
HIV and Malignancy Alaka Deshpande, Himanshu Soni Emergence of new infectious disease was documented in 1981. Within a short span of time it became a pandemic. It was Acquired Immunodeficiency Syndrome
More informationLymphoma Read with the experts
Lymphoma Read with the experts Marc Seltzer, MD Associate Professor of Radiology Geisel School of Medicine at Dartmouth Director, PET-CT Course American College of Radiology Learning Objectives Recognize
More informationPathology of Hematopoietic and Lymphoid tissue
CONTENTS Pathology of Hematopoietic and Lymphoid tissue White blood cells and lymph nodes Quantitative disorder of white blood cells Reactive lymphadenopathies Infectious lymphadenitis Tumor metastasis
More informationPlasma cell myeloma (multiple myeloma)
Plasma cell myeloma (multiple myeloma) Common lymphoid neoplasm, present at old age (70 years average) Remember: plasma cells are terminally differentiated B-lymphocytes that produces antibodies. B-cells
More informationIndolent Lymphomas. Dr. Melissa Toupin The Ottawa Hospital
Indolent Lymphomas Dr. Melissa Toupin The Ottawa Hospital What does indolent mean? Slow growth Often asymptomatic Chronic disease with periods of relapse (long natural history possible) Incurable with
More informationPathology of Hematopoietic and Lymphoid tissue
Pathology of Hematopoietic and Lymphoid tissue Peerayut Sitthichaiyakul, M.D. Department of Pathology and Forensic Medicine Faculty of Medicine, Naresuan University CONTENTS White blood cells and lymph
More informationImmunopathology of Lymphoma
Immunopathology of Lymphoma Noraidah Masir MBBCh, M.Med (Pathology), D.Phil. Department of Pathology Faculty of Medicine Universiti Kebangsaan Malaysia Lymphoma classification has been challenging to pathologists.
More informationIndolent Lymphomas: Current. Dr. Laurie Sehn
Indolent Lymphomas: Current Dr. Laurie Sehn Why does indolent mean? Slow growth Often asymptomatic Chronic disease with periods of relapse (long natural history possible) Incurable with current standard
More informationClassifications of lymphomas
Classifications of lymphomas Lukes and Collins Kiel classification Working formulation REAL classification (1994) WHO classification (2000) WHO CLASSIFICATIONF OF NEOPLASMS HAEMATOPETIC AND LYMPHOID TISSUES
More informationPage 1 of 9 Title Authored By Course No Contact Hours 2 ABCs of Lymphoma Anita Rothera RNC, BS, CDE LYM020108 Purpose The goal of this course is to help health care professionals learn about the different
More informationHODGKIN LYMPHOMA DR. ALEJANDRA ZARATE OSORNO HOSPITAL ESPAÑOL DE MEXICO
HODGKIN LYMPHOMA DR. ALEJANDRA ZARATE OSORNO HOSPITAL ESPAÑOL DE MEXICO HODGKIN LYMPHOMA CLASSIFICATION Lukes & Butler Rye WHO-2016 Linphocytic and/or histiocytic Nodular & diffuse Nodular Sclerosis Lymphocyte
More informationIndolent B-Cell Non-Hodgkin s Lymphomas
Review Article [1] December 01, 1997 Myelodysplastic Syndromes [2] By John E. Seng, MD [3] and Bruce A. Peterson, MD [4] The indolent B-cell non-hodgkin s lymphomas are a diverse group of disorders that
More informationWHAT ARE PAEDIATRIC CANCERS
WHAT ARE PAEDIATRIC CANCERS INTRODUCTION Childhood cancers are RARE 0.5% of all cancers in the West Overall risk that a child will develop cancer during first 15 years of life is 1 in 450 and 1 in 600
More informationHarmesh Naik, MD. GME Presentation to Family Practice Residents October 16, 2013.
Harmesh Naik, MD. GME Presentation to Family Practice Residents October 16, 2013. Lymphoma: Lympho-proliferative disorders arising from lymphocytes Heterogeneous group of disorders Differing patterns of
More informationUpdate in Lymphoma Imaging
Update in Lymphoma Imaging Victorine V. Muse, MD Lymphoma Update in Lymphoma Imaging Victorine V Muse, MD Heterogeneous group of lymphoid neoplasms divided into two broad histological categories Hodgkin
More informationLymphoma: What You Need to Know
Lymphoma: What You Need to Know www.lymphoma.org.au Lymphoma What You Need to Know Whilst Lymphoma Australia (LA) has made every effort to confirm the accuracy of the information contained herein, it makes
More informationClassification of Hematologic Malignancies. Patricia Aoun MD MPH
Classification of Hematologic Malignancies Patricia Aoun MD MPH Objectives Know the basic principles of the current classification system for hematopoietic and lymphoid malignancies Understand the differences
More informationNodular lymphocyte predominant Hodgkin lymphoma. Lymphoma Tumor Board. January 5, 2018
Nodular lymphocyte predominant Hodgkin lymphoma Lymphoma Tumor Board January 5, 2018 Etiology Subtypes of Classical Hodgkin Lymphoma (chl)* Nodular sclerosing HL Most common subtype Composed of large tumor
More informationCase 3. Ann T. Moriarty,MD
Case 3 Ann T. Moriarty,MD Case 3 59 year old male with asymptomatic cervical lymphadenopathy. These images are from a fine needle biopsy of a left cervical lymph node. Image 1 Papanicolaou Stained smear,100x.
More informationChange Summary - Form 2018 (R3) 1 of 12
Summary - Form 2018 (R3) 1 of 12 Form Question Number (r3) Type Description New Text Previous Text Today's date was removed 2018 N/A Today's Date Removed from Key Fields 2018 N/A HCT Type 2018 N/A Product
More informationPrimary Cutaneous CD30-Positive T-cell Lymphoproliferative Disorders
Primary Cutaneous CD30-Positive T-cell Lymphoproliferative Disorders Definition A spectrum of related conditions originating from transformed or activated CD30-positive T-lymphocytes May coexist in individual
More informationDone By : WESSEN ADNAN BUTHAINAH AL-MASAEED
Done By : WESSEN ADNAN BUTHAINAH AL-MASAEED Acute Myeloid Leukemia Firstly we ll start with this introduction then enter the title of the lecture, so be ready and let s begin by the name of Allah : We
More information2012 by American Society of Hematology
2012 by American Society of Hematology Common Types of HIV-Associated Lymphomas DLBCL includes primary CNS lymphoma (PCNSL) Burkitt Lymphoma HIV-positive patients have a 60-200 fold increased incidence
More informationWBCs Disorders. Dr. Nabila Hamdi MD, PhD
WBCs Disorders Dr. Nabila Hamdi MD, PhD ILOs Compare and contrast ALL, AML, CLL, CML in terms of age distribution, cytogenetics, morphology, immunophenotyping, laboratory diagnosis clinical features and
More informationLymphoma Case Scenario 1
Lymphoma Case Scenario 1 HISTORY: A 23-year-old healthy female presented with a month-long history of persistent headache of increasing severity. She noted episodic nausea and vomiting in association with
More informationOsteosclerotic Myeloma (POEMS Syndrome)
Osteosclerotic Myeloma (POEMS Syndrome) Osteosclerotic Myeloma (POEMS Syndrome) Synonyms Crow-Fukase syndrome Multicentric Castleman disease Takatsuki syndrome Acronym coined by Bardwick POEMS Scheinker,
More informationAggressive NHL and Hodgkin Lymphoma. Dr. Carolyn Faught November 10, 2017
Aggressive NHL and Hodgkin Lymphoma Dr. Carolyn Faught November 10, 2017 What does aggressive mean? Shorter duration of symptoms Generally need treatment at time of diagnosis Immediate, few days, few weeks
More informationFrom Morphology to Molecular Pathology: A Practical Approach for Cytopathologists Part 1-Cytomorphology. Songlin Zhang, MD, PhD LSUHSC-Shreveport
From Morphology to Molecular Pathology: A Practical Approach for Cytopathologists Part 1-Cytomorphology Songlin Zhang, MD, PhD LSUHSC-Shreveport I have no Conflict of Interest. FNA on Lymphoproliferative
More informationInstructions for Chronic Lymphocytic Leukemia Post-HSCT Data (Form 2113)
Instructions for Chronic Lymphocytic Leukemia Post-HSCT Data (Form 2113) This section of the CIBMTR Forms Instruction Manual is intended to be a resource for completing the CLL Post-HSCT Data Form. E-mail
More informationIncidence. Bimodal age incidence 15-40, >55 years Childhood form (0-14) more common in developing countries M:F=1.5:1; in all subtypes except NS
Hodgkin Lymphoma Hodgkin Lymphoma 30% of all lymphomas Absolute incidence unchanged Arise in lymph node, cervical region Neoplastic tissues usually contain a small number of tumor cells Incidence Bimodal
More informationContents. vii. Preface... Acknowledgments... v xiii
Contents Preface... Acknowledgments... v xiii SECTION I 1. Introduction... 3 Knowledge-Based Diagnosis... 4 Systematic Examination of the Lymph Node... 7 Cell Type Identification... 9 Cell Size and Cellularity...
More informationPathology of the Lymphoid System
Pathology of the Lymphoid System Learning Objectives: Define lymphadenitis and enumerate its types. Briefly describe the morphological appearance of reactive lymph node. Describe the microscopic picture
More informationPearls and pitfalls in interpretation of lymphoid lesions in needle biopsies
Pearls and pitfalls in interpretation of lymphoid lesions in needle biopsies Megan S. Lim MD PhD University of Pennsylvania October 8, 2018 Objectives To understand how the trend toward less invasive lymph
More informationMantle Cell Lymphoma
Mantle Cell Lymphoma Clinical Case A 56 year-old woman complains of pain and fullness in the left superior abdominal quadrant for the last 8 months. She has lost 25 kg, and lately has had night sweats.
More informationHematopathology Lab. Third year medical students
Hematopathology Lab Third year medical students Objectives Identify the lesion Know the specific name of the lesion Know associated disease Know relevant pathologic background Spherocytes: appear small,
More informationLymphoma 101. Nathalie Johnson, MDPhD. Division of Hematology Jewish General Hospital Associate Professor of Medicine, McGill University
Lymphoma 101 Nathalie Johnson, MDPhD Division of Hematology Jewish General Hospital Associate Professor of Medicine, McGill University Disclosures Consultant and Advisory boards for multiple companies
More informationMethotrexate-associated Lymphoproliferative Disorders
Methotrexate-associated Lymphoproliferative Disorders Definition A lymphoid proliferation or lymphoma in a patient immunosuppressed with methotrexate, typically for treatment of autoimmune disease (rheumatoid
More informationOverview of Cutaneous Lymphomas: Diagnosis and Staging. Lauren C. Pinter-Brown MD, FACP Health Sciences Professor of Medicine and Dermatology
Overview of Cutaneous Lymphomas: Diagnosis and Staging Lauren C. Pinter-Brown MD, FACP Health Sciences Professor of Medicine and Dermatology Definition of Lymphoma A cancer or malignancy that comes from
More informationPathology #07. Hussein Al-Sa di. Dr. Sohaib Al-Khatib. Mature B-Cell Neoplasm. 0 P a g e
Pathology #07 Mature B-Cell Neoplasm Hussein Al-Sa di Dr. Sohaib Al-Khatib 0 P a g e Thursday 18/2/2016 Our lecture today (with the next 2 lectures) will be about lymphoid tumors This is a little bit long
More information2007 ANNUAL SITE STUDY HODGKIN S LYMPHOMA
2007 ANNUAL SITE STUDY HODGKIN S LYMPHOMA SUSQUEHANNA HEALTH David B. Nagel, M.D. April 11, 2008 Hodgkin s lymphoma was first described by Thomas Hodgkin in 1832. It remained an incurable malignancy until
More informationLymphoma is a cancer that develops in the white blood cells (lymphocytes) of the lymphatic system, which is part of the body's immune system.
Scan for mobile link. Lymphoma Lymphoma is a cancer that develops in the white blood cells of the lymphatic system. Symptoms may include enlarged lymph nodes, unexplained weight loss, fatigue, night sweats
More informationHead and Neck: DLBCL
Head and Neck: DLBCL Nikhil G. Thaker Chelsea C. Pinnix Valerie K. Reed Bouthaina S. Dabaja Department of Radiation Oncology MD Anderson Cancer Center Case 60 yo male Presented with right cervical LAD
More informationPathology of the indolent B-cell lymphomas Elias Campo
Pathology of the indolent B-cell lymphomas Elias Campo Hospital Clinic, University of Barcelona Small B-cell lymphomas Antigen selection NAIVE -B LYMPHOCYTE MEMORY B-CELL MCL FL LPL MZL CLL Small cell
More informationPediatric Oncology. Vlad Radulescu, MD
Pediatric Oncology Vlad Radulescu, MD Objectives Review the epidemiology of childhood cancer Discuss the presenting signs and symptoms, general treatment principles and overall prognosis of the most common
More informationNew Evidence reports on presentations given at EHA/ICML Bendamustine in the Treatment of Lymphoproliferative Disorders
New Evidence reports on presentations given at EHA/ICML 2011 Bendamustine in the Treatment of Lymphoproliferative Disorders Report on EHA/ICML 2011 presentations Efficacy and safety of bendamustine plus
More informationNon Hodgkin s lymphoma with cutaneous involvement in AIDS patients. Report of five cases and review of the literature
Non Hodgkin s lymphoma with cutaneous involvement in AIDS patients. Report of five cases and review of the literature OrIGINAl CASE report ArTIClE ABSTRACT Cutaneous B cell lymphoma (CBCL) is a lymphoproliferative
More informationNon-Hodgkin Lymphoma in Clinically Difficult Situations
Winship Cancer Institute of Emory University Non-Hodgkin Lymphoma in Clinically Difficult Situations James Armitage, MD Professor, Department of Internal Medicine Joe Shapiro Distinguished Chair of Oncology
More informationBlood Cancers. Blood Cells. Blood Cancers: Progress and Promise. Bone Marrow and Blood. Lymph Nodes and Spleen
Blood Cancers: Progress and Promise Mike Barnett & Khaled Ramadan Division of Hematology Department of Medicine Providence Health Care & UBC Blood Cancers Significant health problem Arise from normal cells
More informationClinical Policy: Bendamustine (Bendeka, Treanda) Reference Number: PA.CP.PHAR.307
Clinical Policy: (Bendeka, Treanda) Reference Number: PA.CP.PHAR.307 Effective Date: 01/18 Last Review Date: 11/17 Coding Implications Revision Log Description The intent of the criteria is to ensure that
More informationCorrigenda. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (revised 4th edition): corrections made in second print run
Corrigenda WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (revised 4th edition): corrections made in second print run In addition to corrections of minor typographical errors, corrections
More informationAcute Lymphoblastic Leukaemia
Acute Lymphoblastic Leukaemia Terri Boyer 17 th October 2006 Overview Disease information: Aetiology of ALL proposed theory, contributing factors Symptoms Complications Diagnostic approaches - morphology
More informationDr Rodney Itaki Lecturer Anatomical Pathology Discipline
Lymphoid Neoplasia & Hodgkin s Disease Dr Rodney Itaki Lecturer Anatomical Pathology Discipline Lymphomas Are neoplasms of lymphoid cells. Classified as: Hodgkin Disease (30%) Non-Hodgkin lymphoma (70%).
More informationCase Report A case of EBV positive diffuse large B-cell lymphoma of the adolescent
Int J Clin Exp Med 2014;7(1):307-311 www.ijcem.com /ISSN:1940-5901/IJCEM1311029 Case Report A case of EBV positive diffuse large B-cell lymphoma of the adolescent Qilin Ao 2, Ying Wang 1, Sanpeng Xu 2,
More informationLymphocyte Predominant Hodgkin s Lymphoma. Case Presentation. How would you treat the patient?
Lymphocyte Predominant Hodgkin s Lymphoma Wei Ai, MD, PhD Assistant Clinical Professor University of California, San Francisco January 2010 Case Presentation 32 yo male, diagnosed with stage IIIA lymphocyte
More informationNon-Hodgkin s Lymphoma
Non-Hodgkin s Lympoma Non-Hodgkin s Lymphomas Janet H. Van Cleave MSN, ACNP-CS, CS, AOCN Acute Care Nurse Practitioner The Mount Sinai Medical Center of New York City Doctoral Student, Yale University
More informationLymphoid Neoplasms. Sylvie Freeman Department of Clinical Immunology, University of Birmingham
Lymphoid Neoplasms Sylvie Freeman Department of Clinical Immunology, University of Birmingham Incidence of Haematological Malignancies UK2001 (CRUK) Malignancy New Cases All Cancers 271,000 Leukaemia 6,760
More informationAggressive B-Cell Lymphomas
Aggressive B-cell Lymphomas Aggressive B-Cell Lymphomas Stephen Hamilton Dutoit Institute of Pathology Aarhus Kommunehospital B-lymphoblastic lymphoma Diffuse large cell lymphoma, NOS T-cell / histiocyte-rich;
More informationEQA SCHEME CIRCULATION 33 EDUCATIONAL SLIDES DR GRAEME SMITH MONKLANDS DGH
EQA SCHEME CIRCULATION 33 EDUCATIONAL SLIDES DR GRAEME SMITH MONKLANDS DGH CASE E1 M: 68 yrs Left destructive sinonasal lesion.?lymphoma?adenocarcinoma CD20 CD10 BCL6 MIB1 Answers Diffuse large B cell
More informationDuring past decades, because of the lack of knowledge
Staging and Classification of Lymphoma Ping Lu, MD In 2004, new cases of non-hodgkin s in the United States were estimated at 54,370, representing 4% of all cancers and resulting 4% of all cancer deaths,
More informationLymphoma (Lymphosarcoma) by Pamela A. Davol
Lymphoma (Lymphosarcoma) by Pamela A. Davol Cells derived from the bone marrow that mature and take part in cellular immune reactions are called lymphocytes. When lymphocytes undergo transformation and
More informationDiagnosis and patient pathway in lymphomas
The Royal Marsden Diagnosis and patient pathway in lymphomas Dr Ian Chau Consultant Medical Oncologist The Royal Marsden Hospital London & Surrey Change Presentation title and date in Footer dd.mm.yyyy
More informationInternational Journal of Health Sciences and Research ISSN:
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Hodgkin s Lymphoma in Children Aged 6 Years Or Below- Long Term Follow Up Results Giri G V
More informationInfections and nonmicrobial inflammatory stimuli can cause leukocytosis (as seen in Lab 1) as well as lymph node enlargement (lymphadenopathy).
LAB 5: LYMPHOID TISSUE AND SKIN The focus of this week s lab will be pathology of the lymphoid tissue and skin. The lymphoid organs include the thymus, spleen, and lymph nodes. Abnormalities in the lymph
More informationLYMPHOMA DIAGNOSIS and PROGNOSIS. LC Lim Dept of Hematology Singapore General Hospital
LYMPHOMA DIAGNOSIS and PROGNOSIS LC Lim Dept of Hematology Singapore General Hospital OUTLINE Accurate diagnosis Define subtype : WHO classification Staging : Defines extent of involvement Prognosis Determining
More informationNON HODGKINS LYMPHOMA: AGGRESSIVE Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary)
NON HODGKINS LYMPHOMA: AGGRESSIVE Updated June 2015 by Dr. Manna (PGY-5 Medical Oncology Resident, University of Calgary) Reviewed by Dr. Michelle Geddes (Staff Hematologist, University of Calgary) and
More informationMyeloproliferative Disorders - D Savage - 9 Jan 2002
Disease Usual phenotype acute leukemia precursor chronic leukemia low grade lymphoma myeloma differentiated Total WBC > 60 leukemoid reaction acute leukemia Blast Pro Myel Meta Band Seg Lymph 0 0 0 2
More informationHepatic Lymphoma Diagnosis An Algorithmic Approach
Hepatic Lymphoma Diagnosis An Algorithmic Approach Ryan M. Gill, M.D., Ph.D. University of California, San Francisco PLEASE TURN OFF YOUR CELL PHONES Disclosure of Relevant Financial Relationships USCAP
More information