Lymph Node, Spleen, Lymphoid Disorder

HODGKIN'S

MIXED CELLULARITY



NODULAR SCLEROSIS

A diagnostic (multi-nucleated) Reed-Sternberg cell lies dead-center. Just below it is a non-diagnostic, uninuclear cell that has been called a "Reed-Sternberg variant" or a "Hodgkin" cell. Although this cell is characteristic of hodgkin lymphoma, the pathologist who plays by the rules will scrutinize a node suspected of Hodgkin lymphoma involvement until a diagnostic cell is found.

Lacunar cells are a feature of nodular sclerosis Hodgkin lymphoma and are not found in other subtypes. In formalin-fixed tissue, the cytoplasm around Reed-Sternberg cell nuclei retracts, leaving a cleared space possibly spanned by a few shreds of cytoplasm. The nuclei are also contracted and have diminished nucleoli.

LYMPHOCYTE DEPLETED

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IMPORTANT PRINCIPLES REGARDING LYMPHOID NEOPLASM

- VAST MAJORITY(80~85%) B-CELL ORIGIN
REMAINDER ARE T-CELL, RARELY ARE NK OR HISTIOCYTIC ORIGIN
MAY REPRESENT CELLS ARRESTED AT AY STAGE OF DIFFERENTIATION
- AS TUMORS OF IMMUNE SYSTEM DISRUPTING NORMAL REGULATORY FUNCTION,
INCREASE SUSCEPTIBILITY TO INFECTION OR AUTOIMMUNITY
- ALL LYMPHOID NEOPLASMS DERIVED FROM A SINGLE TRANSFORMED CELL AND ARE MONOCLONCAL
- NEOPLASTIC B AND T CELLS TEND TO HOME IN AND GROW IN AREAS WHERE THEIR NORMAL COUTNERPARTS RESIDE
- HD SPREADS IN ORDERLY FASHION, NHL LESS PREDICTABLE






































































































ACUTE LYMPHOBLASTIC LEUKEMIA/LYMPHOMA (ALL)
- VERY IMMATURE CELLS WITH LARGE NUCLEOLI
- FEWER NUCLEOLI THAN DO MYELOBLASTS
- NUCLEAR CHROMATIN MORE CONDENSED
- CYTOPLASMIC GRANULES ABSENT


ACUTE MYELOBLASTIC LEUKEMIA (AML)
- VERY LARGE, IMMATURE MYELOBLASTS
- LINEAR RED, AUER ROD, COMPOSED OF CRYSTALLIZED GRANULES
- DELICATE NUCLEAR CHROMATIN
- PROMINENT NUCLEOLI
- FINE AZUROPHILIC GRANULES IN THE CYTOPLASM

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5 most common NHL



SMALL LYMPHOCYTIC LYMPHOMA (SLL, PROLYMPHOCYTES, BELOW: SMUDGE CELL)



FOLLICULAR LYMPHOMAS (TWO TYPES OF CELLS: CENTROCYTIC, CENTROBLASTIC)
a mixture of small lymphocytes with scanty cytoplasm and irregular nuclei (centrocytes) mixed with a population of larger lymphocytes with scanty cytoplasm with rounded nuclei and single or multiple small nucleoli (centroblasts).


DIFFUSE LARGE B-CELL LYMPHOMA(CELL SIZE 5 X A SMALL LYMPHOCYTE)



BURKITT LYMPHOMA(STARRY SKY DUE TO APOPTOSIS, MOST EXTRANODAL)
TWO TYPES, 1)AFRICAN(EBV), 2)NON-ENDEMIC

MANTLE CELL LYMPHOMA

- TOP: Note that the cells in the germinal center, which are not neoplastic, bear no resemblance to the small lymphocytes of the tumor.

- TWO PATTERNS, 1) MANTLE ZONE PATTERN, 2) DIFFUSE PATTERN
- REGARDLESS OF PATTERN, THE PROLIFERATION CONSISTS OF A HOMOGENOUS POP'N OF SMALL LYMPHOCYTES WITH ROUND TO IRREGULAR TO OCCASIONALLY DEEPLY CLEFTED(CLEAVED) NUCLEAR COUNTOURS