Romanowsky stain, x 100 objective. The leukemic presentation of mantle-cell lymphoma: disease features and prognostic factors in 58 patients. Br J Haematol, 130, 800—801. N Engl J Med, 347, 89—94. This work also outlines differential diagnosis, prognostic indicators and methods of treatment. J Pediatr Hematol Oncol, 24, 763—764. Prognosis with earlier treatment regimes was adverse but this is no longer so.
Cytogenetic abnormalities are often complex. Microarray studies of prognostic stratification and transformation of follicular lymphomas. High-grade transformation is characterized by large cells, Follicular lymphoma 47 Figure 5. Primary effusion lymphoma: a distinct clinicopathologic entity associated with the Kaposis sarcoma-associated herpes virus. Myelodysplastic syndromes in childhood — classification, epidemiology, and treatment. Blast cells are negative for myeloperoxidase and chloroacetate esterase. Bone marrow infiltration, when present, may be interstitial, nodular or paratrabecular; a strikingly paratrabecular pattern of infiltration is less common than in follicular lymphoma.
It is a disease of adult life, occurring in young, middle aged and elderly adults. Szary syndrome has a much worse prognosis than mycosis fungoides with median survivals of 24 years. The infiltrate is often closely related to a mucous membrane, which may be invaded lymphoepithelial lesions Figures 9. The differential diagnosis on lymph node biopsy is reactive follicular hyperplasia and nodular lymphocyte-predominant Hodgkins disease. Prognosis Cytogenetic and molecular genetic abnormalities No specific cytogenetic or molecular genetic abnormality has yet been recognized.
Arcaini L, Paulli M, Boveri E, Magrini U and Lazzarino M 2003. Sometimes specific abnormalities indicate likely refractoriness to treatment, e. Treatment is more difficult than in other patients because of poor bone marrow reserve and a high probability of opportunistic infections during treatment. Abnor- malities in 9q were observed in three cases. The bone marrow is usually hard to aspirate and often aspiration is impossible. Romanowsky stain, x 100 objective.
Multiple myeloma also needs to be included in the differential diagnosis since some cases of lymphoplasmacytic lymphoma have numerous plasma cells and some cases of multiple myeloma have lymphoplasmacytic rather than plasmacytic morphology. Disease is mainly medullary i. These categorizations are of considerable prognostic significance. The proliferation 54 Mantle cell lymphoma Figure 6. J Clin Pathol, 49, 154—158. Invariably they involve oncogenes and often there is also loss of function of tumour suppressor genes. References Diagnosis and differential diagnosisThe differential diagnosis includes large cell lymphoma of T lineage.
Some paraproteins have the features of a cold agglutinin or a cryoglobulin. British Committee for Standards in Haematology 2004. If bone marrow cannot be aspirated, an imprint should be made from the trephine biopsy specimen. Long-term follow-up of patients with hairy cell leukaemia after treatment with pentostatin or cladribine. Splenic marginal zone lymphoma, including splenic lymphoma with villous lymphocytes 73 Figure 10. Lead nitrate and uranyl acetate stain. With thanks to Mr Ricardo Morilla.
Oertel J, Kingree D, Busemann C, Stein H and Dorken B 2002. Int J Cancer, 35, 65—72. With thanks to Dr John Swansbury. Hypercalcaemia is seen only with very advanced disease. Anaemia and thrombocytopenia are uncommon at presentation, but may be seen in patients with advanced disease. Human hematopoietic colonies in health and disease. Erythropoiesis is usually greatly reduced but may be increased.
The thymus is a lymphoid organ of major importance in T-cell maturation and in the selection of T cells recognizing Figure 1. In addition to surface membrane immunoglobulin, some cells have cytoplasmic immunoglobulin Figure 7. Haematological and pathological featuresThe peripheral blood is usually normal in mycosis fungoides but circulating lymphoma cells may be present in later stages. The pattern of infiltration is variable; it may be interstitial with or without nodules, random focal, paratrabecular or diffuse. Prognosis The disease may be either indolent or aggressive. Homing of lymphocytes to tissues similar to those from which they originated e. The two cytological variants represent the same disease.