Malignant lymphoma - classification
Hodgkin’s
non- Hodgkin’s lymphomas
o precursor cells
B
T/NK
o Mature cells
B
T/NK
Follicle center lymphoma
Morphology Mixture of germinal center blasts and cleaved cells (centroblasts and centrocytes). Immunology Surface Ig + CD5 – CD10 ± CD19, 20, 22, 79a + BCL-2 + Genetics t(14;18) & BCL-2 rearrange- ment in majority of cases. Clinical Adults. Indolent course (median survival 7-9 yrs).
Equivalent to
“centroblastic / centrocytic”
and “follicular centroblastic”
lymphomas in Kiel
scheme
H&E
BCL-2
Follicular lymphoma – nodal infiltration,
(Van Gieson staining)
1 1
1
1 nodules of tumour infiltrate
2 capsule of lymph node
2
Mantle cell lymphoma
Morphology Small irregularly shaped centrocyte-like cells. Immunology Surface Ig (l>k) + CD5 – CD10 ± CD19, 20, 22, 79a + CD23 – Cyclin D1 + Genetics t(11;14). BCL-1 rearrangement. Clinical Adults. Moderately aggressive course (median survival 3-4 yrs). Equivalent to
“centrocytic lymphoma”
in Kiel scheme
Giemsa
Diffuse large B cell lymphoma
Morphology Monomorphous large cells with prominent nucleoli and basophilic cytoplasm. Immunology Surface Ig +/- Cytoplasmatic Ig -/+ CD5, 10 -/+ CD19, 20, 22, 79a + Genetics t(14;18) in approw 30%. BCL-6 rearranged (40%) and/or mutated (75%). Clinical Chidren or adults. Aggressive course, but may be curable.
Combines
“centroblastic” and
“immunoblastic” categorie
from Kiel scheme
Diffuse large B cell lymphoma
1
2 3
1 gastric foveoles
2 gastric glands
3 tumour infiltrate
4 reactive lymphoid nodule
4
Hodgkin’s lymphoma
Classical – diagnostic cells, non-tumorous backround:
o Nodular sclerosis
o Mixed cellularity
o Lymphocyte depleted
o Lymphocyte rich
Nodular lymphocyte predominant: background with
lymphocytes and histiocytes
Diagnostic cells in classical Hodgkin’s lymphoma
Hodgkin’s cells – one nucleus with a large
eosinophilic nucleolus
Reed-Sternberg cells – two nuclei with nucleoli
Sternberg cells – multiple nuclei and nucleoli
Lacunar cells – clear large cytoplasma, small
nucleus
CD20-, CD 79a-, CD 30+, CD 15+, CD 45-, Ig-