CLINICAL FEATURES

FRONTIERS IN BIOSCIENCE;
TYPES OF LYMPHOMAS, THEIR SALIENT CLINICAL FEATURES, MORPHOLOGY AND IMMUNOPHENOTYPES

LYMPHOMA TYPE OR GROUP; GRADE	% IN ADULTS	CLINICAL FEATURES	SALIENT MORPHOLOGY	IMUNOPHENOTYPE
SMALL LYMPHOCYTIC LYMPHOMA (SLL); LOW GRADE	3-4	OCCURS IN OLD INDIVIDUALS GENERALIZED LYMPHADENOPATHY MARROW INVOLVED CELLS IN THE BLOOD RESEMBLE THOSE SEEN IN CLL INDOLENT COURSE PROLONGED SURVIVAL	SMALL UNSTIMULATED LYMPHOCYTES IN A DIFFUSE PATTERN	>95% B CELLS (SURFACE IGM, IGD, PAN B CELL ANTIGEN CD19). EXPRESS CD5 (FOUND ON A SMALL NUMBER OF B CELLS AND T CELLS)
FOLLICULAR LYMPHOMA (FL); LOW GRADE	40	OCCURS IN OLD INDIVIDUALS GENERALIZED LYMPHADENOPATHY ASSCOCIATED WITH CHROMOSOMAL TRANSLOCATION T(14:18) AT THE JUNCTION OF THE LOCATION OF THE BCL-2 BLOOD INVOLVEMENT UNCOMMON INDOLENT COURSE DIFFICULT TO CURE	GERMINAL CENTER CELLS ARRANGED IN A FOLLICULAR PATTERN OCCURS IN SMALL CLEAVED (CLEAVEND NUCLEI, PROMINENT INDENTATIONS, COARSE CHROMATIN AND INDISTINCT NUCLEOLI) AND FOLLICULAR MIXED CELL (LARGE CELLS EXCEED 20% OF CELL POPULATION) TYPES	B CELLS )EXPRESS CD19, CD10 AND CD21)
FOLLICULAR, PREDOMINANTLY LARGE CELL LYMPHOMA; INTERMEDIATE GRADE	<15%	UNCOMMON POORER PROGNOSIS THAN OTHER FOLLICULAR LYMPHOMAS	MOST NEOPLASTIC CELLS ARE LARGE WITH CLEAVED OR NON-CLEAVED NUCLEI MITOSIS NUMEROUS	B CELL
DIFFUSE, SMALL CLEAVED CELL LYMPHOMA (DSCCL); INTERMEDIATE GRADE	;8&9	MORE COMMON IN MALES AGGRESSIVE MEDIAN SURVIVAL 2-4 YEARS SHOW CHROMOSOMAL TRANSLOCATION T(11:14)	SMALL CLEAVED CELLS	B CELLS (EXPRESS PAN B CELL MARKER, EXPRESS CD5, DO NOT EXPRESS CD10)
DIFFUSE, MIXED SMALL AND LARGE CELL LYMPHOMA (DM) ;INTERMEDIATE GRADE	;8&9	;8&9	MIXED SMALL CELAVED CELLS AND LARGE IRREGULAR CLEAVED OR NON-CLEAVED (FOUR TIMES THE SIZE OF NORMAL LYMPHOCYTES) WITH ONE TO TWO PROMINENT NUCLEOLI) CELLS DISPERSED CHROMATIN INCONSPICUOUS NUCLEOLI SCANT , PALE CYTOPLASM	;8&9
DIFFUSE LARGE CELL LYMPHOMA (DLC); INTERMEDIATE GRADE	40-50%	OCCURS IN OLDER INDIVIDUALS AND CHILDREN FREQUENT PRESENCE OF EXTRANODAL DISEASE MARROW INVOLVEMENT UNCOMMON BLOOD INVOLVEMENT UNCOMMON VISCERAL INVOLVEMENT UNCOMMON AGGRESSIVE TUMORS 60% CURABLE	PREDOMINANTLY GERMINAL CENTER CELLS. CONSISTS OF LARGE CLEAVED AND NON-CLEAVED CELLS OTHER CELLS TYPES INCLUDE SMALLER CELLS AND IMMUNBLASTIC CELLS	~ 80% B CELLS ~20% POST-THYMIC T CELLS
LARGE CELL IMMUNOBLASTIC LYMPHOMA; HIGH GRADE	40-50%	RAPIDLY ENLARGING OFTEN ASYMPTOMATIC MASS AT A NODAL OR EXTRANODAL SITE MAY PRESENT WITH INVOLEMENT OF GI TRACT, BRAIN, BONE OR SKIN UNCOMMON BONE MARROW INVOLVEMENT RARE LEUKMIA AGGRESSIVE RAPIDLY FATAL 60-80% REMISSION, 50% CURE WITH CHEMOTHERAPY	TUMOR CELLS FOUR TO FIVE TIMES LARGER THAN SMALL LYMPHOCYTES ROUND TO MULTILOBATED LARGE VESICULAR NUCLEI ONE TO TWO PROMINENT NUCLEOLI DEEPLY STAINED TO PYRONINOPHILIC TO CLEAR CYTOPLASM	T OR B CELLS
SMALL NONCLEAVED (BURKITT'S LYMPHOMA); HIGH GRADE	<1%	ENDEMIC IN AFRICA SPORADIC IN REST OF THE WORLD OCCURS IN CHILDREN EXTRANODAL INVOLVEMENT RAPIDLY PROGRESSIVE RESPONDS TO THERAPY	CELLS INTERMEDIATE IN SIZE BETWEEN THE SMALL LYMPHOCYTES AND IMMUNOBLASTS MULTIPLE PROMINENT NUCLEOLI HIGH MITOTIC RATE	B CELLS
ADULT T CELL LEUKEMIA/LYMPHOMA	RARE	ENDEMIC IN JAPAN AND CARIBBEAN IS ASSOCIATED WITH HTLV-1 INFECTION MAY INVOLVE SKIN MAY BE ASSOCIATED WITH LEUKEMIA MAY INVOLVE SPLEEN AND LYMPH NODES RAPIDLY FATAL	VARIABLE MORPHOLOGY CELLS MAY HAVE CEREBRIFORM NUCLEI	CD4⁺ T CELLS