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Lymphoma

Lymphoma. Dr. Raid Jastania Dec 2006. By the end of this session you should be able to: Discuss the basis of the classification of lymphomas Know the different stages of B lymphocyte List common genetic abnormalities in lymphomas

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Lymphoma

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  1. Lymphoma Dr. Raid Jastania Dec 2006

  2. By the end of this session you should be able to: • Discuss the basis of the classification of lymphomas • Know the different stages of B lymphocyte • List common genetic abnormalities in lymphomas • Classify Hodgkin lymphoma and the difference between the subtypes

  3. Lymphoma • Classification WHO • Lymphoid, Myeloid, Histiocytic • Definitions: • Precursor, mature, stage of differentiation, naïve, peripheral, small cell, large cell • CD’s • Common types: Follicular lymphoma, Diffuse large B cell lymphoma • Age: • Non Hodgkin: 6th- 7th decade • Hodgkin: 3rd decade

  4. Risk factors: • Abnormalities in the immune system. • EBV • HHV8 • Hepatitis C virus • H. pylori

  5. The Journey of the B cells Bone marrow Peripheral blood Lymph node

  6. The Journey of the B cells • Bone marrow- Blast- VDJ gene rearrangement- mature naïve Ig positive cells- IgM, IgD, CD5+ • Antigen- transformation- proliferation- mature B cell IgM • Germinal center maturation, Somatic mutation. • IgG, IgA plasma cells and memory cells. • Plasma cells- bone marrow

  7. The Journey of the B cells • Bone marrow- Blast- VDJ gene rearrangement- mature naïve Ig positive cells- IgM, IgD • CD20, CD19,CD10, TdT, CD5+/- • Antigen- transformation- proliferation- mature B cell IgM • CD20, CD10, Bcl-2 • Germinal center maturation, Somatic mutation. • CD20 • IgG, IgA plasma cells and memory cells. • Loose all the B cell markers CD138+ • Plasma cells- bone marrow

  8. The Journey of the B cells Bone marrow Peripheral blood Lymph node

  9. Genetics • Follicular lymphoma t(14;18) • Bcl-2 over expression • Mantle cell lymphoma: t(11;14) • CyclinD1 over expression • Burkitt lymphoma: t(8;14) • C-myc over expression

  10. Classification • Based on: • Morphology • Immunophenotyping • Clinical presentation • Molecular/cytogenetic findings

  11. Classification • Predominantly disseminated: lymphoma/Leukemia • Primary extranodal • Primary nodal

  12. Classification • Predominantly disseminated: lymphoma/Leukemia • CLL, lymphoplasmacytic lymphoma, Myeloma • Primary extranodal • Marginal zone lymphoma • Primary nodal • Follicular lymphoma, mantle cell lymphoma • Aggressive types • Diffuse large B cell lymphoma, Burkitt lymphoma

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