Lymphoproliferative Neoplasms

CLL/SLL architecture

diffuse proliferation

Mantle Cell Lymphoma architecture

Diffuse

Follicular Lymphoma architecture

enlarged & numerous follicles (nodular)

Hairy Cell Leukemia architecture

Interstitial diffuse; BM infiltration with small lymphs & large cytoplasms; widely spaced

Burkitt Lymphoma architecture

Diffuse with starry sky pattern due to many tingible body macrophages

Mycosis Fungoides architecture

Diffuse infiltrates into skin

Large Granular Lymphocyte Leukemia architecture

Diffuse infiltrates into BM; persistent increase in PB (lymphocytosis)

Classical Hodgkin Lymphoma architecture

Diffuse or nodular in lymph nodes; no BM involvement

Plasma Cell Myeloma (multiple myeloma)

Increased plasma cell infiltrates in BM

CLL/SLL cell morphology

small lymphs; condensed chromatin; Smudge cells

Mantle Cell Lymphoma cell morphology

Medium-sized lymphs w/ irregular nuclei

Hairy Cell Leukemia cell morphology

Hairy Cells with cytoplasmic projections in PB; medium sized ovid to indented; fried egg; rare

Burkitt Lymphoma cell morphology

Medium sized with basophilic cytoplasm & many vacuoles

Mycosis fungoides cell morphology

Sezary cells in PB; medium-sized, lobulated, hyperchromic

Large Granular Lymphocyte Leukemia cell morphology

Large Granular Lymphs (mature lymphs w/abundant cytoplasm and azurophilic granules)

Classical Hodgkin Lymphoma cell morphology

Rare Reed-Sternberg (binucleated) cells & Hodgkin cells in reactive background

Plasma Cell Myeloma cell morphology

Atypical plasma cells

CLL/SLL immunophenotype

CD19+

CD20 dim

CD5+

CD23+

dim kappa or lambda

Mantle Cell Lymphoma immunophenotype

CD19+

CD20+

CD5+

Cyclin D1+

CD23=

dim kappa or lambda

Follicular Lymphoma immunophenotype

CD19+

CD20+

CD10+

bcl6+

bcl2+

CD5=

dim kappa or lambda

Hairy Cell Leukemia immunophenotype

CD19+

CD11c+

CD103+

CD123+

bright CD20+

dim kappa or lambda

Burkitt Lymphoma immunophenotype

CD19+

CD20+

CD10+

bcl2=

Ki67 = 100%

dim kappa or lambda

Cutaneous T-cell Lymphoma/Mycosis fungoides immunophenotype

CD3+

CD2+

CD5+

CD4+

CD7=

CD8=

Large Granular Lymphocyte Leukemia immunophenotype

CD3+

CD2+

CD5 +/=

CD7 +/=

CD4=

CD8+

CD57+

CD16+

TIA1+

Granzyme B+

Classical Hodgkin Lymphoma immunophenotype

CD30+

CD15+

CD3=

CD20=

CD45=

kappa and lambda negative

CLL/SLL genetics

used only for prognosis; particularly del(17p)

Mantle Cell Lymphoma genetics

t(11;14)

Follicular Lymphoma

t(14;18); leads to overexpression of bcl2+

Hairy Cell Leukemia genetics

BRAF-V600E

Burkitt Lymphoma genetics

t(8;14) MYC oncogene to the Ig heavy chain

Cutaneous T-cell Lymphoma/Mycosis Fungoides genetics

TCR gene rearrangement to determine clonality

Large Granular Lymphocyte Leukemia genetics

STAT3 gene mutation; STAT5B

Classical Hodgkin Lymphoma genetics

Used only to confirm B-cell origin

CLL/SLL additional features

May involve PB, lymphoid organs, and BM; B-cells; Smudge cells

Mantle Cell Lymphoma additional features

B-cells

Follicular Lymphoma additional features

Most common non-Hodgkin lymphoma; B-cells; No tingible body macrophages

Hairy Cell Leukemia additional features

B-cells, monocytopenia, & TRAP stain positive

Burkitt lymphoma additional features

Mainly in children & young adults; B-cells; Ki67 ~100% (high proliferation)

Mycosis fungoides additional features

most common extranodal lymphoma; rash presentation; T-cell origin

Large Granular Lymphocyte Leukemia additional features

T-cell; neutropenia; anemia; RA

Classical Hodgkin Lymphoma additional features

B-cell origin; often presents with localized LN involvement; cervical or mediastinal; bimodal with teens—30s and 60s—70s

Plasma Cell Myeloma additional features

Monoclonal IgG or IgA in serum or urine; rouleaux; bone lesions; B-cell origin