Color Atlas of Hematology - Practical Microscopic and Clinical ...

More documents

Recommendations

Info

70Abnormalities of the White Cell SeriesDiseases of the Lymphatic System(Non-Hodgkin Lymphomas)Malignant diseases of the lymphatic system are further classified as Hodgkinand non-Hodgkin lymphomas (NHL). NHL will be discussed here becausemost NHLs can be diagnosed on the blood analysis.➤ Non-Hodgkin lymphomas arise mostly from small or blastic B-cells.➤ Small-cell NHL cells are usually leukemic and relatively indolent, of thetype of chronic lymphocytic leukemia and its variants.➤ Blastic NHL (precursor lymphoma) is not usually leukemic. An exceptionis the lymphoblastic lymphoma, which takes its course as an acutelymphocytic leukemia.➤ Plasmacytoma is an osteotropic B-cell lymphoma that releases not itscells but their products (immunoglobulins) into the bloodstream.➤ Malignant lymphogranulomatosis (Hodgkin disease) cannot be diagnosedon the basis of blood analysis. It is therefore discussed underlymph node cytology (p. 176).The modern pathological classification of lymphomas is based on morphologyand cell immunology. The updated classification system accordingto Lennert (Kiel) has been adopted in Germany and was recently modifiedto reflect the WHO classification. The definitions of stages I–IV in NHLagree with the Ann Arbor classification for Hodgkin’s disease.Classification of non-Hodgkin: comparison of the relevant classes in the Kiel and WHO classifica-Table 6ationsWHO Kiel ClinicalCharacteristicsMarker*Precursor lymphomas/leukemias➤➤Precursor-B-lymphoblasticlymphomaPrecursor B-cell active lymphoblasticleukemiaMature B-cell lymphoma➤Chronic lymphocytic leukemia– contains the lymphoplasmacytoidimmunocytomaB-lymphoblasticlymphomaB-ALLB-CLLLymphoplasmacytoidimmunocytomaAggressiveUsually indolentUsually indolent➤ B-cell prolymphocytic leukemia AggressiveTdt,CD19, 22,79 aCD5, 19,20, 23tris 12 or13 q-,11 q-, 6 q-,p 53
Predominance of Mononuclear Round to Oval Cells71Table 6aContinuedWHO Kiel ClinicalCharacteristicsMarker*➤ Lymphoplasmacytic leukemia LymphoplasmacyticimmunocytomaSometimes IgMparaprotein(Waldenströmdisease)➤ Mantle cell lymphoma Centrocytic lymphoma Usually aggressive➤➤Marginal zone lymphoma– Nodal– Extranodal in mucosa (MALT)– Lienal (splenic)Follicular lymphoma– Grade 1, 2– Grade 3 (a, b)Monocytoid lymphomaMALT (mucosa-assoc.lymphoid tissue) lymphomaLymphoma withsplenomegalyCentroblastic/centrocyticlymphoma;centroblastic lymphoma(a), secondary (b), follicularUsually aggressiveOften indolentUsually indolentHighly malignant–/+ CD5– CD23,CD5t(11;14)bcl-1rearr.–CD5,CD23–CD5, CD10t(14;18)bcl2➤ Hairy cell leukemia Hairy cell leukemia Usually indolent –CD103,CD11 c,CD25t(2;8)t(8;14)➤Plasma cell myeloma (plasmacytoma)– Monoclonal hypergammaglobulinemia(GUS)– Solitary bone plasmacytoma– Extraosseous bone plasmacytoma– Primary amyloidosis– Heavy-chain disease[Plasmacytoma is notincluded in the Kielclassification]CD 138Primary large-cell lymphoma➤Diffuse large-cell B-celllymphoma– Centroblastic– Immunoblastic– Large-cell anaplasticCentroblasticImmunoblasticLarge-cell anaplasticExtremely malignantExtremely malignantExtremely malignant➤ Burkitt lymphoma Burkitt lymphoma Extremely malignantCD20,79 a, 19,22t(2;8)t(8;14)myc* Cited markers are positive, absent markers are indicated with a minus sign.
Page 3 and 4:
iiiColor Atlas of HematologyPractic
Page 5 and 6:
vPrefaceOur Current EditionAlthough
Page 7 and 8:
viiContentsPhysiology and Pathophys
Page 9 and 10:
ContentsixAcute Lymphoblastic Leuke
Page 12 and 13:
2Physiology and Pathophysiology of
Page 14 and 15:
Page 16 and 17:
Page 18 and 19:
Page 20 and 21:
Page 22 and 23:
Page 24 and 25:
Page 26 and 27:
Page 28 and 29:
Page 30 and 31: 20Physiology and Pathophysiology of
Page 39 and 40: Normal Cells of the Blood andHemato
Page 41: Normally erythropoiesis takes place
Page 44 and 45: 34Normal Cells of the Blood and Hem
Page 49 and 50: Advancing nuclear contraction and s
Page 51: Note the granulations, inclusions,
Page 71 and 72: Abnormalities of the White Cell Ser
Page 73 and 74: Predominance of Mononuclear Round t
Page 77 and 78: During lymphatic reactive states, v
Page 79: Extreme transformation of lymphocyt
Page 85 and 86: Monotonous proliferation of small l
Page 87 and 88: Atypical lymphocytes are not part o
Page 89 and 90: Deep nuclear indentation suggests f
Page 91 and 92: Cytoplasmic processes the main feat
Page 93 and 94: Plasmacytoma cannot be diagnosed wi
Page 95 and 96: Atypias and differential diagnoses
Page 97 and 98: Bone marrow diagnosis is indicated
Page 99 and 100: Conspicuously large numbers of mono
Page 107 and 108: Fundamental characteristic of acute
Page 109 and 110: The diagnosis of acute leukemia is
Page 111 and 112: Acute leukemias may also derive fro
Page 113 and 114: New WHO classification: AML with dy
Page 115 and 116: The cells in acute lymphocytic leuk
Page 117 and 118: In unexplained anemia and/or leukoc
Page 119 and 120: The classification of myelodysplasi
Page 121 and 122: Prevalence of Polynuclear (Segmente
Page 123 and 124: Predominance of the granulocytic li
Page 125 and 126: Prevalence of Polynuclear (Segmente
Page 127 and 128: Left shift as far as myeloblasts, p
Page 129 and 130: Bone marrow analysis is not obligat
Page 131 and 132:
In the course of chronic myeloid le
Page 133 and 134:
Enlarged spleen and presence of imm
Page 135 and 136:
Eosinophilia and basophilia are usu
Page 137 and 138:
Erythrocyte and ThrombocyteAbnormal
Page 139 and 140:
Hypochromic Anemias129Insufficient
Page 141 and 142:
Hypochromic Anemias131BSGIron Ferri
Page 143 and 144:
Small, hemoglobin-poor erythrocytes
Page 145 and 146:
Hypochromic erythrocytes of very va
Page 147 and 148:
Hypochromic Anemias137Hypochromic S
Page 149 and 150:
Hypochromic anemia without iron def
Page 151 and 152:
Consistently elevated “young” e
Page 153 and 154:
Distribution pattern and shape of e
Page 155 and 156:
Conspicuous erythrocyte morphology
Page 157 and 158:
Unexplained decrease in cell counts
Page 159 and 160:
Hypochromic Anemias149Differential
Page 161 and 162:
Thrombocytopenia with leukocytosis
Page 163 and 164:
Conspicuous large erythrocytes sugg
Page 165 and 166:
In older patients, myelodysplastic
Page 167 and 168:
Small inclusions are usually a sign
Page 169 and 170:
PlasmodiumfalciparumPlasmodiumvivax
Page 171 and 172:
Conspicuous erythrocyte inclusions
Page 173 and 174:
Bone marrow analysis contributes to
Page 175 and 176:
Thrombocytes: increases, reductions
Page 177 and 178:
Thrombocytes: increases, reductions
Page 179 and 180:
Variant forms of thrombocyte and me
Page 181 and 182:
Thrombocyte proliferation with larg
Page 183 and 184:
Cytology of Organ Biopsiesand Exuda
Page 185 and 186:
Lymph Node Cytology175Anamnesis- su
Page 187 and 188:
Reactive lymph node hyperplasia and
Page 189 and 190:
Lymph Node Cytology179Contact witha
Page 191 and 192:
Epithelioid cells dominate the lymp
Page 193 and 194:
In cases of non-Hodgkin lymphoma an
Page 195 and 196:
Accessible cysts (e.g., branchial c
Page 197 and 198:
Tumor cells can be identified in pl
Page 199 and 200:
Viral, bacterial, and malignant men
Page 201 and 202:
191IndexAActinomycosis 179Addison d
Page 203 and 204:
Index193Disseminated intravascularc
Page 205 and 206:
Index195blast crisis 120-121bone ma
Page 207 and 208:
Index197in hemolytic anemia 140orth
show all

Color Atlas of Hematology - Practical Microscopic and Clinical ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?