Pathologie onderzoek van maligne lymfomen

Datum laatste herziening: 16-12-2014

Procedures

Het lymfoom / lymfklierbiopt

Het beenmergbiopt

Revisies

Classificatie van maligne lymfomen

Rijpcellige lymfoomcategorieŽn gedefinieerd volgens de WHO-classificatie*

Literatuur

Pathologen (per 01-01-2015)

Verwante pagina's

Links in deze pagina

Procedures

Het lymfoom / lymfklierbiopt

Het beenmergbiopt

Sinds 2014 worden in het UMCG alle beenmergbiopten na fixatie van 24 uur gedurende 48 uur ontkalkt met formaline EDTA, waarna ze worden ingebed in paraffine, gesneden en gekleurd. De procedure duurt in totaal ongeveer 4 werkdagen. Afhankelijk van de bevindingen moet dan vaak nog immunohistochemie verricht worden (extra tijd dan ťťn tot twee dagen).

Revisies

Classificatie van maligne lymfomen

Classificatie van maligne lymfomen geschiedt volgens de WHO classificatie van 2008*. Hierin zijn i.t.t. de versie uit 2001 ook de cutane lymfomen opgenomen. De lijst kent een groot aantal entiteiten waarvan sommige in westers landen niet of nauwelijks voorkomen. In de onderstaande lijst is voor het gemak enige hiŽrarchie aangebracht, zo zijn alle varianten DLBCL onder ťťn noemer gebracht (14.a - 14.g).

Rijpcellige lymfoomcategorieŽn gedefinieerd volgens de WHO-classificatie*

B cel lymfomen

  1. B CLL / small lymphocytic lymphoma
  2. B cell prolymphocytic leukemia (PLL)
  3. Lymphoplasmacytic lymphoma
  4. Splenic B-cell marginal zone lymphoma
  5. Hairy cell leukemia (HCL)
  6. Splenic B-cell lymphoma / leukemia, unclassifiable
  7. Hairy cell leukemia variant
  8. Plasma cell dyscrasias
    1. Plasma cell myeloma & MGUS
    2. Solitary plasmacytoma of bone
    3. Extraosseous plasmacytoma
    4. Heavy chain diseases (Alpha, Gamma and Mu chain diseases)
    5. (AL amyloidosis and many localized amyloid tumours)
  9. Nodal marginal zone lymphoma
    1. Pediatric nodal marginal zone lymphoma
  10. Follicular lymphoma (grades 1-3b)
    1. Pediatric follicular lymphoma
  11. Primary cutaneous follicle centre lymphoma (PCFCL)
  12. Mantle cell lymphoma
  13. Extranodal marginal zone (MALT) lymphoma including primary cutaneous marginal zone B cell lymphoma
  14. Diffuse large B cell lymphoma (DLBCL)
    1. Diffuse large B cell lymphoma NOS
    2. T cell / histiocyte rich large B cell lymphoma (TCRBCL)
    3. Intravascular large B cell lymphoma
    4. Primary mediastinal large B cell lymphoma (PMBCL)
    5. Primary DLBCL of the CNS
    6. Primary cutaneous DLBCL, leg type
    7. ALK positive large B cell lymphoma
  15. Burkitt lymphoma / leukaemia (minority EBV+)
  16. B cell lymphoma, unclassifiable, with features intermediate between DLBCL and Burkitt lymphoma
  17. B cell lymphoma, unclassifiable, with features intermediate between DLBCL and classical Hodgkin lymphoma


    EBV geassocieerde B cel lymfomen:

  18. Plasmablastic lymphoma (usually EBV+)
  19. EBV positive DLBCL of the elderly (always EBV+)
  20. DLBCL associated with chronic inflammation (always EBV+)
  21. Large B cell lymphoma arising in HHV8 associated multicentric Castleman disease (usually EBV+)
  22. Primary effusion lymphoma (usually HHV8+ and EBV+)
  23. Lymphomatoid granulomatosis (always EBV+)


    T cel lymfomen

  24. T cell prolymphocytic leukemia
  25. T cell large granular lymphocytic leukemia
  26. Chronic lymphoproliferative disorder of NK-cells
  27. Aggressive NK cell leukemia (EBV+)
  28. Adult T cell leukemia/lymphoma
  29. Angioimmunoblastic T cell lymphoma (AITL)
  30. Peripheral T cell lymphoma NOS (PTCL-NOS)
  31. Anaplastic large cell lymphoma (ALCL), ALK positive
  32. Anaplastic large cell lymphoma (ALCL), ALK negative
  33. Enteropathy associated T cell lymphoma (EATL)
  34. Hepatosplenic T cell lymphoma
  35. Extranodal NK/T cell lymphoma, nasal type (EBV+)
  36. Mycosis Fungoides (with variants, most important folliculotropic)
  37. Sezary syndrome
  38. Primary cutaneous CD30 positive T cell lymphoproliferative disorders
    1. Primary cutaneous anaplastic large cell lymphoma
    2. Lymphomatoid papulosis
  39. Subcutaneous panniculitis-like T cell lymphoma
  40. Primary cutaneous gamma/delta T cell lymphoma
  41. Primary cutaneous CD4+ small/medium T cell lymphoma
  42. Primary cutaneous aggressive CD8+ T cell lymphoma
  43. Systemic EBV positive T cell lymphoproliferative disease of childhood (EBV+)
  44. Hydroa vacciniforme-like lymphoma (EBV+)

    Hodgkin lymfomen

  45. Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) / nodular pragranuloma
  46. Nodular sclerosis classical Hodgkin lymphoma
  47. Lymphocyte rich classical Hodgkin lymphoma
  48. Mixed cellularity classical Hodgkin lymphoma
  49. Lymphocyte depleted classical Hodgkin lymphoma


    ImmunodeficiŽntie geassocieerde lymfoproliferatieve aandoeningen (meeste maar niet allemaal EBV+)

  50. Lymphoproliferative diseases associated with primary immune disorders
  51. Lymphomas associated with HIV infection
  52. Posttransplant lymphoproliferative disorders
    1. Plasmacytic hyperplasia & infectious miononucleosis like PTLD (EBV+)
    2. Polymorphic PTLD (mostly EBV+)
    3. Monomorphic PTLD (NB late cases often EBV-)
    4. Classical Hodgkin lymphoma type PTLD (may be EBV+)
  53. Other iatrogenic immunodefeciency-associated lymphoproliferative disorders (Methotrexate, TNF antagonists, fludarabin etc)

Literatuur

Pathologen (per 01-01-2015)

Dr A Diepstra, a.diepstra@umcg.nl, tel 050-3610404
Dr S Rosati, s.rosati@umcg.nl, tel 050-3614688


VERWANTE PAGINA'S:
- Maligne lymfomen: stadiŽring en response evaluatie algemeen
- Hodgkin lymfoom
- Non-Hodgkin lymfomen (NHL): inleiding
- NHL: lymfoblastair/precursor B en T
- NHL: lymfocytair lymfoom/CLL
- NHL: folliculair lymfoom
- NHL: nodaal en extranodaal marginale zone lymfoom (MALT-type)
- NHL: lymfoplasmocytair lymfoom / ziekte van WaldenstrŲm
- NHL: diffuus grootcellig B-cellymfoom (DLBCL)
- NHL: Burkitt-lymfoom
- NHL: mantelcellymfoom
- NHL: perifeer T-cellymfoom
- NHL: primair in het zenuwstelsel (PCNSL)
- NHL: bij aids of na transplantatie
- Lymfomen van de huid


LINKS IN DEZE PAGINA:
- a.diepstra@umcg.nl
- s.rosati@umcg.nl

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