Leukemia, Lymphoma

1. NEOPLASM OF
HEMATOPOIETIC
TISSUE

2.  Is replacement of hematopoietic stem cells with neoplastic cells.
 There are two main types : Systemic( Leukemia) and Regional
(Lymphomas)
 LEUKEMIAS- may be classified as either acute or chronic base on
leukemic cell maturity, it may also be classified according to cell of
origin; myelogenous or lymphogenous leukemia

4. Acute leukemia
 Presence of blast (immature cells)
 Myeloblast
 Lymphoblast
 Megakaryoblast
 Erythromyeloblast
 Monoblast
 There is rapid progression of condition

5. Chronic leukemia
 Relatively matured cells
 Relative mild clinical course
 May be of myelocyte, lymphocyte or monocyte origin

6. Other classification of leukemia
 Acute lymphoblastic leukemia (ALL)
 Acute myeloblastic leukemia (AML)
 Chronic lymphocytic leukemia (CLL)
 Chronic myeloid leukemia (CML)

7. Changes seen in peripheral blood
 Leukemic –leukocyte level more than 100,000 cell per microliter and
immature leukemic cells are present.
 Sublekeumic –leukocytes not more than 15,000-25,000 per microliter
 Leukopenic- leukocyte count is less than normal but immature cells
are present
 Aleukemic-no changes in the blood

8. General clinico-pathomorphological
presentation of leukemia
 Leukemic infiltration: brain- may lead to non specific nervous system
signs, vessels- may lead to necrotic changes,
 Hemorrhagic syndrome- due to depression of normal hematopoiesis
leads to thrombocytopenia
 Anemia- depression of normal hematopoiesis in bone marrow
 Bone pain and tenderness due to expansion of marrow with
infiltration of sub periosteum
 Infections –due to reduction in immune cells
 Development of extramedullary hemopoiesis in liver, spleen, kidney,
lymphatic as a compensatory mechanism

9. Lymphomas
 Hodgkin’s lymphoma
 Non-Hodgkin’s lymphoma
 NON-HODGKIN’S LYMPHOMA
 Mostly arise from lymph nodes
 Origin –B cells, T cells, histiocytes (rare)
 Growth patern ; nodular (follicular) and diffuse lymphomas
 Divided into low grade, intermediate grade and high grade
 Mantle cell lymphoma, Burkitt’s Lymphoma, Sezary syndrome

10. Burkitt’s lymphoma
 From B cells
 Clinically divided into endemic (Africa) and sporadic ( other parts
of the world)
 Commonly affects children
 Sporadic type begins from bowel and retroperitoneal organs
 Endemic type characteristically involves the jaw or other facial
bone

11. Hodgkin’s lymphoma
(lymphogranulomatosis)
 Is malignant lymphoma characterized by the presence of giant cells
called Reed-Sternberg (RS) cells. They have diagnostic importance

12.  Local or general lymphogranulomatosis is observed
 Never transforms into leukemia
 Clinico-morphological classification; nodular sclerosis (bands of
fibrosis, lacunar cells) , lymphocyte predominance (mostly B cells
with few RS cells), lymphocyte depletion (many RS cells) and mixed
cellularity (many different cells).
 Complications- Renal amyloidosis, Intoxication, Sepsis