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Lymphomas

Lymphomas. Hodgkins Lymphoma. Lymphoid Neoplasms. Leukaemias Lymphomas Plasma cell tumors. Lymphomas. Lymphoid neoplasms which arise as discrete tissue masses Hodgkins Lymphomas Nonhodgkins. Hodgkins Lymphoma.

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Lymphomas

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  1. Lymphomas Hodgkins Lymphoma

  2. Lymphoid Neoplasms • Leukaemias • Lymphomas • Plasma cell tumors

  3. Lymphomas • Lymphoid neoplasms which arise as discrete tissue masses Hodgkins • Lymphomas Nonhodgkins

  4. Hodgkins Lymphoma • Group of lymphoid neoplasms which is characterised by the presence of - neoplastic giant cells -- Reid Sternberg cells - in the company of reactive lymphocytes, histiocytes, eosinophils, neutrophils , plasma cells • RS cells are derived from B cells

  5. Morphology of RS cells • Classical • Variants * Mononuclear variant * Lacunar Cells * L & H variants ( Lymphohistiocytic )

  6. Clinical Features • One of the most common forms of malignancy in young adults • Average age of 32 years • Constitutional symptoms include fever , night sweats , weight loss • Curable in most cases

  7. Classification of HD ( WHO) • 1. Nodular Lymphocyte predominant HD • 2. Classical HD • - Nodular sclerosis • - Mixed Cellularity • - Lymphocyte Rich • - Lymphocyte depletion

  8. HD - Nodular Sclerosis • 65 – 70% • Adolescents & young adults • Characterised by 1. Lacunar cells 2. Collagen bands • Lower cervical , supraclavicular , mediastinal lymph nodes of young adults • Prognosis is excellent

  9. Mixed Cellularity • 20 – 25 % , Most common in patients> 50 years • Diffuse effacement by a mixed cellular infilterate – small lymphocytes , eosinophils, plasma cells , macrophages mixed with RS cells. • Diagnostic RS cells & mononuclear variants are plentiful • systemic symptoms , advanced tumor stage

  10. Lymphocyte Rich Type • Uncommon • Reactive lymphocytes make majority of infilterate • Frequent mononuclear & diagnostic RS cells. • Associated with EBV in 40% • Excellent prognosis

  11. Lymphocyte Depletion type • < 5% • Paucity of lymphocytes, abundance of RS cells • Older patients , HIV + ve • Often HBV associated • Outcome less favourable

  12. Lymphocyte Predominant Type • Uncommon , 5% • Nodal effacement by nodular infilterate of small lymphocytes ,other reactive cells are rare • Typical RS cells rare . More common are L& H variants ( popcorn cells) • Isolated cervical /axillary lymphadenopathy • Excellent prognosis

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