淋巴造血系统疾病1

fibrous tissue
stroma
Eosinophilic substance
Eosinophilic leukocyte
Tumor cell
Lymphocyte
Atypical mirror image cell
Single nuclear R-S cell
karyomitosis
amphinucleolus Single nucleolus

characteristic
1. Clinically, lesions are starting often from one or a group of lymph nodes and diffusing gradually from the neighbor lymph nodes to distant.
2. Primary extranodal Hodgkin's lymphoma is extremely rare. 3. Diverse components of the tumor cells, which contain a unique giant tumor cell , named ReedSternberg cells (R-S cells). 4. infiltration of response cell and fibrosis
B lymphocyte and B lymphocytic predominance
1. Follicular lymphoma(滤泡性淋巴瘤) 2. Mantle cell lymphoma(套细胞淋巴瘤) 3. Diffused big B cell lymphoma
Outline
hematopoietic organ
hemopoietic system
blood
Embryonic liver, marrow, spleen, lymphonode
Structure of lymphonode： cortex:
peripheral cortical area：lymph nodule+dispersed lymph tissue,B-cell area paracortical area：tymus-dependent zone,dispersed lymph tissue,T-cell area lymphoid sinus：subcapsular sinuses+ peripheral sinus
• T cell-paracortical hyperplasia (eg. viral infection)
purulent
(cat-scratch disease)
• Histiocyte hyperplasia
(eg. malignant tumor)
• Mixied hyperplasia
(toxoplasmosis,弓浆虫病)
R-S cell
3. Variant R-S cell
Non-tumor cell
lymphocyte，plasmocyte
inflammatory cell
leucocyte neutrophil eosinophilic leukocyte histiocyte，epithelioid cell
Malignant
primary，secondary
黏液湖
primary
decreasing Quantitative alteration TYPE increasing
Anaemia,leucopenia， thrombopenia(TP) reactive hyperplasia of lymph node leukocytosis thrombocytosis (thrombocythemia)
nodular sclerosis
Wide collagen fibers
nodular sclerosis
nodular sclerosis
陷窝细胞
嗜中性白细胞
lymphocytic predominance
lymphocyte
popcorn cell
Mononuclear R-S cell epithelioid cell
(HodgkinBV Clinical manifestation lymphadenectasis with without pain early stage：no general symptom advanced stage：fever、weight decrease、 pruritus(瘙痒)、anaemia(贫血) Diagnosis：biopsy(活检) Therapy： large dose radiotherapy chemotherapy
mixed cellularity
lymphocytic depletion
Polymorph
undifferentiation cell
R-S cell
lattice fibers
Non-Hodgkin lymphoma
(NHL,非霍奇金淋巴瘤)
TYPE
1. B lymphocyte and B lymphocytic predominance 2. T lymphocyte and T lymphocytic predominance 3. Histiooytic and others .
Follicular hyperplasia
caseous necrosis
Kikuchi’s disease
Histiocytic necrotizing lymphadenitis(组织细胞性坏死性淋巴结炎) Subacute necrotizing lymphadenitis(亚急性坏死性淋巴结炎)
2. lymphocytic monoclonal hyperplasia:T cell and B cell 3 . abnormal immune function, such as serum Ig B cell 4. origin of tumour cell T cell NK cell
Type and degree
Disease of lymphhematopoietic system
Maliqin
Zhejiang University, School of Medicine Department of Pathology & Pathophysiology Tel: 88208130 Maliqin198@
Black arrow:centr-parent cell Yellow arrow: plasmablast
Disease of lymphhematopoietic system
Type
Benign: inflammation, reactive hyperplasia, tuberculosis Malignant: primary，secondary
basic
Pathological change
Early stage: neck and supraclavicular lymph nodes,
mediastinal, retroperitoneal and paraaortic lymph node
Advanced stage: spleen, liver, marrow Gross: size, mobility,adherence,consistency,color,
1. Asian 2. young，woman 3. 1/3-1/2 fever；50% Hypoleukemia of peripheral blood, 4. lymphadenectasis，pain 5. hyperplasia with necrosis in paracortex
Kikuchi’s disease necrosis
necrotic cell
lymphocyte
Lacunar cell
Popcorn cell
浆多 嗜倍 碱体 性型 ， 核 呈细 分胞 叶。 状胞 。
R- S
Classification of WHO
1. Nodular sclerosis(结节性硬化型) 2.Lymphocytic predominance (淋巴细胞为主型) 3.Mixed cellularity (混合细胞型) 4.Lymphocytic depletion (淋巴细胞消减型)
Qualitative alteration
lymphoma, leukocythemia others
Concept of lymphoma
1. malignant lymphoma : Lymphatic tissue‘s malignant tumor come from primarily inside and outside lymph node
lymphoid 淋巴结低倍镜结构 paracortical area sinus peripheral cortical area
cortex
medulla medullary cord medullary sinus
Folliculus lymphaticus
germinal center
Germinal center
Hokdkin's disease
type
B
non-Hokdkin's disease T NK/T Low potential malignancy degree Midrange potential malignancy Height potential malignancy