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3 POSITIVE DIAGNOSIS : HISTOPATHOLOGICAL CRITERIA
3.1 working formulation for the classification of Non-Hodgkin's lymphomas
Now less used because of timing and lower specificity.
low
grade
small lymphocytic, diffuse
small cleaved cell, follicular
mixed small cleaved and large cell, follicular
intermediate grade
large cell, follicular
small cleaved cell, diffuse
mixed small cleaved and large cell, diffuse
large cell, cleaved and non cleaved, diffuse
high
grade
large cell immunoblastic, diffuse lymphoblastic
small non cleaved cell, diffuse (burkitt and non-burkitt's types)
3.2 Immunohistochemical stains +++
Anaplastic lymphoma is actually defined by immunohistochemical staining.
*
CD 30+ (= ki-1 = Ber H2) = Hodgkin or anaplastic large cell L
* EMA+ not in HL
CD30+ and EMA+ = anaplastic large cell Lymphoma
3.3 cytogenetic analysis
*
chromosomal translocation t(2;5) = anaplastic or non anaplastic Lymphomas
* ALK gene
3.4
Tissue that can be analysed
– lung Biopsy
– lymph node Biopsy
– bone marrow examination
– cytologic examination of pleural effusion
– pleural Biopsy
4
QUESTIONS REMAIN UNCLEAR ABOUT
– peripheral blood smears
– Bronchial washings
– BAL
– serum Immno-electrophoresis
– investigations for evaluating extension and for the follow-up
5
ASSOCIATED LYMPHOMAS
– AIDS
Katariya
et al. semin thorax
– Autoimmune disorders (Sjogren syndrome...)
– Sarcoidosis
6
TREATMENT
– Chemotherapy +++
– Surgery –
limited value except isolated node
(neck/axilla/mediastinum/GI tract)
– Radiosensitive but not curable by Xray therapy
THANK YOU FOR JOINING US FOR THE CROSS-CANADA PAEDIATRIC RESPIRATORY ROUNDS. HOPE TO SEE YOU NEXT TIME.
Thank you to AstraZeneca for their support of this program and website.
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