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NHL (Classify (B-Cell (accounting for 80%) of NHL, T- Cell, Once decide B…

- - - - Most common
      - Marker BCL2 (over produced) used to distinguish between benign reactive follicular hyperplasia and also CD20
      - Origin = follicles, centrocyte and centroblast
      - Neoplastic follicles
      - Age 50+ - present late as feel well
      - Indolent but still progress - SR = 70% 5ys
      - Translocation - chromosome 14 and other normally 18 (T14,18)
      - Anti-apoptic gene - confers survival advantage
    - - Good prognosis
      - marker CD5 and CD23
      - Tissue manifestation of chronic lymphocytic leukaemia
      - Richter syndrome (5-10%) can transform to high grade - de-differentiation
      - Ig increased - infection
      - Eldery - adenopathy as present late
    - - Diffuse replacement of node by malignant mantle cell - diffuse like a cloak over shoulders
      - Peak 60 - 70 yo
      - Cyclin D1 positive
      - Poor prognosis - worst
    - - Extranodal
      - GIT - h-plyori predisposes
      - Thyroid - hasimotos
      - Salivary gland - Sjoregens
      - Lungs
  - - - accounts majority high grade b cell
      - cd20 +
    - - Affects children & young adults - Africa
      - aggressive chemo
      - C-myc translocation - deregulates c-myc - usually T 8:14
      - EBV associated
      - Lymphoblastic
      - PC - mass in Jaw, Gonads or GIT
    - - Affects children and young adults
      - aggressive chemo but can be cured
      - TdT markder positive - stains immature or cells resembling immature cells
- - - - Adults
      - Tcell lymphoma of skin
      - rash - plaque and thickens can extend to bloodstream transforming into sezary syndrome
      - radiation - 12 yo SR
    - - Occurs when mycosis fungoides spreads into skin
  - - - Occuring other than on skin
      - accounts for vast majority of high grade
    - - Associated as complication of coeliac - in those with poor dietary control
      - Presents late as confused with coeliac symptoms
      - Chemo - but can lead to perforation of bowel as t cell have infiltrated small bowel
      - Biopsy to see if mass - MRI - use capsule for hard to see area not covered by either scope