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1、LymphomaZhongshan Hospital ,Fudan UniversityZou Shanhua,Definition：A group of neoplastic diseases of lymphoid tissues Classification： Hodgkins Disease, HD (Hodgkins Lymphoma) Non Hodgkin s Lymphoma,NHL),General Considerations,Clinical Features： Painless, progressive lymphadenectasis Fever, weight lo
2、ss, night sweat；cachexia Hepatosplenomegaly Epidemiology： Incidence： in cities / in the country; male/female; age HD 811；NHL 90%,General Considerations,Virulogy: EB virusBurkitt lymphoma, HD Human T-cell Lymphotropic Virus type 1, HTLV-1 Adult T-cell lymphoma/leukemia , ATL HTLV-2Mycosis Fungoides H
3、elicobacter PyloriMALT lymphoma Kaposi sarcoma-associated herpesvirus primary body cavity lymphoma,Etiology and Pathogenesis,Immune States of Host： Immunodeficiency/immunosuppression Mechanism：Antigenic stimulation lymphadenosis ( modulation) infinite proliferation lymphoma,Etiology and Pathogenesis
4、,Classification of Lymphoma,HD：Reed-Sternberg(R-S) Cell,Classification of Lymphoma,Rye Classification ，1966 Lymphocyte predominance Nodular sclerosis Mixed cellularity Lymphocyte depletion,Classification of Lymphoma,WHO Classification, 2001 Nodular lymphocyte predominance Hodgkins lymphoma Classical
5、 Hodgkins lymphoma Lymphocyte-rich classical Hodgkins lymphoma Nodular sclerosis Hodgkins lymphoma Mixed cellularity Hodgkins lymphoma Lymphocyte depletion Hodgkins lymphoma,Classification of Lymphoma,NHL：,Classification of Lymphoma,NHL： IWF，1982 REAL，1994 WHO，2001,Working Formulation,Low-grade lymp
6、homa A. small lymphocytic, consistent with chronic lymphocytic leukemia plasmacytoid B. follicular, predominantly small cleaved cell diffuse areas sclerosis C. follicular, mixed small cleaved and large cell diffuse areas sclerosis,Working Formulation,Intermediate-grad lymphoma D. follicular, predomi
7、nantly large cell diffuse areas sclerosis E. diffuse, small cleaved cell sclerosis F. diffuse, mixed small and large cell sclerosis epithelioid cell component G. diffuse, large cell cleaved cell noncleaved cell sclerosis,Working Formulation,High-grade lymphoma H. mmunoblastic, large cell plasmacytoi
8、d clear cell polymorphous epithelioid cell component I. lymphoblastic, convoluted or nonconvoluted cell J. small noncleaved cell, Burkitts or non-Burkitts,Working Formulation,Miscellaneous composite mycosis fungoides histiocytic extramedullary plasmacytoma unclassifiable other,REAL Classification,B-
9、cell neoplasms I. Precursor B-cell neoplasm: precursor B-lymphoblastic leukemia/lymphoma II. Peripheral B-cell neoplasms A. B-cell chronic lymphocytic leukemia/prolymphocytic leukemia/small lymphocyticlymphoma B. Lymphoplasmacytoid lymphoma/immunocytoma C. Mantle cell lymphoma D. Follicle center cel
10、l lymphoma,follicular 1. Provisional cytologic grades: I small cell, II mixed small and large cell, III large cell 2. Provisional subtype: diffuse, predominantly small cell type,REAL Classification,E. Marginal zone B-cell lymphoma 1. Extranodal (MALT-type +/- monocytoid B cells) 2. Provisional subty
11、pe: nodal (+/- monocytoid B cells) F. Provisional entity: splenic marginal zone lymphoma (+/- villous lymphocytes) G. Hairy cell leukemia H. Plasmacytoma/plasma cell myeloma I. Diffuse large B-cell lymphoma 1. Subtype: primary mediastinal (thymic) B-cell lymphoma J. Burkitts lymphoma K. Provisional
12、entity: high-grade B-cell lymphoma, Burkitt-like,REAL Classification,T-cell and putative NK-cell neoplasms I. Precursor T-cell neoplasm: precursor T- lymphoblastic lymphoma/leukemia II. Peripheral T-cell and NK-cell neoplasms A. T-cell chronic lymphocytic leukemia / prolymphocytic leukemia B. Large
13、granular lymphocyte leukemia 1. T-cell type 2. NK-cell type C. Mycosis fungoides/Sezarysyndrome,REAL Classification,D. Peripheral T-cell lymphomas,unspecified 1. Provisional cytologic categories: medium-sized cell, mixed medium and large cell, large cell, lymphoepithelioid cell 2. Provisional subtyp
14、e: hepatosplenic gamma/delta T-cell lymphoma 3. Provisional subtype: subcutaneous panniculitic T-cell lymphoma E. Angioimmunoblastic T cell lymphoma F. Angiocentric lymphoma,REAL Classification,G. Intestinal T-cell lymphoma (+/- enteropathy associated) H. Adult T-cell lymphoma/leukemia I. Anaplastic
15、 large cell lymphoma 1. CD30+ -cell type 2. T-cell type 3. Null-cell types J. Provisional entity: anaplastic large cell lymphoma, Hodgkins-like,WHO Classification,2001,B-cell neoplasms I. Precursor B-cell neoplasm:a. Precursor B-lymphoblastic leukemia/lymphoma II. Mature (peripheral) B-cell neoplasms a B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma b B-cell prolymphocytic leukemia c Lymphoplasmacytic lymphoma d Spenic marginal zone B-cell lymphoma (+/- villous lymphocytes) e Nodal marginal zone lymphoma(+/- monocytoid B
