Limfoid Neoplasia

dr. Tuti Andayani, Sp.PA

Bagian/ SMF Patologi Anatomi RSU Cut Meutia

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• All lymphoid neoplasms have the potential to spread to
lymph nodes and various tissues throughout the body,
especially the liver, spleen, and bone marrow.
• In some cases lymphomas or plasma cell tumors spill
over into the peripheral blood, creating a leukemia-like
picture.
• Conversely, leukemias of lymphoid cells, originating in
the bone marrow, can infiltrate lymph nodes and other
tissues, creating the histologic picture of lymphoma.

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• Because of the overlap in clinical
presentations, the various lymphoid
neoplasms can only be distinguished
based on the appearance and molecular
characteristics of the tumor cells
• Pathologic diagnosis of lymphomas is
usually dependent upon clinical, histologic,
and molecular features

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Clinical feature:
• Lymphnodes enlargement=lymphadenopathy
• Local or general
• Painless
• Could be on the other lymphoid tissue :
oropharyng, intestine, skin,

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 WHO classification of
Lymphoma
1. Hodgkin Lymphoma
2. Non-Hodgkin Lymphoma:
a. B cell
b. T cell

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 Hodgkin Lymphoma
• Type of malignant lymphoma in which
Reed-Stenberg cells are present in
“characteristic background” of
inflammatory cells of various types.
• Background: matur
lymphocytes,eosinophils,plasma cells
and histiocytes.
• Etiology :unknown, but evidence suggest
that EBV plays an important role.

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Clinical Feature:
• Nontender peripheral lymphadenopathy
involving a single
lymph node or groups of lymph nodes.
• The cervical and mediastinal nodes
(>50%)
• Anterior mediastinum is frequently
involved, especially inthe nodular sclerosis
type.
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WHO 2008 Classification of Hodgkin
Lymphoma
Two major types :
• nodular lymphocyte predominant HL
(non-classical)
• classical HL : (IHK : CD 20 +, CD 30- )
1. Nodular sclerosis
2. Lymphocyte-rich
3. Mixed cellularity
4. Lymphocyte depleted

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 Nodular Sclerosis HL
• Collagen bands surround at least one
nodule
• Thickened capsule
• Lacunar cell

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Mixed Cellularity HL

• Scattered HRS cells in a diffuse or

vaguely nodular mixed inflammatory
background
• WITHOUT nodular sclerosing fibrosis
• Cases which DO NOT FIT into other
subtypes are put in this
category
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Lymphocyte-rich HL

• Nodular or less often diffuse cellular

background consisting of small
lymphocyteswith ABSCENCE of
neutrophils and eosinophils.

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Lymphocyte-depleted HL

• Diffuse subtype and/or depleted in

nonneoplastic lymphocytes
• Definition changed several times

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 NLPHL
Nodular lymphocyte predominant
Hodgkin lymphoma (non-classical)
• Nodular or nodular and diffuse proliferation
of popcorn cell = LP cell (lymphocyte
predominant) = L&H= lymphocytic and/or
histiocytic RS cell variants.
• Reside in large spherical meshwork of
follicular dendritic cell processes filled with
non-neoplastic lymphocytes and
histiocytes.
• IHK :CD 30 +, CD 15+
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Non-Hodgkin Lymphoma

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WHO Classification

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