Pathology of the lymphoid system

AML

• Revision: • Acute myeloid leukaemia: definition? • Tumor of hematopoietic progenitors caused

by mutations accumulation of immature myeloid blasts in marrow

• Leads to complications like??• Anaemia, thrombocytopenia, neutropenia

What makes this AML?

•delicate nuclear chromatin• prominent nucleoli •fine azurophilic granules in the cytoplasm

What makes this ALL?

condensed nuclear chromatin, small nucleoli, and scant agranular cytoplasm

Large spleen in chronic myelocytic (myeloid) leukaemia.

What is this pathology?

Enlargement of hilar lymph nodes due to sarcoidosis in a man aged 52.

Reactive hyperplasia

Small thymoma in an old man. The thymus at this age consists mainly of fat. Cysts like those shown here in the thymic tissue away from the neoplasm are not uncommon in normal elderly people. 3

What is this?

Infiltrate of malignant plasma (myeloma) cells showing very large cell size and binucleate forms

Myeloma

Causes of splenomegaly

what pathology is this?

Multiple well-circumscribed infarcts are present in this spleen, which is massively enlarged (2820 gm; normal: 150–200 gm) by extramedullary hematopoiesis secondary to a myeloproliferative disorder (myelofibrosis). Recent infarcts are hemorrhagic, whereas older, more fibrotic infarcts are a pale yellow-gray color.

What is it? And what is it going through?

Reactive lymph node with follicular hyperplasia, characterized by numerous secondary lymphoid follicles with intact mantle zones

Normal human infant thymus. Higher magnification. Medulla. The two arrows indicate thymic corpuscles (syn. Hassall corpuscles).

What organ? What stage

of life?

And now?

Adult human thymus. (A) Markedly atrophied thymus. Reduced in size with loss of lobular structure and with lightly, rather than densely scattered lymphocytes. (B) Profoundly atrophied adult thymus. Largely fat and connective tissue. Loss of all lymphoid structures. Compare to human infant thymus.

Thymoma. A, Benign thymoma (medullary type). The neoplastic epithelial cells are arranged in a swirling pattern and have bland, oval to elongated nuclei with inconspicuous nucleoli. Only a few small, reactive lymphoid cells are interspersed. B, Malignant thymoma, type I. The neoplastic epithelial cells are polygonal and have round to oval, bland nuclei with inconspicuous nucleoli. Numerous small, reactive lymphoid cells are interspersed.

In thymus? But what?

Organ?Describe?

DDx?

Metastatic breast carcinoma inthe spleen of a woman aged 46.Nodules ofvarying size distinguish secondary cancer fromHodgkin’s lymphoma

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