1. By the end of this session you should know:
How to classify T cell lymphoma
The clinical and pathological features of
Anaplastic large T cell lymphoma
Mycosis fungoides

2. Classification of Non-Hodgkin Lymphoma (selected common entities)
Precursor B cell
Acute lymphoblastic lymphoma
Peripheral B cell
Small lymphocytic lymphoma SLL, Chronic lymphocytic leukemia CLL
Mantle cell lymphoma
Follicular lymphoma
Marginal zone lymphoma
Diffuse large B cell lymphom
Burkitt lymphoma
Precursor T cell
Acute lymphoblastic lymphoma
Peripheral T cell
Anaplastic large T cell lymphoma
Peripheral T cell lymphoma
Mycosis fungoides

3. T cell lymphoma/ NK cell lymphoma
Rare (less common than B cell lymphoma)
TCR: alpha,Beta Gamma,delta
Alpha,Beta: helper and cytotoxic
Gamma,delta: 1st line of immunity
NK cells
Clonality

4. T cell lymphoma/ NK cell lymphoma
Generally aggressive tumors
Clinically can be: nodal, extranodal, cutaneous, leukemic
More common in Asia
HTLV1 (Japan, Caribbean)
Treatment?

5. Anaplastic large T cell lymphoma
Clinical: Systemic, Cutaneous
Systemic can be Alk1 pos or Alk1 neg
Aggressive
Pathology: mixture of cells, Hallmark cells: large cells with horseshoe nucleus.
Immuno: CD3, CD30, Alk1 +/-
Genetic: t(2;5) NPM-Alk1 fusion product

9. Mycosis Fungoides
Epidermotropic T cell lymphoma characterized by a proliferation of small or medium-sized neoplastic T lymphocytes with cerebriform nuclei
Indolent clinical course
Elderly, limited to skin (progress late the course) scaly eruption
slow progression over years
patches, plaques, tumors, lymph node, internal organs

10. Pathology
Epidermotropic, band-like infiltrates involving the papillary dermis
small, medium-sized, and occasionally large mononuclear cells
hyperchromatic, indented (cerebriform) nuclei
Pautrier’s microabscesses

13. Progression to CD30+ or CD30- Large T-cell lymphoma
CD3+, CD4+
5-year survival 87%
Therapy:
confined to skin: skin-targeted therapies, phototherapy, topical nitrogen mustard, radiotherapy
Progression to CD30+ or CD30- Large T-cell lymphoma

16. Sezary’s Syndrome Definition: Micro:
erythroderma, generalized lymphadenopathy, and the presence of neoplastic T cells in skin, lymph nodes and peripheral blood
Micro:
may be similar to MF
more often monotonous cells
CD3+, CD4+
Survival: 11%, Chemo is the treatment

17. Peripheral T cell lymphoma
Adult T cell lymphoma
Extranodal NK/T cell lymphoma of nasal type

18. By the end of this session you should know:
How to classify T cell lymphoma
The clinical and pathological features of
Anaplastic large T cell lymphoma
Mycosis fungoides