tailieunhanh - Chapter 105. Malignancies of Lymphoid Cells (Part 6)

Pathway of normal T cell differentiation and relationship to T cell lymphomas. CD1, CD2, CD3, CD4, CD5, CD6, CD7, CD8, CD38, and CD71 are cell markers used to distinguish stages of development. T cell antigen receptors (TCR) rearrange in the thymus, and mature T cells emigrate to nodes and peripheral blood. ALL, acute lymphoid leukemia; T-ALL, T cell ALL; T-LL, T cell lymphoblastic lymphoma; T-CLL, T cell chronic lymphoid leukemia; CTCL, cutaneous T cell lymphoma; NHL, non-Hodgkin's lymphoma. Although lymphoid malignancies often retain the cell-surface phenotype of lymphoid cells at particular stages of differentiation, this information is of little consequence | Chapter 105. Malignancies of Lymphoid Cells Part 6 Figure 105-3 T CELL Minorhy ol T-aLL Majority ol T-LL Majority ol T 11 ALL Minority ol T-LL Rare T-ALL Mature T Helper Cea PERIPHERAL BLOOD AND NODES T CELL MALIGNANCIES Mature T Suppressor Cell Majority ol T-CLL. CTCL. Sezary Cel NHL CD 2 3 4. 5. 6. 7 TCR Minority of T-CLL. NHL CD 2 3. J. . 7 TCR Souri F ue AS. K ip r Du r unw id E. H .uj r SL. t-onflp Ol. J m son JL. I oicafco J et 17th Ediboni http A nrïT di Copv ght Hi Mqör w-Hi l Comp ni ir mt all right HsJrtitl- Pathway of normal T cell differentiation and relationship to T cell lymphomas. CD1 CD2 CD3 CD4 CD5 CD6 CD7 CD8 CD38 and CD71 are cell markers used to distinguish stages of development. T cell antigen receptors TCR rearrange in the thymus and mature T cells emigrate to nodes and peripheral blood. ALL acute lymphoid leukemia T-ALL T cell ALL T-LL T cell lymphoblastic lymphoma T-CLL T cell chronic lymphoid leukemia CTCL cutaneous T cell lymphoma NHL non-Hodgkin s lymphoma. Although lymphoid malignancies often retain the cell-surface phenotype of lymphoid cells at particular stages of differentiation this information is of little consequence. The so-called stage of differentiation of a malignant lymphoma does not predict its natural history. For example the clinically most aggressive lymphoid leukemia is Burkitt s leukemia which has the phenotype of a mature follicle center IgM-bearing B cell. Leukemias bearing the immunologic cellsurface phenotype of more primitive cells . pre-B ALL CD10 are less aggressive and more amenable to curative therapy than the more mature appearing Burkitt s leukemia cells. Furthermore the apparent stage of differentiation of the malignant cell does not reflect the stage at which the genetic lesions that gave rise to the malignancy developed. For example follicular lymphoma has the cell-surface phenotype of a follicle center cell but its characteristic chromosomal translocation the t 14 18 which involves .