Important note: Information in this article was accurate in 1987. The state of the art may have changed since the publication date.
THE PATHOLOGY OF INCIPIENT NEOPLASIA: THE LYMPHOID SYSTEM
The Pathology of Incipient Neoplasia. Henson DE, Albores-Saavedra J, eds. Philadelphia, W.B. Saunders Company, p. 87-115, 1986.. Unique Identifier : AIDSLINE ICDB/87635869 Jaffe ES; Hematopathology Section, Lab. of Pathology, NCI, Bethesda, MD
Abstract:
The lymphoid system is distinguished from many other systems by the fact that although polyclonal reactive lymphoid hyperplasias are relatively common, benign tumors of lymphoid cells, namely, benign monoclonal tissue proliferations, have not been recognized. Similarly, the concept of 'carcinoma in situ' has not been applied to the lymphoid system. Although benign tumors of the lymphoid cells have not been recognized--with the possible exception of isolated plasmacytoma--reactive lymphoid hyperplasias are relatively common. Moreover, certain atypical reactive hyperplasias and certain atypical immune states have been associated with an increased incidence of malignant lymphoma. These atypical lymphoid hyperplasias could be considered incipient neoplastic events. One study that examined clinical follow-up in patients with atypical lymphoid hyperplasia demonstrated a 30% incidence of malignant lymphoma in subsequent biopsies. When the pathologists tried to predict the likelihood of subsequent malignant evolution, they were correct 84% of the time. It was noted that a major factor contributing to the inability to arrive at a definitive diagnosis was poor technical quality of the histologic material. Immunophenotypic studies may be extremely valuable in distinguishing benign and malignant lesions. In addition to quantifying the numbers of B and T cells present, one can document the presence of a monoclonal B cell proliferation or demonstrate T cell phenotypic abnormalities suggestive of malignancy. Incipient neoplasia of the lymphoid system is further discussed with reference to the following topics: progressive transformation of germinal centers; angioimmunoblastic lymphadenopathy; dilantin hypersensitivity; angiocentric immunoproliferative lesions; pagetoid reticulosis, parapsoriasis en plaque, and alopecia mucinosa; low-grade B cell lymphomas, follicular lymphoma, and small lymphocytic lymphoma; pseudolymphoma; angiomatous lymphoid hamartoma, or giant lymph node hyperplasia; benign monoclonal gammopathy, isolated extraskeletal plasmacytoma, and 'benign monoclonal lymphadenopathy'; Sjogren's syndrome and rheumatoid arthritis; Hashimoto's thyroiditis; gluten-sensitive enteropathy; immunoproliferative small intestinal disease; immunodeficiency syndromes; and Epstein-Barr virus infections. (75 Refs)
Keywords: B-Lymphocytes/PATHOLOGY Cell Transformation, Neoplastic/PATHOLOGY Drug Hypersensitivity/PATHOLOGY Human Hyperplasia Immunoblastic Lymphadenopathy/PATHOLOGY Immunologic Deficiency Syndromes/PATHOLOGY Immunoproliferative Disorders/PATHOLOGY Immunoproliferative Small Intestinal Disease/PATHOLOGY Lymph Nodes/PATHOLOGY Lymphatic System/*PATHOLOGY Lymphoma/*PATHOLOGY Lymphoma, Follicular/PATHOLOGY Lymphoma, Non-Hodgkin's/PATHOLOGY Lymphoma, Small-Cell/PATHOLOGY Phenytoin/ADVERSE EFFECTS Precancerous Conditions/*PATHOLOGY Tumor Virus Infections/PATHOLOGY MONOGRAPH
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Important note: Information in this article was accurate in 1987. The state of the art may have changed since the publication date.
