Non Hodgkin”s Lymphoma -- Histology appearance -- Cell of orgin -- Immunophenotype -- Molecular biology -- Clinical featres -- Prognosis -- Out-come of disease -- Therapy

Ethiologic factors in NHL _ TCR _ Congenital Immunodeficiency s. _ Aquaired I. d. _ Auto-immune disorders _ Viral cofactors: Epstein Barr Virus HIV HTLV-1 Herpes Virus Helicobacter Pylori _ Organ Transplantation

Classification of NHL - Working Formulation ( WF ) Revised European American L.(REAL) 1994 Immunophenotype Cytogenetics factors. Epidemiologic factors. Ethiologic factors.

Low Grade NHLs - Cleaved Cell Type - Mixed Cell Type CD , Neg CD5, t(14-18) 80-90% in advanced stage. Often with marrow infiltration. - Small Lymphocytic L. (CLL) ( CD23+ )

Intermediate Grade NHLs. * Diffuse Large Cell * Mantle Cell Lympfoma CD5+, ( CD23-), t(11;14) * Immunoblastic Sarcoma

High Grade NHL Burkitt’s L. (Small Non cleaved cell) : Associated with EBV Tumor Lysis Syndrome T (8;14) Lymphoblastic Lymphoma: TdT+ Young man Mediastinum Bone M. involve Leptomeninges

Oncogenic viruses : The infection of cells by oncogenic viruses must be considered to be a genetic lesion, since viruses introduce foreign genes into their target cells. Three distinct viruses are associated with the pathogenesis of specific NHL subtypes. -Epstein-Barr virus (EBV) -Human T-cell lymphotropic virusI (HTLV-I) -Human Herpes virus-8 (HHV-8) -Simian virus 40

AIDS-related lymphomas (AIDS-NHL) are invariably derived from B- cells and are classified into 3 main groups: 1- AIDS-related BL (AIDS-BL). 2- AIDS-related DLBCL (AIDS-DLBCL). 3- AIDS-related body-cavity-based lymphomas (AIDS-BCBL) represent a rare additional type of AIDS-NHL.

Simian virus 40 Simian virus-40 (SV-40) is a polyoma virus with oncogenic potential in humans and animals. Its actions are thought to result from inactivation of tumor suppressors p53

MALIGNANCY due to EBV Burkitt's lymphoma (NHL) Hodgkin's disease Nasopharyngeal carcinoma T cell lymphoma Nasal/nasal type angiocentric lymphoma

Approximately 50 percent of these lymphomas are associated with t(9;14), a recurrent chromosomal abnormality in B-cell NHL. Approximately 50 percent of these lymphomas are associated with t(9;14), a recurrent chromosomal abnormality in B-cell NHL. Chromosomal breakpoints of t(9;14)(p13; q32) involve the IgH locus on chromosome 14q32, and, on chromosome 9p13, a genomic region containing the paired homeobox (PAX)–5 gene. PAX-5 encodes a B-cell specific transcription factor involved in the control of B-cell proliferation and differentiation. The juxtaposition of PAX-5 to the IgH locus causes deregulated expression of the gene, contributing to tumor development. Chromosome abnormalty in NHL

INDOLENT LYMPHOMAS 1- B-cell neoplasms B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma B-cell prolymphocytic Leukemia Plasma cell myeloma/plasmacytoma Follicular lymphoma Marginal zone B-cell lymphoma Mantle cell lymphoma 2- T-cell neoplasms: Mycosis fungoides T-cell prolymphocytic leukemia 3- NK cell neoplasms

HODGKIN”s disease Nodular sclerosis HD Mixed cellularity HD Lymphocyte depletion HD Lymphocyte-rich classical HD Nodular lymphocyte predominant HD