Which histologic findings are characteristic of lymphoblastic lymphoma?

Updated: Sep 10, 2019
  • Author: Joseph M Tuscano, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Morphologically, lymphoblastic lymphoma is indistinguishable from L1 acute lymphoblastic leukemia (ALL), as defined in the French-American-British (FAB) classification of ALL. Lymphoblastic lymphoma is composed of medium-sized cells with finely dispersed chromatin and scant cytoplasm. The nuclei are round or highly convoluted, and the nucleoli are inconspicuous.

Based on the rapid growth and cell turnover, mitotic figures and apoptotic bodies are abundant. The apoptotic bodies are often phagocytosed by macrophages, imparting a starry sky appearance, which is characteristic of high-grade lymphomas. The differential diagnosis includes L2 ALL, Burkitt lymphoma, [16] lymphocyte-rich thymoma, and especially in children, small round–cell tumors such as Ewing sarcoma (see also Differential Diagnosis). Modern molecular and immunophenotypic analysis generally provides reliable distinction.

Typical flow cytometric findings for B-lymphoblastic lymphoma are as follows [13, 17] : CD19+ CD10 bright, CD20+/–, CD22+/–, TdT+, HLA-DR+, CD34+/–, slg. Findings for T-lymphoblastic lymphoma are the following: sCD3, but CD3+, CD4+ CD8+ or CD4- CD8, CD2+/–, CD5+/–, CD7+/–, TdT+, CD34+/–, CD10+/–.


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