Page 143 - Haematologica Atlas of Hematologic Cytology

CHAPTER 16 - Precursor lymphoid neoplasms
AB
CD
EF
Figure 1 Precursor lymphoid neoplasms
cytology (A) Blood lm showing blasts with high nuclear:cytoplasmic ra ra ra o o o o o o o o o o o o o o o o o o scan- ty agranular cytoplasm cytoplasm cytoplasm rather rather condensed condensed nuclear nuclear chroma chroma n n n n n n n n n n n n n n n n n n n n n n n n n and and inconspicuous nucleoli nucleoli (B) Bone marrow In this child small blasts blasts blasts predominate: they have scarce cytoplasm cytoplasm round nucleus rather rather condensed condensed chroma chroma n n n n n n n n n n n n n n n n n n n n n n n n n and and indis nct nucleoli nucleoli (FAB L1 category) (C) Lymphoblasts more more heterogeneous in in in in in in size mainly large (D) Large lymphoblasts with irregular nuclear shape open chroma chroma n n n n n n n n n n n n n n n n n n n n n n and and prominent nucleoli nucleoli basophilic cytoplasm these features are more more frequently observed in in in in in in adult ALL (FAB L2 category) (E) Polymorphous blasts blasts with with indented nucleus condensed chroma chroma n n n n n n n n n n n n n n n n n n n n n indis nct nucleoli nucleoli and and and vacuo- lated cytoplasm cytoplasm (F) Lymphoblasts with with scarce light blue cytoplasm cytoplasm and and and and many large vacuoles some mes supranuclear The morphology morphology of of of B-lymphoblas c c c c c c c c c c and and and and T-lymphoblas c c c c c c c c c c neoplasms
is is is is is indis nguishable and and and and there is is is is is no no no correla on on between morphology morphology and and and and the the the the degree of of of of di di di di di di eren eren a a a a a a a a a a a a a a a a a a a on on of of of of precursor lymphoblasts Therefore immunophenotyping is is is is is is is is is essen al al al to dis dis nguish the the the B or or or or or T T T lineage of of of the the the neoplasm and and and also for for di di di di di di eren eren al al al al diagnosis from acute myeloid leukemia leukemia leukemia The The dis dis n- c c c c on on on on on between leukemia leukemia leukemia and and and lymphoma lymphoma is is is is is is is arbitrary Conven onally >25% bone bone marrow marrow blasts indicates leukemia leukemia leukemia whereas the the term lymphoma lymphoma is is is used when there is is is a a a a a a a a a a a a a a a a mass with no or minimal evidence of blood and and bone bone marrow marrow involvement 130