CRC ATLAS DIFF DIAG NEOPLAST HEMATOPATH PDF

Preface

The main purpose of this atlas is to provide practicing pathologists, hematologists, cytogenetists, and oncologists, as well as physicians in training, with an overview of neoplastic hematopathology. The images, reflecting a multidisciplinary approach to the diagnosis of hematologic malignancies, include routine histology, cytology, immunohistochemistry, flow cytometry, cytogenetics, fluorescence in situ hybridization (FISH) and molecular studies. The emphasis of this atlas is on differential diagnosis. The first chapter provides a general overview of the normal histology and hema topoiesis, cytomorphologic features, and abnormal histologic patterns in the bone marrow, blood, and lymph nodes. The second chapter presents an overview of immunophenotyping, including the most commonly used phenotypic markers, basics of flow cytometry and immunohistochemistry, and phenotypic profiles of major hematopoietic tumors. The third chapter is an introduction to cytogenetics, FISH and molecular (polymerase chain reaction; PCR) testing. Chapters 4–11 discuss the diagnostic criteria of hematopoietic tumors and their differential diagnosis. The final three chapters are devoted entirely to differential diagnosis based on phenotypic markers (Chapter 12), chromosomal/molecular features (Chapter 13), and localization of the tumor (Chapter 14).

The text and illustrations of all chapters have been updated and significantly extended to include new terminology, classifications (e.g. primary cutaneous lymphomas or chronic myeloproliferative neoplasms), and new research data. Cytogenetics, FISH, and molecular (PCR) tests play an ever-increasing role in the management of patients with hematologic malignancies and over the past few years have become indispensable for diagnosing, determining prognosis, and patient monitoring. JAK2 mutation analysis or monitoring chronic myeloid leukemia patients treated with imatinib by real-time quantitative (qRT) PCR has become the standard of care since the publication of the first edition of the Atlas. Molecular or chromosomal testing in conjunction with mor phology and immuno phenotype are crucial to the classification of many hematolymphoid tumors, which have different treatment protocols (e.g. diffuse large B-cell lymphoma versus Burkitt lymphoma, or acute promyelocytic leukemia versus non-M3 acute myeloid leukemia). They also help to identify patients who might benefit from specific (targeted) therapies, such as myelodysplastic syndrome with 5q deletion and lenalidomide, or gastric MALT with t(11;18) and response to Helicobacter pylori eradication therapy. Molecular data in conjunction with morphology and immunopheno - typing not only enable a specific diagnosis to be established, but also assess the risk of progression to moreadvanced or aggressive stage (e.g. refractory anemia versus refractory cytopenia with multi-lineage dysplasic, versus refractory anemia with excess blasts or IgM⁺ monoclonal gammopathy of undetermined significance versus Waldenström macroglobulinemia versus smoldering multiple myeloma). New molecular/FISH assays help to better characterize many disorders (e.g. activated B-celllike and germinal center B-cell-like subtypes of DLBCL, IGVH mutation in B-chronic lymphocytic leukemia, or FLT3 and NPM1 mutations in acute myeloid leukemia with normal karyotype) and to differentiate between reactive and malignant conditions (e.g. JAK2, V617F, CHIC2, and 8p11 in chronic myeloproliferative neoplasms). The description of cytogenetics/FISH and molecular testing has been expanded most significantly in this edition with the intention to better complement morphologic and immunophenotypic information. The expansion of the molecular and cytogenetic/FISH tests was one of the most common suggestions for improvement by the users of the first edition, and I hope the current edition will meet their expectations. Numerous new flow cytometry illustrations have been added. The discussion of the entities which often cause diagnostic problems (e.g. angioimmunoblastic T-cell lymphoma, chronic myeloproliferative neoplasms, nodular lym - phocytes predominant Hodgkin lymphoma versus T-cell/ histiocyte-rich large B-cell lymphoma) has been upgraded. Rare entities, such as chronic neutrophilic leukemia are also discussed and illustrated.

I would like to take this opportunity to express my thanks to my editor, Dr Kelly Cornish, and to Informa Healthcare for their continuing help, support, and trust. I also thank the technical staff of Genzyme Genetics' immunohisto chemistry, flow cytometry, cytogenetics/ FISH, and bone marrow laboratories in New York for their assistance and dedication to everyday work. I am also grateful to all clinicians and pathologists who trust us with the specimens from their patients, and often offer kind words of encouragement and suggestions on how to improve this atlas.