<prompt> Which of the following human malignancy is highly malignant, rapidly progressive and delay in treatment of even 1-2 days can lead death?Hodgkins lymphomaNeuroblastomaBurkitts lymphomaMycosis fungoides  <response>: Ans. c Burkitts lymphoma. Ref. Bobbins 8,h e455BURKITTS LYMPHOMA Very aggressive tumor of mature B cells Usually arises at extranodal sites Uniformly associated with translocations involving the c-MYC proto-oncogene Often associated with latent infection by Epstein-Barr virus EBV. Most children and young adults can be cured, the, however, outcome is guarded in adults. A high mitotic index and apoptotic cell death are typical. Starry sky pattern is characteristic cells proliferate by C-MYC deregulation. Chromosome 8, EBV, t 2, 8, t 8, 22 and myc gene translocation are associated with Burkitts lymphoma CNS involvement is common Hodgkins lymphoma, mycosis fungoides are indolent tumors.SUMMARY OF THE MORE COMMON LYMPHOID NEOPLASMSENTITYSALIENT MORPHOLOGYIMMUNOPHENOTYPECOMMENTSPrecursor B-cell lymphoblastic leukemia lymphomaLymphoblasts with irregular nuclear contours, condensed chromatin, small nucleoli, and scant agranular cytoplasmTdTimmature B cells CD19, variable expression of other B-cell markersUsually presents as acute leukemia; less common in adults; prognosis is predicted by karyotypePrecursor T-cell leukemia lymphomaIdentical to the precursorB-cell lymphoblastic leukemialymphomaTdTimmature T cellsCD2, CD7, variable expression of other T-cell markersMost common in adolescent males; often presents as a mediastinal mass due to thymic involvement; highly associated with mutations in NOTCH1Small lymphocytic lymphomachronic lymphocytic leukemiaSmall resting lymphocytes mixed with variable numbers of large activated cells; lymph nodes diffusely effacedCD5B-cell expressing surface IgOccurs in older adults; usually involves nodes, marrow, and spleen; most patients have peripheral blood involvement; indolentFollicular lymphomaFrequent small cleaved cells mixed with large cells; growth pattern is usually nodular follicularCD10BCL2mature B cells that express surface IgOccurs in older adults; usually involves nodes, marrow, and spleen; associated with t 14; 18; indolentMantle cell lymphomaSmall to intermediate-sized irregular lymphocytes growing in a diffuse patternCD5mature B cells that express cyclin D1 and have surface IgOccurs mainly in older males; usually involves nodes, marrow, and spleen; GI tract also commonly affected; t11;14 is characteristic; moderately aggressiveExtranodal marginal zone lymphomaVariable cell size and differentiation; 40 show plasmacytic differentiation; B cells home to the epithelium, creating lymphoepithelial lesionsCDS- CD10- mature B cells with surface IgFrequently occurs at extranodal sites involved by chronic inflammation; very indolent; may be cured by local excisionDiffuse large B-cell lymphomaVariable; most resemble large germinal center B cells; diffuse growth patternMature B cells with variable expression of CD10 and surface IgOccurs in all ages, but most common in older adults; often arise at extranodal sites; aggressiveBurkitt lymphomaIntermediate-sized round lymphoid cells with several nucleoli; diffuse tissue involvement associated with apoptosis produces a starry-sky appearanceMature CD10B cells expressing surface IgEndemic in Africa, sporadic elsewhere; increased frequency in immune suppressed patients; predominantly affects children; often presents with visceral involvement; highly aggressivePlasmacytoma plasma cell myelomaPlasma cells in sheets, sometimes with prominent nucleoli or inclusions containing IgTerminally differentiated plasma cells containing cytoplasmic IgMyeloma presents as a disseminated bone disease, often with destructive lytic lesions. Hypercalcemia, renal insufficiency, and bacterial infections are commonMycosis fungoidesIn most cases, small lymphoid cells with markedly convoluted nuclei; cells often infiltrate the epidermis Pautrier microabscessesCD4mature T cellsPresents with localized or more generalized skin involvement; generally indolent. Sezary syndrome, a more aggressive variant, is characterized by diffuse skin erythema and peripheral blood involvementPeripheral T-cell lymphoma, not otherwise specified NOSVariable; usually a spectrum of small to large lymphoid cells with irregular nuclear contoursMature T-cell phenotype CD3Probably spans a diverse collection of rare tumors. Often disseminated, generally aggressiveHodgkin lymphoma, nodular sclerosis typeLacunar Reed-Sternberg cell variants in a mixed inflammatory background; broad sclerotic bands of collagen usually also presentCD15, CD30Reed- Sternberg cellsMost common in young adults, often arises in the mediastinum or cervical lymph nodesHodgkin lymphoma, mixed cellularity typeFrequent classic Reed- Sternberg cells in a mixed inflammatory backgroundCD15, CD30Reed- Sternberg cellsMost common in men, more likely to present at advanced stages than the nodular sclerosis type EBVin 70 of cases 