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The Korean Journal of Pathology 1973;7(2): 91-101.
악성 임파종과 임파성 백혈병에 관한 검색 -혈액학 및 병리조직학적 감별진단-
A Study on Malignant Lymphoma and Lymphoid Leukemia -It’s Differential Diagnosis from the Hematological Cytological and Histopathological Aspects-
ABSTRACT
As it has been experienced that the differential diagnosis of malignant lymphoma and lymphoid leukemia is a quite frequent problem to the hematologists and surgical pathologists, we made an attempt to clarify it from the hematological, cytological and histopathological aspects with the accumulated materials at the Section of Hematology and Surgical Pathology, Clinical Laboratories, College of Medicine, Seoul National University. The materials consisted of 153 cases of malignant lymphoid and 3 cases of lymphoid leukemia diagnosed by lymph node biopsy, and 101 cases of lymphoid leukemia and 36 cases of malignant lymphoma diagnosed by peripheral blood and bone marrow examinations during the period of January 1969 to September 1973. Original diagnosis were re-evaluated and the results were summerized as follows : 1. Among 153 cases of malignant lymphoma were 73 cases of lymphocytic type, 44 histiocytic type, 8 mixed type, 14 Hodgkin’s disease 14 undifferentiated and unclassified type. While in lymphoid leukemia, 99 were acute type and only 2 cases were chronic type. 2. Leukemic manifestations in the peripheral blood were observed in 25% out of 153 cases of malignant lymphoma. 3. Male to female sex ratio was 2.0 : 1 in malignant lymphoma, while it was 1.8 : 1 in acute lymphoid leukemia. 4. The peak age incidence was 30 to 45 years of age in malignant lymphoma but in acute lymphoid leukemia it ranged from 1 to 15 years of age. 5. The hemoglobin and Hct. in initial stage of diagnosis revealed normal or slightly decreased values in majority cases of malignant lymphoma while it revealed moderate to marked decrease in acute lymphoid leukemia. 6. WBC counts at the initial stage of malignant lymphoma were normal or moderately decreased in majority of cases, but majority of acute lymphoid leukemia case revealed either marked leukocytosis or marked leukopenia. 7. In differential counts, the malignant lymphoma cases without leukemic manifestations revealed marked lymphopenia while those cases of lymphoma with leukemic manifestations revealed considerable increase in number of lymphoid cells but far less than that of acute lymphoid leukemia. Presence of immature granulocytes and eosinophils in peripheral blood was a frequent association of the malignant lymphoma. 8. Lymphosarcoma cells in peripheral blood was a prominent feature of the malignant Iymphoma, however differential diagnosis between each type of lymphoma was extremely difficult by cytological characteristics. 9. Of bone marrow differential count, the mean value of lymphoid cells was 27.4% in total cases of malignant lymphoma and there appeared relatively more lymphoid cells in those cases with leukemic manifestations in peripheral blood while it was 76.6% in acute lymphoid leukemia. Normoblasts, megakaryocytes and granulocytes were relatively high in number in the malignant lymphoma while they were markedly depressed in acute lymphoid leukemia. 10. Histo-pathological findings of lymph node biopsy of the acute lymphoid leukemias comparing to those of lymphoma illustrated monotonous and uniform cellular pattern, less mitosis, more fibrosis, diffuse invasion of capsules and evidences of extramedulary hemopoiesis in subcapsular spaces.
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