Page 283 - Essential Haematology

Chapter 20 Non-Hodgkin lymphoma / 269

Figure 20.18 Burkitt lymphoma: histological section of

lymph node showing sheets of lymphoblasts and
‘ starry sky ’ tingible body macrophages.

radiotherapy. Long - term cognitive dysfunction is an
issue.

Lymphoblastic l ymphomas

Figure 20.17 Burkitt lymphoma: characteristic facial
Lymphoblastic lymphomas (B or T cell) occur
swelling caused by extensive tumour involvement of
mainly in children and young adults and these
the mandible and surrounding soft tissues.
conditions merge clinically and morphologically
with ALL. They are treated using similar

protocols.
with a very high proliferative index of over 95% T - c ell l ymphomas

(Fig. 20.18 ). The prognosis is excellent with the

introduction of chemotherapy regimens which Peripheral T - cell lymphomas that present with lym-
include high - doses of methotrexate, cytosine arabi- phadenopathy rather than extranodal disease are a
noside and cyclophosphamide, e.g. CODOX - M/ heterogeneous group of rare tumours and are usually
+
IVAC (which includes doxorubicin, ifosphamide of CD4 phenotype. Several variants of T - cell lym-
and etoposide). Intrathecal chemotherapy is also phomas are recognized.
given. DA - Epoch, an infusional regimen using
similar agents, has also proved effective.

Peripheral T - c ell n on - Hodgkin l ymphoma,

u nspecifi ed
Primary c entral n ervous s ystem

These derive from post - thymic T cells at various
l ymphoma

stages of diff erentiation. They are treated with com-

These are rare tumours, more common in older bined chemotherapy (e.g. CHOP). Th e prognosis
patients and those with HIV infection. Patients are is poor.
treated with high - dose methotrexate (with high - Autografting for patients with chemosensitive
dose cytosine arabinoside) followed by whole brain disease is often performed.