Neoplasias Linfoproliferativas - SMIBA
Transcript of Neoplasias Linfoproliferativas - SMIBA
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Dardo Riveros Sección Hematología
Departamento de Medicina Interna
Neoplasias Linfoproliferativas
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Diferenciación de Células B
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Williams Hematology. 9th Edition
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Incidence of lymphomas in comparison with other cancers in Canada
Year1985 1990 1995 2000
age
adju
sted
inci
denc
e/10
0,00
0/yr
0
10
20
30
40
50
60
70
Hodgkinlymphoma
NHL
breastcolorectallung
Incidencia de linfomas en comparación con otros tumores. Registro canadiense
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Estirpe B
39
X
X
X
X
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27 T y NK
X
X
X
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Otros 20
X
X
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Instituto Nacional del Cáncer
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Linfomas no Hodgkin a Células B en Adultos
• Difuso a grandes células B: 37 %
• Folicular: 29 %
• MALT: 9 % 7,6 %
• LLC / linfoma de linfocitos pequeños: 12 %
• Manto: 7
• Otros: <10%
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Linfomas no Hodgkin Clasificación por relevancia clínica Indolentes a células B Leucemia linfática crónica/Linfoma a linfocitos pequeños Linfoma folicular grados 1 y 2 Linfoma linfoplasmocítico/Waldenström.
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Clasificación por relevancia clínica Agresivos a células B
Linfoma del manto Folicular grado 3 Difuso a grandes células B Mediastinal B Burkitt y símil-Burkitt
Linfomas no Hodgkin
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Linfomas no Hodgkin Clasificación por relevancia clínica Indolentes a células T y NK
Micosis fungoide/Sézary
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Linfomas no Hodgkin Clasificación por relevancia clínica
Agresivos a células T y NK
Anaplásico a células grandes, sistémico Células T, periférico Linfoblástico, precursor T Leucemia/Linfoma T del adulto
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Otras neoplasias linfoides Clasificación por relevancia clínica Linfoma Hodgkin Discrasias de células plasmáticas - Gamapatía monoclonal de origen incierto (MGUS) - Mieloma - Amiloidosis AL
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Formas de Presentación Clínica
• Adenomegalias y/o hepatoesplenomegalia
• Síntomas B
• Insuficiencia de médula ósea
• Linfocitosis
• Compromiso extraganglionar
• Hipogammaglobulinemia
• Fenómenos autoinmunes
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PET-TC
Linfoma
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Lymphoma. Younes A, and Coiffier B. Humana Press 2013
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Williams Hematology. 9th Edition
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Williams Hematology. 9th Edition
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Stage I Stage II Stage III Stage IV
Staging of lymphoma
A: absence of B symptomsB: fever, night sweats, weight loss
Estadificación de los linfomas
Estadío Estadío Estadío Estadío
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Estadificación de la LLC
Binet Rai
Descripción Descripción
A <3 áreas
ganglionares; no anemia ni
trombocitopenia
0 Bajo riesgo Linfocitosis
B ≥3 áreas
ganglionares; no anemia ni
trombocitopenia
I Intermedio Linfocitosis y adenopatías
II Intermedio Linfocitosis y
esplenomegalia ± adenopatías
C Anemia o
trombocitopenia *
III Alto Linfocitosis y anemia
IV Alto Linfocitosis y trombocitopenia
*Hb <10 g/dL; plaquetas <100,000/µL.