Besonderheiten der histopathologisch-genetischen Diagnose und Klassifikation von Lymphomen im Kindes- und Jugendalter

Zusammenfassung

Lymphome machen im Kindes-und Jugendalter gemeinsam mit den Leukämien fast die Hälfte aller malignen Erkrankungen aus. Die korrekte gewebebasierte Diagnostik und daraus resultierende therapeutische Einordnung der Lymphomerkrankungen bedarf einer engen Zusammenarbeit zwischen pädiatrischen Onkologen und Hämatopathologen. Wir beschreiben hier relevante Charakteristika der im Kindesalter auftretenden Lymphome speziell das Hodgkin-Lymphom, das Burkitt-Lymphom, die Vorläufer-/lymphoblastischen Lmphome, das großzellig anaplastische Lymphom und das diffuse großzellige B-Zell-Lymphom sowie das primär mediastinale B-Zell-Lymphom und das seltene pädiatrische follikuläre Lymphom. Das Augenmerk richtet sich dabei auf spezielle diagnostische Schwierigkeiten sowie neue Erkenntnisse zu den biologischen Besonderheiten dieser Lymphome in Abgrenzung zu gleichnamigen Lymphomen des Erwachsenenalters. Zusätzlich werden neu definierte Lymphomentitäten der WHO-Klassifikation 2008 wie beispielsweise Grauzonenlymphome in ihrer Relevanz für die junge Altersgruppe diskutiert.

Abstract

Malignant lymphoma along with leukemias account for nearly half of all malignancies arising in childhood and adolescence. The correct tissue-based histopathological diagnosis of lymphomas results from a close interdisciplinary exchange between pediatric oncologists and hematopathologists. We describe here relevant features of lymphoma subtypes arising in the young age group, Burkitt lymphoma, precursor/lymphoblastic lymphomas, anaplastic large cell lymphoma and diffuse large B-cell lymphoma as well as primary mediastinal B-cell lymphoma and the rare pediatric follicular lymphomas. Special focus is put on specific diagnostic difficulties as well as new insights into biological features of pediatric lymphomas in comparison with their adult counterpart. In addition the relevance of newly defined lymphoma entities of the WHO-classification 2008, e. g. greyzone lymphomas, will be discussed for the young age group.

Schlüsselwörter

Burkitt-Lymphom - diffuses großzelliges B-Zell- Lymphom - follikuläres Lymphom - großzellig anaplastisches Lymphom - lymphoblastisches Lymphom - Hodgkin-Lymphom

Key words

Burkitt lymphoma - Hodgkin lymphoma - anaplastic large cell lymphoma - follicular lymphoma - diffuse large B-cell lymphoma - lymphoblastic lymphoma

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