Liver and intrahepatic bile ducts - tumor

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Liver and intrahepatic bile ducts - tumor

Leukemia / lymphoma

Leukemia

Reviewers: Deepali Jain, M.D. (see Reviewers page)
Revised: 9 January 2013, last major update February 2012
Copyright: (c) 2004-2013, PathologyOutlines.com, Inc.

Gross description
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● Usually hepatomegaly, but no discrete nodules except for SLL / CLL
● Lymphoblastic lymphoma only rarely presents in liver with no involvement of blood or marrow

Acute T/B cell leukemia / lymphoma
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● Micro: pleomorphic lymphocytes, sinusoidal pattern of infiltration with less hepatocellular injury

Acute myeloid leukemia
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● Case reports: erythroleukemia (AML-M6) in newborn with hepatic failure (Arch Pathol Lab Med 2003;127:1362)
● Positive stains: myeloperoxidase, Leder stain

Erythroleukemic blasts

Chronic lymphoblastic leukemia
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● Liver involvement common
● Micro: periportal infiltrate of monomorphic small lymphocytes with minimal cytoplasm

Chronic myelogenous leukemia
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● Liver involvement common (50%)
● Micro: sinusoidal infiltrate of various myeloid precursors
● Resembles surgical hepatitis (margination reaction of neutrophils in liver sinusoids related to prolonged surgery)

Hairy cell leukemia
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● Hepatomegaly in up to 1/3
● Associated with pancytopenia
● Micro: portal and sinusoidal infiltration, clear cytoplasm, round / reniform nuclei, appears as “beads on a string” along sinusoids; may have angiomatous spaces (World J Gastroenterol 2009;15:4453)
● Positive stains: TRAP

Large granular lymphocyte leukemia
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● Associated with leukemia and neutropenia
● Peripheral smear shows large granular lymphocytes
● Micro: round lymphocytes with abundant pale cytoplasm

End of Liver and intrahepatic bile ducts - tumor > Leukemia / lymphoma > Leukemia

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