182 



LYMPHOCYTIC. 

 LEUKEMIA 



The Lymphocyte and Lymphocytic Tissue 



•FOLLICULAR LYMPHOMA. 



HODGKINS 

 GRANULOMA 



HODGKINS 

 •(RETICULUM CELL) 

 SARCOMA 



MONOCYTIC 

 LEUKEMIA 



Angiosarcoma 



PRIMARY CUTANEOUS LYMPHOMAS 



Follicular ( Spieg | er . Fendt sarco , d ) 

 Lymphocytic 



Granulomatous (Mycosis fungoides) 

 "LYMPHOSARCOMA"*' Reticulum cell 



Fig. 15-1. Flow diagram of interrelationships in lymphomatous disorders. 



graphic variants rather than cellular alterations. The linkage between these 

 last two major groups has not appeared in our series but has been reported 

 by Lawrence and Rosenthal 4 and by others. A number of years passed 

 before we bridged the gap between the lymphomatous and the myleo- 

 proliferative disorder; then in short order we observed four patients, one 

 with Hodgkin's granuloma which had begun as a follicular lymphoma and 

 three with reticulum cell sarcoma, each terminating as acute granulocytic 

 leukemia. Finally, through the courtesy of Dr. Silik Polayes of Brooklyn, 

 I was privileged to examine tissues from a patient whose spleen had been 

 removed for so-called hypersplenism and found to be the seat of follicular 

 lymphoma, and who later developed plasmocytic leukemia. The composite 

 of these various transitions is shown in Figure 15-3. 



ILLUSTRATIVE CASES 



Since these presentations are devoted primarily to the lymphocyte, I shall 

 confine my further comments to changes within the category of lympho- 



GRANULOCYTIC LEUKEMIA ► THROMBOCYTIC LEUKEMIA 



(Myelogenous__ Leukemia) \ ( Megakaryocyte Leukemia) 



3YTHROMYELOSIS" 

 (diGuglielmo) 



"ERYTHREMIA 

 (Polycythemia Vera) 



^PLASMOCYTOMA. 

 (Multiple Myeloma) 



SOLITARY MYELOMA" 



PLASMOCYTIC LEUKEMIA 



k EXTRAMEDULLARY„ 

 PLASMOCYTOMA 



Fig. 1 5-2. Transitions in myeloproliferative disorders. 



