CHAPTER 17 



HISTOPATHOLOGIC BASIS FOR 



EVALUATION OF PROGNOSIS AND 



RESPONSE TO THERAPY OF THE 



LYMPHOCYTIC LYMPHOMAS 



MATTHEW BLOCK 



The microscopic criteria for the recognition of the various types of 

 lymphomas have been fairly well standardized for many years. More recently 

 our attention has been turned to correlation of histopathology with response 

 to therapy and prognosis of each of the diseases comprising the broad group 

 of lymphomas. It is the purpose of this chapter to review this latter aspect 

 and add my own experience based on histopathology and clinical care of the 

 patient. 



PRELIMINARY CONSIDERATIONS 



Technique 



The histopathologic approach to malignant lymphomas is based upon an 

 analysis of architectural pattern and of cytology. It is therefore logical that 

 a histologic technique be used which is adequate for both of these goals. 

 Unfortunately, over the course of years, preparation of tissue sections has 

 been relegated to the technician. Lumb 37 is the only author in recent years 

 who has been properly concerned with histopathologic technique. Others 

 have failed to consider the subject or did so only briefly. The delicacy of the 

 hematopoietic tissues has been overlooked, and as a result specimens have 

 been handled without due regard for the specific techniques needed to dem- 

 onstrate adequately cytologic detail. It is illogical that a microscopist, who 

 examines blood cells only after they have been stained by one of the 



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