Childhood lymphoma-leukemia.I. correlation of morphology and immunological studies

Acute lymphocytic leukemia of childhood (ALL) is a heterogeneous disorder. Furthermore, the related lymphomas have been separated arbitrarily according to clinical presentation. This study is based on a combined clinical, morphological (cytological) and immunological evaluation of 49 cases of childhood lymphoma or leukemia. We have identified three separate groups, which in the past have not always been clearly distinguished, but which do appear to have distinctive clinical and cytological features: 1) convoluted lymphocytic lymphoma/leukemia, of probable T cell origin (7 cases), usually associated with thoracic involvement; 2) small noncleaved follicular center cell (FCC) (Burkitt-like) lymphoma/leukemia, of B cell origin (6 cases), usually associated with abdominal involvement; 3) a heterogeneous (ALL) group (36 cases). This study demonstrates that differentiation of these three entities can often be made on the basis of cytological examination and the features of clinical presentation. It remains to be determined whether these sub-groups, and other more subtle variations in surface marking (E rosettes) and morphology within the ALL group, reflect important differences in behavior pertinent to selection of therapy.