obsolete precursor lymphoblastic lymphoma/leukemia

Based on the provided context, it appears that there are various symptoms associated with precursor lymphoblastic lymphoma/leukemia.

Common symptoms include:

• Weakness [13]
• Fatigue [7][13]
• Bone pain [13]
• Infections [7][13]
• Fevers [7][13]
• Weight loss [7]

Additionally, some unique symptoms associated with leukemia are:

• Pale skin [13]
• Red spots on the skin (called petechiae) [13]
• Frequent infections [13]

It's worth noting that these symptoms may overlap with those of lymphoma, which can include:

• Fevers
• Shortness of breath
• Coughing
• Itchy skin

Diagnostic criteria:

Acute lymphoblastic leukemia (ALL) is diagnosed by the presence of at least 20% lymphoblasts in the bone marrow [9]. The diagnosis of systemic lymphoma was suggested upon the appearance of cutaneous tumors, palpable lymph nodes and general symptoms including asthenia and fever [8].

Classification:

The lymphoblastic neoplasms are classified on the basis of B cell versus T cell lineage:

• B cell lymphoblastic leukemia/lymphoma (B cell ALL/LBL)
• T cell lymphoblastic leukemia/lymphoma (T cell ALL/LBL)

These entities may present with overlapping clinical features, and diagnosis and classification do not distinguish between them [11].

References: [8] - by E Ginoux · 2015 · Cited by 9 [9] - by WP Chen · 2021 · Cited by 1 [11] - INTRODUCTION. The lymphoblastic neoplasms are classified on the basis of B cell versus T cell lineage [] [13] - These symptoms include weakness, fatigue, bone pain, infections, fevers and weight loss. Some symptoms unique to leukemia are pale skin, red spots on the skin (called petechiae) and frequent infections. Symptoms of lymphoma may include fevers, shortness of breath, coughing and itchy skin.

Based on the provided context, it appears that differential diagnosis for precursor lymphoblastic lymphoma/leukemia involves distinguishing it from other conditions such as Acute Myeloid Leukemia (AML) and Burkitt-type subsets.

• To make a differential diagnosis with AML, one must recognize the presence or absence of myeloperoxidase (MPO) expression in the cells. MPO + is indicative of AML, while MPO - suggests precursor lymphoblastic lymphoma/leukemia [12].
• Additionally, flow cytometry can be used to define the cell of origin and stage of differentiation, which helps in differential diagnosis with AML [12].

It's also worth noting that a subset of early T precursor lymphoblastic leukemia / lymphoma (ETP ALL) may have immunophenotypic profiles that overlap with MPAL T / M. However, a threshold of < 3% to define negative myeloperoxidase expression was adopted and may be a helpful distinctive feature [14].

In terms of obsolete precursor lymphoblastic lymphoma/leukemia, it's essential to consider the World Health Organization (WHO) 2017 classification system, which categorizes these disease entities under precursor lymphoid neoplasm. This classification helps in understanding the nuances of differential diagnosis for these conditions.

References: [12] Defines infiltration (>25% required for a diagnosis of ALL vs lymphoblastic lymphoma) Allows a differential diagnosis with AML (MPO – vs + MPO +) Recognizes L3 (Burkitt-type) subsets Flow cytometry Mandatory Allows a differential diagnosis with AML Permits to define the cell of origin Permits to define the stage of differentiation [14] A subset of early T precursor lymphoblastic leukemia / lymphoma (ETP ALL) may have immunophenotypic profiles that overlap with MPAL T / M In the initial definition of ETP ALL, a threshold of < 3% to define negative myeloperoxidase expression was adopted and may be a helpful distinctive feature ( Lancet Oncol 2009;10:147 )