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Part III • White Cell Disorders

Lymphoproliferative disorders comprise those disorders of the B and T lymphocytes, in which there is a clonal, malignant proliferation of either cell subset. This chapter discusses the malignant lymphoproliferative disorders (with variants) and the plasma cell disorders. There are several common features of each of these groups. Primarily these diseases affect the elderly; they are chronic; most complications are related to a compromised immune ability; and these diseases progress slowly.

Hodgkin's and non-Hodgkin's lymphoma are covered briefly in this chapter. These diseases have complicated staging systems and are primarily diagnosed through lymph node biopsy, through bone marrow studies, and with molecular techniques. The laboratory involvement in these diseases is peripheral at best. Major plasma cell disorders such as multiple myeloma and Waldenstrom's macroglobulinemia will be presented. Molecular diagnostic techniques such as flow cytometry and chromosomal analysis with a molecular component provide essential data for diagnosis of the malignant disorders. These techniques will be mentioned throughout the text.

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