Histological classification

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There are different types of lymphoma and they all behave slightly differently. There are also different ways to class the disease. In Hodgkin's disease there are two main ways - RYE classification and REAL classification. In Non-Hodgkins Lymphoma there are several including. Working formulation, REAL and KEIL classification.

 

HODGKINS LYMPHOMA

RYE  (Luke's et el Can Res. 1966. 26; 1311). Also see REAL classification (within NHL section)

Lymphocyte predominance Including nodular and diffuse variants of lymphocytic and/or histiocytic proliferation
Mixed cellularity  
Nodular sclerosis Including variant where sclerosis is sparse: cellular phase
Lymphocyte depleted Including diffuse fibrosis and reticular categories

 

NON HODGKINS LYMPHOMA

Working formulation classification of non-Hodgkin s lymphomas Rosenberg S.A et al. Cancer 49: 2112-35, 1982 (Rappaport terminology)

A Malignant Lymphocytic small Diffuse well differentiated

Lymphocytic consistent with lymphocytic

chronic lymphocytic leukaemia

plasmacytoid

B Malignant Lymphoma, follicular Nodular poorly differentiate/ lymphocytic

Predominantly small cleaved

cell diffuse areas sclerosis

C Malignant Lymphoma follicular Nodular mixed lymphocytic / Histiocytic

Mixed, small cleaved and

large cell diffuse areas sclerosis

D Malignant Lymphoma, Nodular histiocytic

follicular

Predominantly large cell

diffuse area / sclerosis

E Malignant Lymphoma, diffuse Diffuse poorly

small cleaved cell differentiated lymphocytic

F Malignant lymphoma, diffuse Diffuse mixed

Mixed, small and large cell lymphocytic-histiocytic

sclerosis

epitheloid cell component

G Malignant Lymphoma, diffuse Diffuse histiocytic

Large cell

cleaved cell / sclerosis

H Malignant Lymphoma Diffuse histiocytic

large cell, immunoblastic

plasmacytoid / clear cell

polymorphous

epitheloid cell component

I Malignant Lymphoma Diffuse lymphoblastic

lymphoblastic

convoluted cell

J Malignant Lymphoma Diffuse undifferentiated

small non-cleaved cell

Burkitt's

follicular areas

 

REAL CLASSIFICATION (BLOOD, 1994. Vol.84, No. 5, pp.1361-1392 & Pileri et al Current opinion in oncology 1995,7:401)).

B-cell

B-cell chronic lymphocytic leukaemia

Lymphocytic small B-cell lymphoma

Plasmacytoid and myeloma

Hairy cell leukaemia

Marginal zone B-cell lymphoma

Follicle center lymphoma, follicular (grades 1&2)

T-Cell

Large granual lymphocytic leukaemia

Adult T-cell lymphoma or leukaemia (Smouldering)

Mycosis fungoides, Sezary’s syndrone

B-cell

B-cell pro-lymphocytic leukaemia

Mantle cell lymphoma*

Follicle centre lymphoma, follicular (grade3)

T-cell

T-cell CLL, prolymphocytic leukaemia

Adult T-cell lymphoma, leukaemia (Chronic)

Angiocentric ymphoma*

Angio-immunoblastic lymphoma*

B-cell

Diffuse large B-cell lymphoma

T-cell

Peripheral T-cell lymphoma, unspecified

Intestinal T-cell lymphoma

Anaplastic large-cell lymphoma

Adult T-cell lymphoma or leukaemia (acute and lymphomatous)

B-cell

Precursor B-cell lymphoblastic lymphoma, leukaemia

Burkitt’s lymphoma

High grade B-cell lymphoma, Burkitt’s - like

T-cell

Precursor T lymphoblastic lymphoma, leukaemia

Lymphocyte predominance

Others * These types should be referred to Dr Marcus

 

KIEL CLASSIFICATION

B CELL LYMPHOMA T CELL LYMPHOMA
Low grade malignancy Low grade malignancy
Lymphocytic

Lymphoplasmacytic

Plasmacytic

Centroblastic/centrocytic

follicular

diffuse

Centrocytic

Lymphocytic

Small cerebriform cell

mycosis fungoides

sezary’s syndrome

Lymphoepithelioid

(Lennert’s syndrome)

Angioimmunoblastic

T-zone

Pleomorphic small cell

High grade maligancy High grade maligancy
Centroblastic

Immunoblastic

Large cell anaplastic (Ki-1+)

Burkitt’s lymphoma

Rare types

Pleomorphic medium and large cell

Immunoblastic

Large cell anaplastic (Ki-1+)

Lymphoblastic

Rare type