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Lymphoma Classification Lymphoma first used in 1858 Old terminology –Hodgkins Disease –Lymphosarcoma –Reticulum cell sarcoma –Giant follicle lymphoma.

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Presentation on theme: "Lymphoma Classification Lymphoma first used in 1858 Old terminology –Hodgkins Disease –Lymphosarcoma –Reticulum cell sarcoma –Giant follicle lymphoma."— Presentation transcript:

1 Lymphoma Classification Lymphoma first used in 1858 Old terminology –Hodgkins Disease –Lymphosarcoma –Reticulum cell sarcoma –Giant follicle lymphoma

2 Rye Classification Classification for Hodgkins Disease Conference in Rye NY 1965 Modification of Lukes-Butler classification Divided HD into four histologic types

3 Rye Classification Lymphocyte predominance (LP) Nodular sclerosis (NS) Mixed cellularity (MC) Lymphocyte depletion (LD)

4 Rappaport Classification Rappaport proposed classification in 1966 Nodular or Diffuse –Lymphocytic, well differentiated –Lymphocytic, poorly differentiated –Mixed lymphocytic-histiocytic –Histiocytic –Undifferentiated

5 Modified Rappaport Classification Nodular –Lymphocytic, poorly differentiated –Mixed lymphocytic-histiocytic –Histiocytic

6 Modified Rappaport Classification Diffuse –Lymphocytic, well differentiated –Lymphocytic, intermediate differentiation –Lymphocytic, poorly differentiated –Mixed lymphocytic-histiocytic –Undifferentiated, Burkitts type –Undifferentiated, non-Burkitts type –Histiocytic –Lymphocytic

7 New Classification Schemes British National Lymphoma Investigation (1974) Lukes and Collins (1974) Dorfman (1974) Kiel (1974) World Health Organization (1976)

8 Lukes and Collins Classification Attempt to correlate lymphoma to current understanding of normal immune system proposed immunologic subtypes could be recognized by morphology

9 Lukes and Collins Classification Undefined cell type T cell types –Small lymphocytic –Mycosis fungoides / Sezary syndrome (cerebriform) –Convoluted lymphocytic –Immunoblastic sarcoma (T cell) Histiocytic Unclassifiable

10 Lukes and Collins Classification B cell types –Small lymphocytic –Plasmacytoid lymphocytic –Follicular center cell small cleaved large cleaved small noncleaved large noncleaved –Immunoblastic sarcoma (B cell)

11 Kiel Classification Proposed by Lennert and a European consortium Updated in 1988

12 Kiel Classification Low Grade Malignancy –Lymphocytic –Lymphoplasmacytoid –Centrocytic –Centroblastic-centrocytic Follicular Follicular and Diffuse Diffuse

13 Kiel Classification High Grade Malignancy –Centroblastic –Lymphoblastic Burkitts type Convoluted cell type –Immunoblastic

14 Updated Kiel Classification (B Cell) Low Grade –Lymphocytic: CLL, PLL and hairy cell leukemia –Lymphoplasmacytic/cytoid (LP immunocytoma) Plasmacytic Centroblastic/centrocytic –follicular –diffuse Centrocytic

15 Updated Kiel Classification (B Cell) High Grade –Centroblastic –Immunoblastic –Large Cell Anaplastic (Ki-1) –Burkitts lymphoma –Lymphoblastic Rare Types

16 Updated Kiel Classification (T Cell) Low Grade –lymphocytic: CLL and PLL –Small cerebriform cell: MF and SS –Lymphoepithelioid (Lennerts lymphoma) –Angioimmunoblastic (AILD) –T zone –Pleomorphic, small cell (HTLV 1+/-)

17 Updated Kiel Classification (T Cell) High Grade –Pleomorphic, medium and large cell ( HTLV 1 +/-) –Immunoblastic (HTLV 1 +/-) –Large cell anaplastic (Ki 1 ) –Lymphoblastic Rare Types

18 Working Formulation Collaborative international study sponsored by NCI Published new terminology in 1982 A Working Formulation of Non-Hodgkins Lymphoma for Clinical Usage Not a new classification but a means o translation from one classification to another

19 Working Formulation - Low Grade A. Malignant lymphoma (small lymphocytic) Consistent with CLL Plasmacytoid B. Malignant lymphoma, follicular (predominantly small cleaved cell) Diffuse areas Sclerosis C. Malignant lymphoma, follicular (mixed, small cleaved and large cell) Diffuse areas Sclerosis

20 Working Formulation - Intermediate Grade D. Malignant lymphoma, follicular (predominantly large cell) Diffuse areas Sclerosis E. Malignant lymphoma, diffuse (small cleaved cell) Sclerosis F. Malignant lymphoma, diffuse (mixed, small and large cell) Sclerosis Epithelioid cell component G. Malignant lymphoma, diffuse (large cell) Cleaved cell Noncleaved cell Sclerosis

21 Working Formulation - High Grade H. Malignant lymphoma (large cell, immunoblastic) Plasmacytoid Clear cell Polymorphous Epithelioid cell component I. Malignant lymphoma (lymphoblastic) Convoluted cell Nonconvoluted cell J. Malignant lymphoma (small noncleaved cell) Burkitts Follicular areas

22 Working Formulation - Miscellaneous Composite Mycosis fungoides Histiocytic Extramedullary plasmacytoma Unclassifiable Other

23 Revised European-American Lymphoma Classification Consensus conference in Berlin Germany in hematopathologists - The International Lymphoma Study Group Define diseases which can be reliably recognized with currently available morphologic, immunologic, and genetic techniques

24 Revised European-American Lymphoma Classification B-Cell Neoplasms I. Precursor B-cell neoplasm: B-precursor lymphoblastic leukemia/lymphoma II. Peripheral B-cell neoplasms T-Cell and Putative NK-Cell Neoplasms I. Precursor T-cell neoplasms: T-precursor lymphoblastic leukemia/lymphoma II. Peripheral T-cell and NK-cell neoplasms Hodgkins Disease

25 Revised European-American Lymphoma Classification Peripheral B-cell Neoplasms B-cell chronic lymphocytic leukemia/prolymphocytic leukemia/small lymphocytic lymphoma Lymphoplasmacytoid lymphoma/immunocytoma Mantle cell lymphoma

26 Revised European-American Lymphoma Classification Peripheral B-cell Neoplasms Follicle center lymphoma Provisional cytologic grades: I (small cell), II (mixed small and large cell), III (large cell) Provisional subtype: diffuse, predominantly small cell type

27 Revised European-American Lymphoma Classification Peripheral B-cell Neoplasms Marginal zone B-cell lymphoma Extranodal (MALT type +/- monocytoid B cells) Provisional category: nodal (+/- monocytoid B cells) Provisional entity: splenic marginal zone lymphoma (+/- villous lymphocytes) Hairy cell leukemia Plasmacytoma/myeloma

28 Revised European-American Lymphoma Classification Peripheral B-cell Neoplasms Diffuse large B-cell lymphoma Subtype: primary mediastinal (thymic) B-cell lymphoma Burkitts lymphoma Provisional category: high-grade B-cell lymphoma, Burkitts-like

29 Revised European-American Lymphoma Classification T-Cell and Putative NK-Cell Neoplasms T-cell chronic lymphocytic leukemia/prolymphocytic leukemia Large granular lymphocytic leukemia (LGL) T-cell type NK-cell type Mycosis fungoides/Sezary syndrome

30 Revised European-American Lymphoma Classification T-Cell and Putative NK-Cell Neoplasms Peripheral T-cell lymphomas, unspecified Provisional cytologic categories: medium sized cell, mixed medium and large cell, large cell, lymphoepithelioid cell Provisional subtype: Hepatosplenic T-cell lymphoma Provisional subtype: Subcutaneous panniculitic T-cell lymphoma

31 Revised European-American Lymphoma Classification T-Cell and Putative NK-Cell Neoplasms Angioimmunoblastic T-cell lymphoma Angiocentric lymphoma Intestinal T-cell lymphoma (+/- enteropathy associated) Adult T-cell leukemia/lymphoma

32 Revised European-American Lymphoma Classification T-Cell and Putative NK-Cell Neoplasms Anaplastic large cell lymphoma (ALCL), CD30 + T- and null cell types Provisional entity: Anaplastic large cell lymphoma, Hodgkins-like

33 Revised European-American Lymphoma Classification Hodgkins Disease Lymphocyte predominance Nodular sclerosis Mixed cellularity Lymphocyte depletion Provisional entity: Lymphocyte-rich classical Hodgkins Disease


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