CATEGORIES OF LYMPHOMA - Based primarily on WHO
|
Incidence
per year
|
Mortality
per year
|
Percentage of NHL
|
Hodgkin's lymphomas - Reed-Sternberg cell
|
7,000 |
1,300 |
- |
Non-Hodgkin's Lymphomas (NHL) B-cell and T-cell types
|
54,000 |
24,000 |
100% |
B-cell NHL
|
45,900 |
|
85% |
T-cell NHL
|
6,885 |
|
15% |
Aggressive (fast-growing)
- High or intermediate grade B-cell or T- cell NHL
|
32,400 |
|
60% |
Indolent (slow-growing)
- Low grade B-cell or T-cell NHL
|
21,600 |
|
40% |
|
Most common NHL types:
|
Most Common
Grade
|
Incidence
per year
|
Mortality
per year
|
Percentage of NHL
|
Diffuse large B-cell |
High |
|
|
31% |
Follicular cell B-cell (Center cell) |
Low |
|
|
22% |
|
Precursor B-cell and T-cell NHL:
|
Most Common
Grade
|
Incidence
per year
|
Mortality
per year
|
Percentage of NHL
|
Lymphoblastic lymphoma - B-cell - can lead to CNS type * |
High |
|
|
|
Lymphoblastic lymphoma - T-cell |
High |
|
|
|
|
Mature B-cell NHL: Markers CD19, 20, 22, 23
|
Most Common
Grade
|
Incidence
per year
|
Mortality
per year
|
Percentage of NHL
|
Burkitt's |
High |
|
|
2% |
Chronic lymphocytic leukemia/
small lymphocytic lymphoma (CLL/SLL) |
Low |
|
|
6% |
CNS (Central Nervous System) * |
High |
|
|
|
Diffuse large B-cell lymphoma |
High |
|
|
|
Follicular (center cell) lymphomas: |
Low |
|
|
|
large cell (Grade 3)
|
High |
|
|
|
mixed large and small (Grade 2)
|
Low |
|
|
|
small cleaved (Grade 1)
|
Low |
|
|
|
Hairy cell leukemia |
Low |
|
|
|
Large Cell immunoblastic |
|
|
|
|
Large B-cell lymphomas: |
High |
|
|
|
Follicular
|
High |
|
|
|
Mediastinal (thymic)
|
High |
|
|
|
Mantle cell lymphoma |
High |
|
|
6% |
Marginal zone lymphomas |
|
|
|
|
MALT - mucosa associated:
|
Low |
|
|
5% |
gastric, eye, skin, lung, salivary, orbit,
|
|
|
|
|
nasopharynx, larynx, breast
|
|
|
|
|
Nodal +/- Moncytotal b-cells
|
Low |
|
|
|
Splenic with Villous Lymphocytes
|
Low |
|
|
|
Plasma cell myeloma / plasmacytomas |
|
|
|
|
Primary amyloidosis |
|
|
|
|
Primary effusion lymphoma |
|
|
|
|
Solitary plasmacytoma of bone |
|
|
|
|
Waldenström’s Macroglobulinemia (Lymphoplasmacytic) |
|
|
|
1% |
T-cell and NK-cell NHL
(Mature cell stage unless "precursor cell" is indicated) Markers CD2, 3, 4, 5, NK: CD16, 56
|
Most Common
Grade
|
Incidence
per year
|
Mortality
per year
|
Percentage of NHL
|
Adult T-cell |
High |
|
|
|
Aggressive NK cell leukemia |
High |
|
|
|
Anaplastic large cell lymphoma - CD30 positive Subtype: Ki-l-positive |
|
|
|
|
Angioimmunoblastic T-cell lymphoma (13%) |
|
|
|
|
Blastic NK cell lymphoma (precursor cell) |
|
|
|
|
Enteropathy type T-cell lymphoma |
|
|
|
|
Extranodal NK/T cell lymphoma, nasal type (Angiocentric) |
High |
|
|
|
Gamma-delta T-cell phenotype 1 - provisional subtype |
|
|
|
|
Hepatosplenic T-cell lymphoma |
|
|
|
|
Lymphomatoid papulosis (uncertain malignant status) |
|
|
|
|
Mycosis fungoides - cutaneous (skin) t-cell lymphoma (CTCL) Subtype: Angiocentric |
Low |
|
|
|
Peripheral T-cell lymphomas, unspecified |
|
|
|
15 -20% |
Precursor T-cell lymphoma (precursor cell) |
|
|
|
|
Primary cutaneous anaplastic large cell lymphoma
(favorable prognosis) |
|
|
|
|
Sezary syndrome - leukemic form of Mycosis fungoides |
|
|
|
|
Subcutaneous panniculitis-like T-cell lymphoma |
|
|
|
|
T-cell Large granular lymphocytic leukemia |
|
|
|
|
T-cell proliferation of uncertain malignant potential |
|
|
|
|
T-cell prolymphocytic leukemia - T-cell CLL (1% of CLL) |
|
|
|
|
|
|
|
|
|
"About 85% of non- Hodgkin's lymphomas arise in B-cells; the rest occur in T-cells. Activation of a gene called BCL-2 is believed to be partly responsible for many B-cell lymphomas. This defect prevents apoptosis in the lymphoma cells (a natural process whereby cells self- destruct)."
"Lymphomas are also grouped by certain properties:
Size (large versus small).
Shape (round versus irregular).
Whether they are or resemble blood plasma cells.
Whether they are follicular (organized in round clusters)
or diffuse (spread evenly throughout the lymph node)." - ucdavis.edu
Systems for classifying non-Hodgkin's Lymphoma
Types of Lymphoma > Classifications (types) of lymphoma
Last update: 01/03/2014
|
What's New:
|
Recommended: Dr. Sharman's CLL & Lymphoma Blog:
Making sense of all the different lymphomas
|
|
Classifications - Ash Education:
The 2008 WHO classification of lymphomas: implications for clinical practice and translational research
|
Detailed background:
|
Revised European-American Classification of Lymphoid Neoplasms:
A Proposal From the International Lymphoma Study Group bloodjournal.hematology.org
|
|
Pathology of b-cell lymphomas surgpathcriteria.stanford.edu/
|
|
Pathology of t-cell lymphomas surgpathcriteria.stanford.edu
|
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PATHOLOGY OF HODGKIN’S AND NON-HODGKIN’S LYMPHOMAS medschool.pitt.edu pdf
|
|
Lymphoma 101: Biology and Classification-
Richard I. Fisher, MD Transcript or Webcast
|
What is the difference between lymphoma and non-Hodgkins lymphoma?
We have someone in our family who has been diagnosed in the past with non-Hodgkins lymphoma and would like to know the difference. Are the treatments and prognosis the same?
Answer: Lymphoma is the broadest category of a family of related blood cancers. That is it is any blood cancer that involves lymphocytes (the cell type of origin) that is found primarily in the lymphatic system. It includes all the subtypes or variations of lymphoma.
The diagnosis is based on the type of lymphocytes involved - the so called cell of origin.
In Hodgkin's disease, the abnormal lymphocyte is the Reed-Sternberg cell (a B lymphocyte). This particular lymphocyte isn't found in other types of lymphomas. All other types of lymphomas are called non-Hodgkin's (NHL). There are about 30 subtypes of NHL.
Identifying the correct type of lymphoma is important because treatment for Hodgkin's and non-Hodgkin's can be very different. Pathologists can distinguish between Hodgkin's and non-Hodgkin's by examining the cell sample from a biopsy under a microscope.
Lymphomas
Hodgkins (often curable)
Nodular Sclerosis, Mixed Cellularity, Lymphocyte Depleted, Lymphocyte Predominant
Non-Hodgkins
Diffuse large b-cell (aggressive)
Follicular (indolent)
Mantle Cell (aggressive or indolent)
MALT (indolent)
T-cell and NK-cell types
. . .
Other ways to categorize lymphomas are by the rate of growth: indolent, intermediate, and aggressive.
Another ways is by areas of presentation: such as CNS (central nervous system), which is rare, and MALT which presents in mucosal linings, such as the stomach.
Anther way to classify is by lymphocyte type: b-cell, t-cell, NK-cell. (B-cell is most common).
Treatments for the various subtypes of lymphoma can vary significantly.
This group supports all types of lymphoma. Or does it's best to find and post evidence-based information as questions comes in.
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|
Rappaport: Based on morphology (how the cells look in the microscope) alone; used until the 1970s.
|
|
Kiel: Based on morphologic and immunologic (what types of proteins are produced by the cell) characteristics; updated in 1992; used mainly in Europe
|
|
National Cancer Institute's Working Formulation (IWF): Divided lymphomas into low-grade, intermediate-grade and high-grade, with ten sub-groups labeled A to J.
|
|
Revised European-American Classification of Lymphoid Neoplasms (REAL): Describes the different types of lymphomas as entities, with each type classified according to cell origin, based on morphologic, immunologic and genetic characteristics; introduced in 1994.
|
|
World Health Organization (WHO): Uses the latest information on the appearance and growth pattern of the cancerous cells and genetic features. It also offers a more accurate description of the different types of tumors and identifies several new categories of non-Hodgkin's lymphatic cancer; updated version of REAL. Introduced in 2001 as an international standard.
|
Resources
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Background information on NHL - FDA
|
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Table of contents-Lymphomas and Plasma cell neoplasms pathologyoutlines
|
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WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues Cancer.gov
|
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The Revised European-American Classification of Lymphoid Neoplasms
(REAL classification) umich.edu
|
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Pathology of Lymphomas ncl.ac.uk
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