Past classification

   

 

Older classifcation systems

Many classification systems have come and gone over the years. Here is a brief history of them.

 

Rappaport and Lukes Collins

This classification was developed before lymphoid cells were divided into B-cells and T-cells. It was developed in 1966 with the Lukes Collins modifications in 1974

 

Well-differentiated lymphocytic lymphoma small lymphocytic lymphoma
Poorly differentiated lymphocytic lymphoma 6633 (NOS), 96643 (cellular phase) also:
96653 (HD NS, lymphocyte predominance)
96663 (HD NS mixed cellularity),
96673 (HD NS, lymphocytic depletion)
follicular center cell lymphoma with a large component of small-cleaved cells.
Histiocytic lymphoma large cell lymphoma

 



 

Kiel Classification

This was developed in 1974, the first to recognize B and T cell subtypes.

B-cell T-cell
Low grade Low grade
*Lymphocytic -chronic lymphocytic and prolymphocytic leukemia -hairy-cell leukemia Lymphocytic -chronic lymphocytic and prolymphocytic leukemia
- Small, cerebriform cell -mycosis fungoides, Sézary's syndrome
Lymphoplasmacytic/cytoid (LP immunocytoma) Lymphoepithelioid (Lennert's lymphoma)
Plasmacytic Angioimmunoblastic (AILD, LgX)
*Centroblastic/centrocytic - follicular ± diffuse - diffuse T-zone
* Centrocytic Pleomorphicm, small cell (HTLV-1
High grade High grade
Centroblastic Pleomorphic, medium and large cell (HTLV-1 ±)
*Immunoblastic Immunoblastic (HTLV-1 ±)
*Large cell anaplastic
(Ki-1+
Large cell anaplastic (Ki-1+)
Burkitt's lymphoma -
*Lymphoblastic Lymphoblastic
Rare types Rare types

 



 

Working Formulation

This was developed by the National Cancer Institute in 1982 as a method of translating among the recognized classification systems for non-Hodgkin lymphoma (Rappaport, Dorfman, Lukes and Collins, Kiel, and the British Lymphoma system). The major groups are identified by letters, A - J, and grouped according to prognosis:

Most favourable Low grade A, B, C
  Intermidiate grade D, E, F, G
Least favourable High grade H, I, J

 

 

Low grade  Intermediate grade High grade
Small lymphocytic   Follicular large cell   Large cell immunoblastic  
Follicular small-cleaved cell   Diffuse small cleaved cell   Lymphoblastic  
Follicular mixed small-cleaved and large cell   Diffuse mixed small and large cell   Small non-cleaved cell (Burkitt and non-Burkitt type)  
  Diffuse large cell    

Cell types categorized as unclassified by the Working Formulation include the non-specific terms malignant lymphoma, non-Hodgkin lymphoma, diffuse malignant lymphoma, nodular or follicular malignant lymphoma, and cutaneous lymphoma.

 

Differences in histology refer to differences in the first 3 digits of the ICD-O morphology code.

 

A simultaneous diagnosis of malignant lymphocytic lymphoma (small cell type) and chronic lymphocytic leukemia (CLL) is coded to CLL

 


 

-- Updated REAL/WHO Classification --

This system was used from 2001-2009 but replaced with the current 2008 WHO classification system.

 

NOTE: The WHO  adopted a new classification system for cutaneous lymphomas. The classification system below is still the current one used, but it will eventually be integrated with these new changes to the cutaneous lymphomas.

Click here to read about the new cutaneous classification.

 

B-cell neoplasms    

T-cell and putative NK-cell neoplasms    

(Hodgkin's disease)     

  • I. Nodular lymphocyte-predominant Hodgkin's lymphoma
  • II. Classical Hodgkin's lymphoma
    • A. Nodular sclerosis Hodgkin's lymphoma
    • B. Lymphocyte-rich classical Hodgkin's lymphoma
    • C. Mixed cellularity Hodgkin's lymphoma.
    • D. Lymphocyte depletion Hodgkin's lymphoma

Back to the current REAL/WHO classification system

 

Classification systems source information