Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Hematology Am Soc Hematol Educ Program. 2009:523-31. doi: 10.1182/asheducation-2009.1.523.
The 4(th) edition of the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues published in 2008 builds upon the success of the 2001 3(rd) edition; new entities are defined, and solutions for problematic categories are sought. Recent studies have drawn attention to the biological overlap between classical Hodgkin lymphoma (CHL) and diffuse large B-cell lymphomas (DLBCL). Similarly, there is a greater appreciation of the borderlands between Burkitt lymphoma and DLBCL. Strategies for the management of these borderline lesions are proposed. Additionally, age-specific and site-specific factors play an important role in the definition of several new entities, which also have biological underpinnings. Among the peripheral T-cell lymphomas (PTCL), more precise definitions were introduced for several entities, including anaplastic large cell lymphoma, angioimmunoblastic T-cell lymphoma, enteropathy-associated T-cell lymphoma, and subcutaneous panniculitis-like T-cell lymphoma. Several new variants of primary cutaneous T-cell lymphomas are proposed. Finally, the subclassification and categorization of the most common lymphoma subtypes, follicular lymphoma (FL) and DLBCL, were altered to enhance diagnostic accuracy and aid in clinical management. The 2008 WHO classification also draws attention to early events in lymphomagenesis. These lesions help delineate the earliest steps in neoplastic transformation and generally mandate a conservative therapeutic approach. The 2001 classification was rapidly adopted for clinical trials and successfully served as a common language for scientists comparing genetic and functional data. The modifications made in the 2008 classification are the result of this successful partnership among pathologists, clinicians, and biologists, but are only a stepping stone to the future.
2008 年出版的第四版《世界卫生组织造血和淋巴组织肿瘤分类》建立在 2001 年第三版成功的基础上;定义了新的实体,并为有问题的类别寻找解决方案。最近的研究引起了人们对经典霍奇金淋巴瘤(CHL)和弥漫性大 B 细胞淋巴瘤(DLBCL)之间生物学重叠的关注。同样,人们对伯基特淋巴瘤和 DLBCL 之间的边界有了更多的认识。提出了管理这些边界病变的策略。此外,年龄特异性和部位特异性因素在定义几个新实体方面发挥了重要作用,这些实体也有生物学基础。在外周 T 细胞淋巴瘤(PTCL)中,对几个实体,包括间变性大细胞淋巴瘤、血管免疫母细胞性 T 细胞淋巴瘤、肠病相关 T 细胞淋巴瘤和皮下脂膜炎样 T 细胞淋巴瘤,进行了更精确的定义。提出了几种新的原发性皮肤 T 细胞淋巴瘤的变体。最后,对最常见的淋巴瘤亚型滤泡性淋巴瘤(FL)和 DLBCL 的亚分类和分类进行了修改,以提高诊断准确性并有助于临床管理。2008 年世界卫生组织分类还提请注意淋巴瘤发生的早期事件。这些病变有助于描绘肿瘤转化的最早步骤,通常需要采取保守的治疗方法。2001 年的分类很快被用于临床试验,并成功地成为科学家比较遗传和功能数据的通用语言。2008 年分类中的修改是病理学家、临床医生和生物学家之间成功合作的结果,但这只是迈向未来的一个步骤。