Department of Haematology and Oncological Sciences L. and A. Seràgnoli, Bologna University School of Medicine, Bologna, Italy.
Semin Diagn Pathol. 2011 May;28(2):113-23. doi: 10.1053/j.semdp.2011.02.001.
The classification of malignant lymphomas remained controversial for over 30 years. The first scheme was proposed by Rappaport in the '60th and was based on incorrect histogenetic concepts. To overcome these limitations, several groups formulated new proposals in '70th. Among these two merited attention: the Lukes and Collins and the Kiel Classifications. They were based on the assumption that each lymphoma category might be related to a precise differentiation step of the lymphoid system, thus excluding any correlation with histiocytes, present on the Rappaport scheme. The Kiel Classification became very popular in Europe, while the one of Luke and Collins did not meet success in the United States (U.S.). In 1978, the National Cancer Institute proposed an international trial to compare the classifications used in Europe and U.S. The result was the genesis of the Working formulation, the tool for lymphoma classification in the U.S. up to the early '90th, but which was conversely rejected in Europe. In order to get over this lack of transatlantic communication, in 1994 the Revised European-American Lymphoma (REAL) Classification was proposed by the International Lymphoma Study Group. Its goal was to list "real" entities, each defined by the presence of homogeneous morphologic, phenotypic, cytogenetic, molecular, and clinical criteria, along with the possible recognition of its normal counterpart. The REAL Classification became the model for the WHO Classification of all haematopoietic tumours published in 2001. The present review aims to analyse future perspectives after the fourth edition of the WHO Classification released in 2008.
恶性淋巴瘤的分类在 30 多年来一直存在争议。第一个方案是 Rappaport 在 60 年代提出的，该方案基于错误的组织发生概念。为了克服这些局限性，70 年代的几个小组提出了新的建议。其中两个值得注意：Lukes 和 Collins 分类和 Kiel 分类。它们基于这样的假设，即每种淋巴瘤类别可能与淋巴细胞系统的精确分化步骤有关，因此排除了与 Rappaport 方案中存在的组织细胞的任何相关性。Kiel 分类在欧洲非常流行，而 Lukes 和 Collins 分类在美国没有成功。1978 年，美国国家癌症研究所提出了一项国际试验，以比较欧洲和美国使用的分类。结果是产生了工作分类，这是美国直到 90 年代初用于淋巴瘤分类的工具，但在欧洲却被拒绝。为了克服这种跨大西洋沟通的缺乏，1994 年国际淋巴瘤研究组提出了修订的欧洲-美洲淋巴瘤（REAL）分类。其目标是列出“真实”的实体，每个实体都由同质的形态学、表型、细胞遗传学、分子和临床标准定义，并可能识别其正常对应物。REAL 分类成为 2001 年发布的世界卫生组织所有造血肿瘤分类的模型。本综述旨在分析 2008 年发布的第四版世界卫生组织分类后的未来展望。
