Jaffe Elaine S, Barr Paul M, Smith Sonali M
From the Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD; Wilmot Cancer Institute, University of Rochester, Rochester, NY; Section of Hematology/Oncology, The University of Chicago, Chicago, IL.
Am Soc Clin Oncol Educ Book. 2017;37:535-546. doi: 10.1200/EDBK_175437.
Improved delineation of lymphoid malignancy biology has prompted refinement of the 2008 World Health Organization (WHO) classification of hematopoietic and lymphoid tumors with a new framework introduced in 2016. This knowledge has provided valuable insights regarding management. Early clonal proliferations have been set apart given their limited potential for malignant dissemination. Increasing knowledge of molecular drivers of aggressive lymphomas has allowed subclassification and opportunity for clinical investigations to personalize therapy. New insights into T-cell pathophysiology has allowed grouping based on shared molecular and cellular features. This article will summarize the key changes in terms of diagnosis and histopathologic definitions, the impact of these changes on clinical management, and the challenges of future research in this field.
对淋巴恶性肿瘤生物学认识的不断提高促使2008年世界卫生组织(WHO)造血与淋巴组织肿瘤分类得以完善,并于2016年引入了新的框架。这些知识为疾病管理提供了宝贵的见解。早期克隆性增殖因其恶性播散潜力有限而被区分开来。对侵袭性淋巴瘤分子驱动因素的了解不断增加,使得能够进行亚分类,并为个性化治疗的临床研究提供了机会。对T细胞病理生理学的新认识使得能够根据共同的分子和细胞特征进行分组。本文将总结在诊断和组织病理学定义方面的关键变化、这些变化对临床管理的影响以及该领域未来研究面临的挑战。