Haematopathology Unit, Hospital Clinic, Barcelona University, Barcelona, Spain.
Int J Lab Hematol. 2018 May;40 Suppl 1:97-103. doi: 10.1111/ijlh.12817.
Over the last decade, there has been a significant body of information regarding the biology of the lymphoid neoplasms. This clearly supports the need for updating the 2008 WHO (World Health Organization) classification of haematopoietic and lymphoid tumours. The 2017 WHO classification is not a new edition but an update and revision of the 4th edition. New provisional entities but not new definitive entities are included, and novel molecular data in most of the entities and changes in the nomenclature in few of them have been incorporated. In the context of the mature T- and NK-cell neoplasms, the most relevant updates concern to: 1-dysregulation of the JAK/STAT pathway due to gene mutations which are common to various aggressive and indolent neoplasms; 2-incorporation of new molecular players that are relevant to the pathogenesis of these neoplasms and/or have prognostic implications; 3-inclusion of new provisional entities within the subgroups of anaplastic, primarily intestinal and cutaneous lymphomas such as breast implant-associated anaplastic large cell lymphoma, indolent T-cell lymphoproliferative disorder of the gastrointestinal tract and primary cutaneous acral CD8 T-cell lymphoma; 4-identification of poor prognostic subtypes of peripheral T-cell lymphomas not otherwise specified (PTCL, NOS) characterized by overexpression of certain genes and of a subgroup PTCL, NOS with a T follicular phenotype that now is included together with angioimmunoblastic T-cell lymphoma under the umbrella of lymphomas with a T follicular helper phenotype; and 5-refinement on the designation and definition of already established entities. A review of the major changes will be outlined.
在过去的十年中,关于淋巴肿瘤的生物学已经有了大量的信息。这显然支持更新 2008 年世界卫生组织(WHO)血液和淋巴肿瘤分类的需要。2017 年的 WHO 分类不是一个新版本,而是第四版的更新和修订。包括了新的暂定实体,但没有新的明确实体,并且在大多数实体中纳入了新的分子数据,在少数实体中改变了命名法。在成熟的 T 和 NK 细胞肿瘤方面,最相关的更新涉及:1.由于基因突变导致 JAK/STAT 途径失调,这些基因突变常见于各种侵袭性和惰性肿瘤;2.纳入与这些肿瘤的发病机制相关且/或具有预后意义的新分子因素;3.在间变性、主要是肠和皮肤淋巴瘤的亚组中纳入新的暂定实体,如乳房植入物相关间变性大细胞淋巴瘤、惰性 T 细胞胃肠道淋巴组织增生性疾病和原发性皮肤肢端 CD8 T 细胞淋巴瘤;4.确定外周 T 细胞淋巴瘤非特指型(PTCL,NOS)的预后不良亚型,其特征是某些基因的过度表达,以及具有 T 滤泡表型的 PTCL,NOS 亚组,现在与血管免疫母细胞性 T 细胞淋巴瘤一起归入具有 T 滤泡辅助表型的淋巴瘤下;5.对已建立的实体的指定和定义进行细化。将概述主要变化。