Division of Hematopathology, University of Pittsburgh School of Medicine, UPMC Presbyterian, Hill Building, Room 359, 3477 Euler Way, Pittsburgh, PA 15213, USA.
Department of Laboratory Medicine, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Hum Pathol. 2020 Jan;95:55-77. doi: 10.1016/j.humpath.2019.08.019. Epub 2019 Sep 5.
The last century and a half has seen first the recognition of lymphomas, and then the publication of one lymphoma classification after another often together with highly critical comments about preceding classifications or a welcome that was less than warm. The introduction of HUMAN PATHOLOGY in 1970 came just before one of the very acrimonious periods in lymphoma classification, as we were learning more about the normal immune system and with the proposed functional lymphoma classifications of Lukes/Collins and Kiel in 1974 relating the lymphomas to their normal B-cell or T-cell 'counterparts'. Those difficult times were followed by the regressive strictly morphologic NCI Working Formulation in 1982, with the REAL classification in 1994 putting us back on a rational path, once again grouping the lymphoid neoplasms first into those of B-cell and T- and putative NK-cell origin, and then using multiple parameters to define specific entities. Planning for the first modern WHO lymphoma classification began soon afterward, with concordance and collegiality leading to the 2001 WHO classification, which then evolved with publication of the 2008 and 2016 WHO classifications. While this review looks at these important past developments which have gotten us to where we are today, it also concentrates on where we are now, what has been learned since the most recent WHO classification and 'Blue Book' were published and on some of the unanswered questions that remain as we look to the future.
上个世纪和半个世纪以来，首先认识到了淋巴瘤，然后又出版了一个又一个淋巴瘤分类，这些分类往往伴随着对先前分类的高度批评，或者是不温不火的欢迎。1970 年出版的《人类病理学》正值淋巴瘤分类非常激烈的时期之一，因为我们对正常免疫系统的了解越来越多，同时，Lukes/Collins 和 Kiel 提出的功能性淋巴瘤分类将淋巴瘤与其正常 B 细胞或 T 细胞“对应物”联系起来。在那段艰难的时期之后，1982 年出现了 NCI 严格形态学工作分类，1994 年的 REAL 分类使我们再次走上了合理的道路，再次将淋巴肿瘤分为 B 细胞和 T 细胞以及假定的 NK 细胞起源，然后使用多个参数来定义特定实体。随后，不久之后就开始计划进行第一次现代 WHO 淋巴瘤分类，一致性和合作性促成了 2001 年的 WHO 分类，然后随着 2008 年和 2016 年 WHO 分类的出版而不断发展。虽然本综述着眼于这些重要的过去发展，这些发展使我们走到了今天的位置，但它也关注我们现在所处的位置，自最近出版的 WHO 分类和“蓝皮书”以来所学到的内容，以及在展望未来时我们仍然存在的一些未解答的问题。
