Anagnostopoulos Ioannis, Zamò Alberto
Institut für Pathologie, Universität Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland.
Pathologie (Heidelb). 2023 May;44(3):154-165. doi: 10.1007/s00292-023-01186-5. Epub 2023 Apr 24.
The 5th edition of the WHO classification (WHO-HAEM5) and the International Consensus Classification (ICC) have considerable overlap but also some distinct differences in categorizing indolent B‑cell lymphomas. Most differences with the expected impact on the daily diagnostic routine relate to follicular lymphoma (FL). Grading of FL remains mandatory only in the ICC; a diffuse growth pattern in an FL with > 15 blasts per high-power field (FL grade 3A) is not automatically classified as DLBCL according to WHO-HAEM5, and an FL subtype with unusual morphology (blastoid or large centrocyte) and biology is recognized as an entity only in the WHO-HAEM5. With the exception of B‑prolymphocytic leukemia, which is no longer acknowledged in WHO-HAEM5, there are only minor differences between both classifications and include updated names of entities, improved diagnostic criteria, and upgrades from provisional to definite entities.
世界卫生组织分类第5版(WHO-HAEM5)和国际共识分类(ICC)在惰性B细胞淋巴瘤的分类上有相当多的重叠,但也存在一些明显差异。与日常诊断常规预期影响相关的大多数差异与滤泡性淋巴瘤(FL)有关。FL分级仅在ICC中仍然是强制性的;根据WHO-HAEM5,在每高倍视野有>15个原始细胞的FL中出现弥漫性生长模式(FL 3A级)不会自动归类为弥漫性大B细胞淋巴瘤(DLBCL),并且具有不寻常形态(母细胞样或大中心细胞)和生物学特征的FL亚型仅在WHO-HAEM5中被视为一个独立实体。除了WHO-HAEM5中不再认可的B-原淋巴细胞白血病外,两种分类之间只有细微差异,包括实体名称更新、诊断标准改进以及从临时实体升级为确定实体。