Choi John Kim, Quintanilla-Martinez Leticia
Department of Pathology, The University of Alabama at Birmingham, WP P30N, 619 19Th Street South, Birmingham, AL, 35249-7331, USA.
Institute of Pathology and Neuropathology, Eberhard Karls University of Tuebingen and Comprehensive Cancer Center, University Hospital Tuebingen, Liebermeisterstr. 8, 72076, Tuebingen, Germany.
Virchows Arch. 2025 Jan;486(1):81-100. doi: 10.1007/s00428-024-03980-9. Epub 2024 Dec 21.
Only 10% of new lymphoma diagnoses in the USA occur in children < 15 years. Although the same diagnostic criteria apply to both adult and pediatric lymphomas, there are important differences in some lymphoma subtypes. These differences are recognized by the World Health Organization (WHO) with the recent 2022 classification of pediatric tumors including pediatric hematopoietic tumors. Here, we review the WHO classification scheme for pediatric lymphomas and summarize the diagnostic criteria, recent genetic findings, and differences from their adult counterparts for some subtypes including those yet to be included as a definitive subtype. In general, there are differences in relatively frequency, genetic mutation, and prognosis with the pediatric counterpart often having better prognosis. Emerging B-cell lymphomas with recurrent gene alterations such as IRF4 rearrangement and 11q gain/loss chromosomal alterations will be reviewed. The overlapping pathological, clinical, and molecular features between pediatric-type follicular lymphoma (PTFL) and pediatric nodal marginal zone lymphoma (PNMZL) suggesting one disease with broad morphological spectrum will be discussed. The pathogenetic role of EBV in subclassifying Burkitt lymphoma is highlighted. The revised classification of the EBV-positive lymphoproliferative disorders in children is discussed. This review will focus on novel findings, areas of special interest, and diagnostic challenges in pediatric lymphomas.
在美国，新诊断出的淋巴瘤病例中只有10%发生在15岁以下的儿童身上。尽管成人和儿童淋巴瘤适用相同的诊断标准，但某些淋巴瘤亚型存在重要差异。世界卫生组织（WHO）在其最近的2022年儿童肿瘤分类（包括儿童造血系统肿瘤）中认识到了这些差异。在此，我们回顾了WHO的儿童淋巴瘤分类方案，总结了诊断标准、近期的遗传学发现，以及某些亚型与成人淋巴瘤亚型的差异，这些亚型包括尚未被确认为明确亚型的淋巴瘤。总体而言，儿童淋巴瘤在相对发病率、基因突变和预后方面存在差异，儿童淋巴瘤的预后通常较好。我们将对具有复发性基因改变的新兴B细胞淋巴瘤进行综述，例如IRF4重排和11号染色体的获得/缺失改变。我们还将讨论儿童型滤泡性淋巴瘤（PTFL）和儿童淋巴结边缘区淋巴瘤（PNMZL）之间重叠的病理、临床和分子特征，这表明它们可能是一种具有广泛形态谱的疾病。EBV在伯基特淋巴瘤亚分类中的致病作用也将得到强调。我们还将讨论儿童EBV阳性淋巴增殖性疾病的修订分类。本综述将聚焦于儿童淋巴瘤的新发现、特别感兴趣的领域以及诊断挑战。
