Hodgkins Lymphoma

Given the increasing evidence that Hodgkin's disease is a B-cell neoplasm,20,21 the authors of the REAL classification took the decision to include Hodgkin's disease in the lymphoma classification albeit as a separate table. This concept was continued in the WHO classification with the modification that Hodgkin's disease is now designated as Hodgkin's lymphoma (HL). There is, however, still a preference for maintaining the "Hodgkin" eponym since in this way, the unique features of HL, including, importantly, its specific therapy and good prognosis will continue to be recognized. Not surprisingly, the classification of this disorder is little changed from those of Jackson and Parker, and Lukes and Collins. The only changes in its classification are the implicit recognition that lymphocyte-predominant HL is a different disorder from classical HL and the addition of the entity "lymphocyte-rich HL." The intention is that the inclusion of this new category will serve to prevent misdiagnosis of these cases as lymphocyte-predominant HL especially when they present with nodular or follicular histology.22 It could be argued that Hodgkin's lymphoma eventually will be listed in the table of B-cell lymphomas.

The World Health Organization classification of lymphoid malignancies

Table 51.1

B-cell neoplasms

Precursor B-cell neoplasm

B-cell lymphoblastic lymphoma/leukemia Mature B-cell neoplasms

Chronic lymphocytic leukemia/small lymphocytic lymphoma

Prolymphocyte leukaemia Lymphoplasmacytic lymphoma Splenic marginal zone lymphoma Hairy cell leukaemia Plasma cell myeloma

Monoclonal gammopathy of undetermined significance

Solitary plasmacytoma of bone

Extraosseous plasmacytoma

Primary amyloidosis

Heavy chain diseases

Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT-lymphoma) Nodal marginal zone lymphoma Follicular lymphoma Mantle cell lymphoma Diffuse large B-cell lymphoma Mediastinal (thymic) large B-cell lymhoma Intravascular large B-cell lymphoma Primary effusion lymphoma Burkitt lymphoma B-cell proliferations of uncertain malignant potential Lymphomatoid granulomatosis

Posttransplant lymphoproliferative disorder, polymorphic

T and putative NK-cell neoplasms

Precursor T-cell neoplasm

T-lymphoblastic lymphoma/leukemia Mature T-cell and NK-cell neoplasms T-cell prolymphocytic leukemia T-cell large granular lymphocytic leukemia Aggressive NK-cell leukemia Adult T-cell lymphoma/leukemia (HTLV-1 +) Mycosis fungoides and Sezary syndrome Extranodal T/NK-cell lymphoma, nasal type Enteropathy-type T-cell lymphoma Angioimmunoblastic T-cell lymphoma Peripheral T-cell lymphoma unspecified Hepatosplenic T-cell lymphoma Subcutaneous panniculitis-like T-cell lymphoma Blastic NK-cell lymphoma Angioimmunoblastic T-cell lymphoma Peripheral T-cell lymphoma, unspecified Systemic anaplastic large cell lymphoma T-cell proliferations of uncertain malignant potential Primary cutaneous CD30 positive lymphoproliferative disorders

Hodgkin's lymphoma

Nodular lymphocyte predominance Classical

Nodular sclerosis Lymphocyte rich (nodular) Mixed cellularity Lymphocyte depletion

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