Cellular classification of non-Hodgkin's lymphoma, REAL/WHO classification

In an effort to increase the understanding of lymphoma and standardize treatment, pathologists in Europe and North America have revised the classification of lymphoma (Revised European-American Lymphoma [REAL]/World Health Organization [WHO]).

The classification depends on how the lymphoma cells look under a microscope. The REAL/WHO classification system includes all cancers (neoplasms) of the lymphatic system and recognizes three main categories of lymphoma. Your doctor will use this information to help you decide which treatment will work best for you.

B-cell

  • Precursor B-cell cancers (neoplasms)
    • B-acute lymphoblastic leukemia (B-ALL)
    • Lymphoblastic lymphoma (LBL)
  • Peripheral B-cell neoplasms
    • B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma
    • B-cell prolymphocytic leukemia
    • Lymphoplasmacytic lymphoma/immunocytoma
    • Mantle cell lymphoma
    • Follicular lymphoma
    • Extranodal marginal zone B-cell lymphoma of MALT type
    • Nodal marginal zone B-cell lymphoma
    • Splenic marginal zone lymphoma
    • Hairy cell leukemia
    • Plasmacytoma/plasma cell myeloma
    • Diffuse large B-cell lymphoma
    • Burkitt's lymphoma

T-cell and natural killer-cell (NK)

  • Precursor T-cell neoplasm
    • Precursor T-acute lymphoblastic leukemia (T-ALL)
    • Lymphoblastic lymphoma (LBL)
  • Peripheral T-cell and NK-cell neoplasms
    • T-cell chronic lymphocytic leukemia/prolymphocytic leukemia
    • T-cell granular lymphocytic leukemia
    • Mycosis fungoides/Sezary syndrome
    • Peripheral T-cell lymphoma, not otherwise characterized
    • Hepatosplenic gamma/delta T-cell lymphoma
    • Angioimmunoblastic T-cell lymphoma
    • Extranodal T-/NK-cell lymphoma, nasal type
    • Enteropathy-type intestinal T-cell lymphoma
    • Adult T-cell lymphoma/leukemia (HTLV1+)
    • Anaplastic large cell lymphoma, primary systemic type
    • Anaplastic large cell lymphoma, primary cutaneous type
    • Aggressive NK-cell leukemia

Hodgkin's lymphoma (Hodgkin's disease)

  • Nodular lymphocyte-predominant Hodgkin's lymphoma
  • Classical Hodgkin's lymphoma
    • Nodular sclerosis Hodgkin's lymphoma
    • Lymphocyte-rich classical Hodgkin's lymphoma
    • Mixed cellularity Hodgkin's lymphoma
    • Lymphocyte depletion Hodgkin's lymphoma


Author: Robin Parks, MSLast Updated: June 12, 2006
Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Douglas A. Stewart, MD - Medical Oncology

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