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Non-Hodgkin lymphoma may be classified into subtypes according to updated [[WHO]] classification and rate of growth.
Non-Hodgkin lymphoma may be classified into subtypes according to updated [[WHO]] classification and rate of growth.
==Classification==
==Classification==
===A. Updated WHO classification===
===A. Updated WHO classification (2016)===
* Non-Hodgkin lymphoma may be classified according to updated [[WHO]] classification into 2 groups:<ref name="”cancer">National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/publications/pdq</ref>
* Non-Hodgkin lymphoma may be classified according to updated [[WHO]] classification into 2 groups:<ref name="”cancer">National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/publications/pdq</ref>
:* B-cell neoplasms
:* B-cell neoplasms
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| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | Lymphoplasmacytic lymphoma
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | Lymphoplasmacytic lymphoma
[[Waldenström's macroglobulinemia|Waldenström's macroglubulinemia]]
[[Waldenström's macroglobulinemia|Waldenström's macroglubulinemia]]
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | Hydroa vacciniforme–like lymphoproliferative disorder
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | Hydroa vacciniforme like lymphoproliferative disorder
|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Monoclonal gammopathy of undetermined significance]] (MGUS),  
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Monoclonal gammopathy of undetermined significance]] (MGUS),  
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|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Multiple myeloma|Plasma cell myeloma]] (multiple myloma)
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Multiple myeloma|Plasma cell myeloma]] (multiple myloma)
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Enteropathy-type intestinal T-cell lymphoma]]
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Enteropathy-type intestinal T-cell lymphoma|Enteropathy associated intestinal T-cell lymphoma]]
|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Solitary plasmacytoma of bone
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Solitary plasmacytoma of bone
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|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Extraosseous plasmacytoma
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Extraosseous plasmacytoma
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Indolent T-cell lymphoproliferative disorder of the GI trac
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Indolent T-cell lymphoproliferative disorder of the GI tract
|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Monoclonal immunoglobulin deposition diseases
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Monoclonal immunoglobulin deposition diseases
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Hepatosplenic T-cell lymphoma
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Hepatosplenic T cell lymphoma|Hepatosplenic T-cell lymphoma]]
|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Extranodal marginal zone lymphoma of [[MALT lymphoma|mucosa-associated lymphoid tissue]] (MALT lymphoma)
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Extranodal marginal zone lymphoma of [[MALT lymphoma|mucosa-associated lymphoid tissue]] (MALT lymphoma)
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|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Large B-cell lymphoma with IRF4 rearrangement
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Large B-cell lymphoma with IRF4 rearrangement
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Primary cutaneous CD301 T-cell lymphoproliferative disorders Lymphomatoid papulosis Primary cutaneous anaplastic large cell lymphoma
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |Primary cutaneous CD30 T-cell lymphoproliferative disorders  
* Lymphomatoid papulosis  
* Primary cutaneous anaplastic large cell lymphoma
|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | [[Primary cutaneous follicle centre lymphoma|Primary cutaneous follicle center lymphoma]]
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | [[Primary cutaneous follicle centre lymphoma|Primary cutaneous follicle center lymphoma]]
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*DLBCL associated with chronic inflammation
*DLBCL associated with chronic inflammation
*HHV81 DLBCL, NOS
*HHV81 DLBCL, NOS
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | Angioimmunoblastic T-cell lymphoma
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | [[Angioimmunoblastic T-cell lymphoma]]
|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |T-cell/histiocyte-rich large B-cell lymphoma
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |T-cell/histiocyte-rich large B-cell lymphoma
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EBV1 mucocutaneous ulcer
EBV1 mucocutaneous ulcer
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | Nodal peripheral T-cell lymphoma with TFH phenotype
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | Nodal peripheral T-cell lymphoma with TFH phenotype
Adult T-cell lymphoma / leukemia (human T-lymphotrophic virus [HTLV] 1+)
|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Lymphomatoid granulomatosis]]
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Lymphomatoid granulomatosis]]
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|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Primary mediastinal large B-cell lymphoma|Primary mediastinal (thymic) large B-cell lymphoma]]
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Primary mediastinal large B-cell lymphoma|Primary mediastinal (thymic) large B-cell lymphoma]]
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | Breast implant–associated anaplastic large-cell lymphoma
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" | Breast implant associated anaplastic large-cell lymphoma
|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Intravascular large B-cell lymphoma]]  
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |[[Intravascular large B-cell lymphoma]]  
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |
Hepatosplenic gamma / delta T-cell lymphoma
|-
|-
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |ALK1 large B-cell lymphoma  
| style="padding: 5px 5px; background: #F5F5F5; text-align: left;" |ALK1 large B-cell lymphoma  

Revision as of 20:47, 14 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Overview

Non-Hodgkin lymphoma may be classified into subtypes according to updated WHO classification and rate of growth.

Classification

A. Updated WHO classification (2016)

  • Non-Hodgkin lymphoma may be classified according to updated WHO classification into 2 groups:[1]
  • B-cell neoplasms
  • T-cell and putative NK-cell neoplasms
Updated WHO classification of Non-Hodgkin lymphoma
B-cell neoplasms T-cell and putative NK-cell neoplasms
Precursor B-cell neoplasm Precursor T-cell neoplasm
Precursor B-acute lymphoblastic leukemia / lymphoblastic lymphoma (LBL) Precursor T-acute lymphoblastic leukemia / lymphoblastic lymphoma (LBL)
Mature B-cell neoplasms Peripheral T-cell and NK-cell neoplasms
Chronic lymphocytic leukemia / small lymphocytic lymphoma T-cell prolymphocytic leukemia
Monoclonal B-cell lymphocytosis T-cell granular lymphocytic leukemia
B-cell prolymphocytic leukemia Chronic lymphoproliferative disorder of NK cells
Splenic marginal zone lymphoma (± villous lymphocytes)

Splenic B-cell lymphoma/leukemia, unclassifiable

1. Splenic diffuse red pulp small B-cell lymphoma

2. Hairy cell leukemia-variant

Aggressive NK-cell leukemia
Hairy cell leukemia Systemic EBV positive T-cell lymphoma of childhood
Lymphoplasmacytic lymphoma

Waldenström's macroglubulinemia

Hydroa vacciniforme like lymphoproliferative disorder
Monoclonal gammopathy of undetermined significance (MGUS),
  • IgM
  • IgG/A
Adult T-cell leukemia/lymphoma
Heavy chain disease
  • µ heavy-chain disease
  • ɣ heavy-chain disease
  • α heavy-chain disease
Extranodal T/NK-cell lymphoma, nasal type
Plasma cell myeloma (multiple myloma) Enteropathy associated intestinal T-cell lymphoma
Solitary plasmacytoma of bone Monomorphic epitheliotropic intestinal T-cell lymphoma
Extraosseous plasmacytoma Indolent T-cell lymphoproliferative disorder of the GI tract
Monoclonal immunoglobulin deposition diseases Hepatosplenic T-cell lymphoma
Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) Subcutaneous panniculitis-like T-cell lymphoma
Nodal marginal zone B-cell lymphoma (± monocytoid B-cells)

pediatric

Nodal marginal zone B-cell lymphoma

Mycosis fungoides
Follicular lymphoma
  • In situ follicular neoplasia
  • Duodenal-type follicular lymphoma
  • Pediatric-type follicular lymphoma
Sézary syndrome
Large B-cell lymphoma with IRF4 rearrangement Primary cutaneous CD30 T-cell lymphoproliferative disorders
  • Lymphomatoid papulosis
  • Primary cutaneous anaplastic large cell lymphoma
Primary cutaneous follicle center lymphoma Primary cutaneous gamma delta T-cell lymphoma

Primary cutaneous CD8 aggressive epidermotropic cytotoxic T-cell lymphoma

Primary cutaneous acral CD8 T-cell lymphoma

Primary cutaneous CD4 small/medium T-cell lymphoproliferative disorder

Mantle cell lymphoma

In situ mantle cell neoplasia

Peripheral T-cell lymphoma, NOS *

Peripheral T-cell lymphoma, not otherwise characterized

Diffuse large B-cell lymphoma (DLBCL), NOS
  • Germinal center B-cell type
  • Activated B-cell type
  • Primary DLBCL of the central nervous system (CNS)
  • Primary cutaneous DLBCL, leg type
  • DLBCL associated with chronic inflammation
  • HHV81 DLBCL, NOS
Angioimmunoblastic T-cell lymphoma
T-cell/histiocyte-rich large B-cell lymphoma Follicular T-cell lymphoma
EBV1 DLBCL, NOS

EBV1 mucocutaneous ulcer

Nodal peripheral T-cell lymphoma with TFH phenotype
Lymphomatoid granulomatosis Anaplastic large cell lymphoma
  • ALK positive
  • ALK negitive
Primary mediastinal (thymic) large B-cell lymphoma Breast implant associated anaplastic large-cell lymphoma
Intravascular large B-cell lymphoma
ALK1 large B-cell lymphoma
Plasmablastic lymphoma
Primary effusion lymphoma
Burkitt lymphoma

Burkitt-like lymphoma with 11q aberration

High-grade B-cell lymphoma, with MYC and BCL2 and/or BCL6 rearrangements

High-grade B-cell lymphoma, NOS*

B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and classical Hodgkin lymphoma

B. Classification based on rate of growth

  • Non-Hodgkin lymphoma may be classified based on rate of growth into 2 groups:[2]
  • Low-grade or Indolent lymphoma
  • High-grade or Aggressive lymphoma
Non-Hodgkin lymphoma classification
Grade Description
Low-grade or Indolent lymphoma
  • Tend to grow very slowly
  • Tend to be widespread by the time they are diagnosed
  • Often involving the bone marrow and spleen
  • Often treated only when symptoms appear
  • Can shrink or seem to disappear with treatment, but they tend to come back
  • Can change into more aggressive lymphomas
  • Have a fairly good prognosis
High-grade or Aggressive lymphoma
  • Grow quickly and tend to spread to lymph nodes or other organs throughout the body
  • Cause symptoms and need treatment right away
  • Can frequently be successfully treated with intensive chemotherapy treatment
Non-Hodgkin's Lymphoma

References

  1. National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/publications/pdq
  2. "Canadian Cancer Society Grades of non-Hodgkin lymphoma".

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