[Clinical and pathological reassessment of 493 cases of non-Hodgkin's lymphomas according to current WHO classification of lymphoid neoplasms].
OBJECTIVE
To investigate the clinical and pathological features of non-Hodgkin's lymphoma (NHL) and to evaluate the applicability of the new WHO classification of lymphoid neoplasms.


METHODS
According to the new WHO classification, a total of 500 cases of non-Hodgkin's lymphoma diagnosed during the period 1992 - 2003 were reviewed and reappraised with their morphological, immunological and clinical characteristics. Clinical survival analysis was performed in 156 cases that accompanied with follow-up data.


RESULTS
Among 500 cases previously diagnosed as lymphomas, 493 cases (98.6%) were confirmed to be NHL, of which B-cell neoplasms was 69.0% and T/NK-cell neoplasms 29.8%. Overall, 6 subtypes including diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), unspecified peripheral T-cell lymphoma (PT-un), precursor T-lymphoblastic lymphoma (T-LBL), extranodal marginal zone B-cell lymphoma of MALT type (MALT) and B-small lymphocytic lymphoma (B-SLL) were among the most common subtypes. In pediatric and young patient populations, the most common subtypes were LBL, DLBCL and Burkitt's lymphoma. The frequency of LBL in all patients, especially in the juniors, was much higher than those reported outside Mainland China, and the frequency of FL was much higher than the reported in Mainland China. The frequency of FL was much higher than the reported in Mainland China. Clinical survivals among different histological subtypes of NHL varied considerably with statistic significance (P < 0.001). Marginal zone B-cell lymphoma and SLL demonstrated the best prognosis, LBL and PT-un both the worst, whereas DLBCL and FL had an intermediate prognosis, however, subgrouping of FL according to WHO classification did not reveal a significant survival difference (P > 0.05).


CONCLUSIONS
Basing upon the results of a comprehensive survey on the morphologic features, immunophenotyping and clinical data of the above cases, the new WHO classification of lymphoid neoplasms is practical and easily applicable for routine pathological evaluation of lymphoproliferaive disorders and in guiding the clinical management. It appears that the diagnostic and grading criteria for FL in Mainland China need to be re-evaluated.
Xiao
Chang
C
The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China.
Su
Zu-lan
ZL
Wu
Qiu-liang
QL
Gao
Hong-yi
HY
Fang
Jian-chen
JC
Xia
Zhong-jun
ZJ
Guan
Zhong-zhen
ZZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002051:Burkitt Lymphoma / Q000453:epidemiology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural; D016393:Lymphoma, B-Cell / Q000145:classification / Q000453:epidemiology / Q000473:pathology; D008224:Lymphoma, Follicular / Q000145:classification / Q000453:epidemiology / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000453:epidemiology / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000145:classification* / Q000453:epidemiology / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000145:classification / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014944:World Health Organization