Morphologic and Immunologic Terms for Lymphomas
aultk.mmcwp4@mmc.org
Wed, 8 Jan 97 9:46:17 -0500
I have been "listening" to the discussion about the
confusion between terms like "follicular lymphoma" and
specific immunophenotypes with interest because this is a
topic of interest to me for many years. At the risk of
offending some of my good friends on this list I would like to
add my two cents to the discussion and maybe expand it
somewhat.
I think that we are all gratified that the continual evolution in
lymphoma classification has begun to utilize
immunophenotypic descriptions more and more - this is long
overdue. However, we must remember that all of the
historical classifications, especially those including such
terms as "follicular", "mantle", etc. are based on (highly
subjective in my view) morphology. We now seem to be in a
transition phase between morphologic descriptions and
immunophenotypic and genetic definitions of these diseases.
We are asking for a lot of confusion, and we are doing
ourselves a disservice, if we keep trying to align morphologic
descriptions with specific immunophenotypes.
In my view, it is especially unfortunate when we create new
disease entities based not upon clinical criteria but upon
variations in our own classification systems. For example:
is a CD10 positive follicular lymphoma a different disease
than CD10 negative follicular lymphoma? We shouldn't
mistake a failure of our multiple classification systems for
new diseases!
This may a lengthy restatement of the obvious, but I needed
to say it - and I feel better now!
Ken Ault
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