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Klassifikation indolenter B-Zell-Lymphome

Neuigkeiten und offene Fragen

Classification of indolent B-cell lymphomas

Novelties and open questions

  • Schwerpunkt: Neue Klassifikationen in der Hämatopathologie
  • Published:
Die Pathologie Aims and scope Submit manuscript

Zusammenfassung

Die 5. Auflage der WHO-Klassifikation der Lymphome (WHO-HAEM5) und die International Consensus Classification (ICC) zeigen hinsichtlich der Einteilung indolenter B‑Zell-Lymphome wesentliche Überschneidungen, aber auch einige Differenzen. Die meisten Unterschiede, die unseren diagnostischen Alltag beeinflussen werden, betreffen die follikulären Lymphome (FL). Die Anwendung der klassischen Gradierung wird nur von der ICC weiterhin als obligat angesehen, ein diffuses Wachstumsmuster bei einem FL mit > 15 Zentroblasten/Gesichtsfeld bei starker Vergrößerung (FL Grad 3A) wird von der WHO-HAEM5 nicht mehr automatisch als diffuses großzelliges B‑Zell-Lymphom eingestuft. Eine Subgruppe von FL mit besonderen morphologischen (wie blastoide Zellen oder großen Zentrozyten) und biologischen Merkmalen wird zudem nur von der WHO-HAEM5 als eigenständige Variante beschrieben. Ansonsten finden sich mit Ausnahme der Abschaffung der B‑Prolymphozytenleukämie in der WHO-HAEM5 nur kleine Unterschiede zwischen beiden Klassifikationen, darunter geringfügige Namensänderungen einzelner Entitäten, Anpassungen diagnostischer Kriterien oder eine Aufwertung vormals „vorläufiger“ zu „eigenständigen“ Entitäten.

Abstract

The 5th edition of the WHO classification (WHO-HAEM5) and the International Consensus Classification (ICC) have considerable overlap but also some distinct differences in categorizing indolent B‑cell lymphomas. Most differences with the expected impact on the daily diagnostic routine relate to follicular lymphoma (FL). Grading of FL remains mandatory only in the ICC; a diffuse growth pattern in an FL with > 15 blasts per high-power field (FL grade 3A) is not automatically classified as DLBCL according to WHO-HAEM5, and an FL subtype with unusual morphology (blastoid or large centrocyte) and biology is recognized as an entity only in the WHO-HAEM5. With the exception of B‑prolymphocytic leukemia, which is no longer acknowledged in WHO-HAEM5, there are only minor differences between both classifications and include updated names of entities, improved diagnostic criteria, and upgrades from provisional to definite entities.

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  1. Institut für Pathologie, Universität Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland

    Ioannis Anagnostopoulos & Alberto Zamò

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  1. Ioannis Anagnostopoulos
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  2. Alberto Zamò
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Correspondence to Ioannis Anagnostopoulos.

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I. Anagnostopoulos und A. Zamò geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Anagnostopoulos, I., Zamò, A. Klassifikation indolenter B-Zell-Lymphome. Pathologie 44, 154–165 (2023). https://doi.org/10.1007/s00292-023-01186-5

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  • DOI: https://doi.org/10.1007/s00292-023-01186-5

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