Role of molecular studies in the classification of lymphoma

The classification of lymphomas has historically lacked both precision and accuracy, potentially compromising both optimal diagnosis and therapy. The genetic characterization of key oncogenic events and the advent of expression profiling have afforded the opportunity to understand, diagnose and treat these diseases in a much more rational and targeted manner. As exciting as these new and testable data are, it is also worth noting that molecular genetic analysis of the tumor in isolation will not be the sole arbiter of patient outcome. It is likely that we will remain reliant on traditional and sometimes subjective technologies, albeit probably to a lesser degree, with molecular studies significantly complementing, but certainly not replacing, microscopic, immunophenotypic and cytogenetic approaches. Furthermore, we will perhaps need to extend genotyping to the tumor milieu (the patient) in order to molecularly dissect drug metabolic pathways and the immune response.