Rappaport classification of non-Hodgkin's lymphoma: histologic features and clinical significance

The architectural arrangement of the neoplastic cells and their cytologic identification form the histologic basis of the Rappaport classification of non-Hodgkin's lymphomas clinical studies have shown the favorable prognosis of the nodular lymphomas while the diffuse lymphomas irrespective of cell type have a poor prognosis. Several recent studies have shown that pathologists can identify the nodular and diffuse patterns with a high degree of reproducibility. The cytologic subclassification has, however, not achieved a similar high degree of reproducibility. The Southwest Oncology Group study has shown the most reproducible subgroups to be the nodular poorly differentiated lymphocytic malignant lymphoma (ML) and the diffuse histiocytic ML. The clinical significance of the Rappaport classification when applied to childhood lymphomas is not as clear as in adult lymphomas. In view of the recent description of a new clinicopathologic entity primarily in children and adolescents (ie, lymphoblastic ML), IT IS APPARENT THAT THE CHILDHOOD LYMPHOMAS Will have to be examined more critically in order to determine the clinical significance of this classification. Although some have proposed new classifications of these lymphomas based upon immunologic identification of cell origin, none have been shown to be of clinical significance. Based on recent immunologic and clinical studies, a modified classification of the non-Hodgkin's lymphoma is proposed which does not alter its clinical usefulness.