large cell non hodgkin's lymphoma | Classification of non-Hodgkin lymphomas

Classification of non-Hodgkin lymphomas



Your team of health professionals must determine the exact type of NHL you are suffering from, or its classification, as it is a way for doctors to choose the most appropriate treatment for you. The NHL is not a single disease; Rather, it is part of a group of at least 50 closely related cancers that affect the lymphatic system. The biopsy procedure is paramount in the classification process because it provides cells taken directly from the tumor so that doctors can establish from what cell type the tumor has formed (B cells or T cells), and other important information about tumor cells. B-cell lymphomas are much more common than T-cell lymphomas. The biopsy procedure is performed by a surgeon and the cells are observed microscopically by a pathologist to determine whether or not there is a cancer presence. The name of the tissue diagnosis is often given to the biopsy (diagnosis is made from tissue or cell observation) and the treatment cycle given to the patient is determined based on these results.

Once the surgeon has performed the biopsy and the pathologist has observed the tissues and recorded the tumor cell information, they must use this information to determine the exact type of NHL you are suffering from. The classification process is complicated. Many organizations have tried to simplify the classification process and establish a standardized international standard NHL classification system. The most frequently used system is the World Health Organization's Lymphoma classification system. It allows to classify the different types of NHL according to a standardized model for doctors from all over the world.

The classification of the World Health Organization's B-cell and T-cell lymphomas
The most frequently used method for classifying NHL is the classification of lymphoid malignancies of the World Health Organization. Here is a list of the different types of NHL according to the World Health Organization:

B-Cell lymphomas
B cell precursor lymphomas

Lymphoblastic lymphoma/leukemia with B cell precursors
Mature B Cell lymphomas

Follicular lymphoma
Mantle cell lymphoma
Diffuse lymphoma with large B cells
Mediastinal lymphoma with large B cells
Burkitt's lymphoma
B-Cell chronic lymphocytic leukemia/small lymphocyte lymphocytic lymphoma
The lymphoma of the marginal zone
Extra-ganglionic B-cell lymphoma of the marginal area of the lymphoid tissue type associated with the mucous membranes (MALT)
B-cell lymphoma of the splenic marginal zone
Ganglionic lymphoma of the marginal zone
Lymphoplasmocytaire lymphoma (the waldenstrom of Macroglobulinemia)


T-Cell lymphomas
T cell precursor lymphomas

Lymphoblastic lymphoma/leukemia with precursors of T cells
Mature T-cell lymphomas

Leukemia-Adult T-cell lymphoma
Anaplastic lymphoma with large cells
T-cell cutaneous lymphoma (including fungoides fungus and sezary syndrome)
Peripheral T-Lymphomas:
Subcutaneous T-type lymphoma Panniculitis
T Hepatosplenic Gamma-Delta lymphoma
Intestinal T-type lymphoma Entéropathique
Extra-ganglionic nasal T-type lymphoma
Angioimmunoblastique T lymphoma
Peripheral T lymphoma, not specified

The NHL clinical Ranking

Once the type or classification of the NHS has been established, it is important to determine the stage and degree of differentiation of the NHL. The degree of differentiation of the tumor provides information on the aggressiveness of the tumor and helps to predict how it will behave. This information is used to determine the intensity of the treatment strategy. The degree of differentiation is established by the appearance of cancer cells, their unique characteristics, their functioning and their rapid evolution and division. We are talking about the poorly differentiated, moderately differentiated or well-differentiated NHL. The poorly differentiated NHL are often called indolent NHL or slow growth. The moderately differentiated or well-differentiated NHL are often called aggressive or fast-growing NHL.

The following table summarizes the process of classification, stadium establishment and NHL differentiation:

NHL Description Details Classification NHL Type stage magnitude of propagation degree of differentiation aggression → NHL indolent (poorly differentiated, slow-growing)

→ Aggressive (moderately and well-differentiated, fast-growing) NHL

NHL indolent and aggressive

NHL is often referred to as indolent or aggressive

The indolent NHL is a poorly differentiated NHL, i.e. the growth of the tumor is very slow and often patients only have symptoms at an advanced stage of the disease. Therefore, at the time of diagnosis, the indolent NHL tends to be extended. Patients who are diagnosed with an indolent NHL do not require immediate treatment, the method used is often to wait while remaining vigilant. Treatment is ultimately necessary: it is effective in reducing tumours and providing the patient with a disease-free period called remission. However, the indolent NHL may reappear and additional treatment cycles are often required. The poorly differentiated indolent NHL sometimes turns into lymphoma moderately or well differentiated (aggressive), and at this stage the patient requires more urgent and intensive treatment. However, indolent NHL patients often live for a long time and enjoy a good quality of life, and some patients may never need treatment. Follicular lymphoma, small lymphocyte lymphocyte lymphoma, and mucosa-associated lymphoid tissue lymphoma are examples of indolent NHL.

The moderately or well-differentiated NHL generally have much faster growth than indolent lymphomas, and for this reason they are described as aggressive or fast-growing lymphomas. Unlike indolent lymphomas, aggressive NHL requires intensive treatment as soon as the diagnosis is established. Even if the word aggressive seems scary, aggressive lymphomas really react very well to treatment and patients can often heal. Indolent lymphomas that are transformed into aggressive lymphomas may be more difficult to treat. The following table gives you an overview of the major differences between an indolent NHL and an aggressive NHL. An explanation of all different types of NHL is as a result.