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March 8, 1985

Non-Hodgkin's Lymphoma for the Nononcologist

Author Affiliations

From the Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn.

JAMA. 1985;253(10):1431-1435. doi:10.1001/jama.1985.03350340083022

RECENT advances in the understanding of immunology have led to more precise classification of the non-Hodgkin's lymphomas (NHLs).1 However, this precision has left the internist faced with a bewildering variety of classification schemes that may have engendered as much confusion as clarification. In this review we have attempted to present the development of current nosology in a manner that will help incorporate recent classifications into daily use.

The early classification of lymphomas into giant-follicle lymphoma, lymphosarcoma, and reticulum cell sarcoma2 did not accurately describe the wide variation in histological and clinical manifestations of the lymphoproliferative diseases. Therefore, there was a need for a better scheme of classification.

CLASSIFICATION ACCORDING TO HISTOLOGY  A major advance in the classification of lymphomas was proposed by Rappaport and co-workers in 19561 (Table 1). This scheme divided NHLs based on the architectural characteristics of the lymph node and the cytological characteristics of the