1. ‫خدا‬ ‫نام‬ ‫به‬
The 2008 WHO Classification of Lymphoid
Neoplasms

3. ‫بندی‬ ‫تقسیم‬ ‫اساس‬WHO
•‫اطالعات‬ ‫تمای‬ ‫از‬ ‫استفاده‬(،‫ایمونوفنوتیپ‬ ،‫سیتوشیمی‬ ،‫مورفولوژی‬
،‫ژنتیک‬‫بالینی‬ ‫نمای‬)
•‫عمومی‬ ‫موافقت‬( Consensus Classification)
•‫رسانی‬ ‫روز‬ ‫به‬ ‫قابلیت‬

4. ‫بندی‬ ‫تقسیم‬ ‫تغییرات‬WHO 2008
•‫قدیمی‬ ‫بیماریهای‬ ‫برای‬ ‫جدید‬ ‫نامهای‬
•‫دیگر‬ ‫گروه‬ ‫به‬ ‫گروه‬ ‫یک‬ ‫از‬ ‫بیماری‬ ‫یک‬ ‫جابجایی‬
•‫تقسیم‬ ‫در‬ ‫اصلی‬ ‫شاخص‬ ‫یک‬ ‫عنوان‬ ‫به‬ ‫ژنتیک‬ ‫اختالت‬ ‫سهم‬ ‫افزایش‬
‫بندی‬
•‫عنوان‬ ‫تحت‬ ‫گروههایی‬Provisional entity
•‫ضایعات‬ ‫به‬ ‫بیشتر‬ ‫توجه‬in situ
Monoclonal B cell lymphocytosis
In situ FL
In situ MCL
Early gastric MALT lymphoma

5. ‫بندی‬ ‫تقسیم‬ ‫تغییرات‬WHO 2008
(‫ادامه‬)
•‫بیماری‬ ‫تعریف‬ ‫در‬ ‫فاکتورکلیدی‬ ‫یک‬ ‫عنوان‬ ‫به‬ ‫سن‬ ‫به‬ ‫توجه‬
Pediatric FL
Pediatric NMZL
T-cell LPD associated with EBV in children
•‫بیماری‬ ‫تعریف‬ ‫در‬ ‫ضایعه‬ ‫محل‬ ‫به‬ ‫توجه‬
PMBL
Primary DLBCL of the CNS
•Borderline Malignancies (Grey zone lymphoma)
Gray zones between HL and PMBL
Gray zones between Burkit L and DLBCL

6. The 2008 WHO Classification of Lymphoid
Neoplasms
B-cell neoplasms
• Precursor B-cell neoplasms
• Mature B-cell neoplasms
T cell and NK-cell neoplasms
• Precursor T-cell neoplasms
• Mature T-cell neoplasms
Hodgkin lymphoma
• Nodular lymphocyte predominant HL
• Classical HL

7. B lymphoblastic leukemia/lymphoma
B lymphoblastic leukemia/lymphoma, NOS
B lymphoblastic leukemia/lymphoma with recurrent genetic abnormalities
B lymphoblastic leukemia/lymphoma with t(9;22)(q34;q11.2);BCR-ABL 1
B lymphoblastic leukemia/lymphoma with t(v;11q23);MLL rearranged
B lymphoblastic leukemia/lymphoma with t(12;21)(p13;q22) TEL-AML1 (ETV6-RUNX1)
B lymphoblastic leukemia/lymphoma with hyperdiploidy
B lymphoblastic leukemia/lymphoma with hypodiploidy
B lymphoblastic leukemia/lymphoma with t(5;14)(q31;q32) IL3-IGH
B lymphoblastic leukemia/lymphoma with t(1;19)(q23;p13.3); E2A-PBX1 (TCF3-PBX1)
T lymphoblastic leukemia/lymphoma
WHO 2008: Precursor B-cell and T cell neoplasms
(continued)

8. WHO 2008: the mature B-cell neoplasms
CLL/SLL
B-cell prolymphocytic leukemia
Splenic marginal zone lymphoma
Hairy cell leukemia
Splenic lymphoma/leukemia, unclassifiable *
 Splenic diffuse red pulp small B-cell lymphoma
 Hairy cell leukemia-variant
Lymphoplasmacytic lymphoma
 Waldenstrom macroglobulinemia
Heavy chain diseases
 Alpha heavy chain disease
 Gamma heavy chain disease
 Mu heavy chain disease

9. WHO 2008: the mature B-cell neoplasms (continued)
Plasma cell myeloma
Solitary plasmacytoma of bone
Extraosseous plasmacytoma
Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid
tissue (MALT lymphoma)
Nodal marginal zone B-cell lymphoma (MZL)
 Pediatric type nodal MZL*
Follicular lymphoma
 Pediatric type follicular lymphoma*
Primary cutaneous follicle center lymphoma
Mantle cell lymphoma

10. WHO 2008: the mature B-cell neoplasms (continued)
Diffuse large lymphoma (DLBCL), NOS
DLBCL, specified types
 T cell/histiocyte rich large B-cell lymphoma
 Primary DLBCL of the CNS
 Primary cutaneous DLBCL, leg type
 Epstein-Barr virus (EBV)+ DLBCL of the elderly*
Other lymphoma of large B-cell
DLBCL associated with chronic inflammation
Primary mediastinal (thymic) large B-cell lymphoma
Intravascular large B-cell lymphoma
Lymphomatoid granulomatosis
ALK+ large B-cell lymphoma
Plasmablastic lymphoma
Primary effusion lymphoma
Large B-cell lymphoma arising in HHV8-associated multicentric Castleman
disease

11. WHO 2008: the mature B-cell neoplasms (continued)
Burkitt lymphoma
B-cell lymphoma, unclassifiable, with features intermediate between diffuse
large B-cell lymphoma and Burkitt lymphoma
B-cell lymphoma, unclassifiable, with features intermediate between diffuse
large B-cell lymphoma and classical Hodgkin lymphoma

12. WHO 2008: the mature T-cell and NK-cell neoplasms
T-cell prolymphocytic leukemia
T-cell large granular lymphocytic leukemia
Chronic lymphoproliferative disorder of NK-cells*
Aggressive NK cell leukemia
Systemic EBV+ T-cell lymphoproliferative disease of childhood (associated with
chronic active EBV infection)
Hydroa vacciniforme-like lymphoma
Adult T-cell leukemia/lymphoma
Extranodal NK/T cell lymphoma, nasal type
Enteropathy-associated T-cell lymphoma
Hepatosplenic T-cell lymphoma

13. WHO 2008: the mature T-cell and NK-cell neoplasms (continued)
Subcutaneous panniculitis-like T-cell lymphoma
Mycosis fungoides
Sézary syndrome
Primary cutaneous CD30+ T-cell lymphoproliferative disorder
 Lymphomatoid papulosis
 Primary cutaneous anaplastic large-cell lymphoma
Primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell
lymphoma*
Primary cutaneous gamma-delta T-cell lymphoma
Primary cutaneous small/medium CD4+ T-cell lymphoma*
Peripheral T-cell lymphoma(NOS)
Angioimmunoblastic T-cell lymphoma
Anaplastic large cell lymphoma (ALCL), ALK+
Anaplastic large cell lymphoma (ALCL), ALK–*

14. Conclusion
•،‫مورفولوژی‬ ‫اطالعات‬ ‫تمای‬ ‫از‬ ‫استفاده‬ ‫با‬ ‫بندی‬ ‫تقسیم‬ ‫این‬
‫بالینی‬ ‫نمای‬ ‫و‬ ‫ژنتیک‬ ،‫ایمونوفنوتیپ‬ ،‫سیتوشیمی‬‫عموم‬ ‫موافقت‬ ‫مورد‬
‫است‬ ‫گرفته‬ ‫قرار‬.
•‫این‬ ‫از‬ ‫زیادی‬ ‫موارد‬ ‫در‬ ‫هنوز‬ ،‫بندی‬ ‫تقسیم‬ ‫این‬ ‫موفقیت‬ ‫وجود‬ ‫با‬
‫جمله‬ ‫از‬ ‫بیماریها‬DLBL, NOS‫و‬PTCL, NOS‫تحقیقات‬ ‫به‬ ‫نیاز‬
‫دارد‬ ‫وجود‬ ‫بیشتری‬.
•‫گروه‬ ‫گنجاندن‬Borderline‫بندی‬ ‫تقسیم‬ ‫این‬ ‫در‬ ‫بینابینی‬ ‫قدم‬ ‫یک‬
‫باشد‬ ‫می‬ ‫انتظار‬ ‫مورد‬ ‫گروه‬ ‫این‬ ‫بیشتر‬ ‫مدیفیکاسیون‬ ‫و‬ ‫بوده‬.

15. WHO 2008: Hodgkin lymphoma
• Nodular lymphocyte predominant Hodgkin
lymphoma
• Classical Hodgkin lymphoma
– Nodular sclerosis classical Hodgkin lymphoma
– Lymphocyte-rich classical Hodgkin lymphoma
– Mixed cellularity classical Hodgkin lymphoma
– Lymphocyte-depleted classical Hodgkin lymphoma

16. WHO 2008: Histiocytic and dendritic cell neoplasms
• Histiocytic sarcoma
• Langerhans cell histiocytosis
• Langerhans cell sarcoma
• Interdigitating dendritic cell sarcoma
• Follicular dendritic cell sarcoma
• Fibroblastic reticular cell tumor
• Intermediate dendritic cell tumor
• Disseminated juvenile xanthogranuloma

17. Posttransplantation lymphoproliferative disorders
(PTLDs)
• Early lesions
• Plasmacytic hyperplasia
• Infectious mononucleosis–like PTLD
• Polymorphic PTLD
• Monomorphic PTLD (B- and T/NK-cell types)†
• Classical Hodgkin lymphoma type PTLD†