Page 74 - The lraternational Journal of the Royal Society of Thailand.indd

The International Journal of the Royal Society of Thailand
Volume XV-2023

Reflections on How to Diagnose and Classify Lymphoma

Sanya Sukpanichnant 1,2

Abstract

Diagnosis and classification (D&C) of lymphoma have been improved in the
past 120+ years since the first description and illustration of Reed-Sternberg cells
in Hodgkin disease by Dorothy Reed in 1902. Morphologic approach paves the

main path to the D&C of lymphoma. Then, immunologic approach unprecedentedly
increases our understanding in lymphoid cells for better D&C of lymphoma since
the introduction of the Lukes-Collins classification and the Kiel classification for
non-Hodgkin lymphoma (NHL) in the early 1970s. Then, genetic approach

comes in when Burkitt lymphoma was found to have a unique non-random
karyotypic abnormality, the t(8;14) translocation, in 1982. Afterwards, more
genetic information and the advances in molecular genetic studies help to
segregate various clusters of lymphomas with morphologic resemblance. All these

multiparameter approaches bring in better understanding and the better D & C
of lymphomas but at the same times leaving pathologists and hematopathologists
alike who cannot access to the sophisticated technics behind. While targeted
therapies improves clinical outcomes since anti-CD20 immunotherapy in the past

25+ years, there is no guarantee about the benefit of the high-throughput workups
over the conventional approach, using morphology and immunophenotype to the
D&C of lymphoma with an appropriate rapid turnaround time under a good
clinical correlation.

Keywords: reflection; diagnosis; classification; lymphoma; rapid turnaround time

1 Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand
2 The Academy of Science, the Royal Society of Thailand
Correspondence to Sanya Sukpanichnant (MD), Department of Pathology, Faculty of Medicine Siriraj
Hospital, Mahidol University, Thailand. Email: sanya.suk@mahidol.ac.th

66 Reflections on How to Diagnose and Classify Lymphoma