ISSN:
1569-8041
Keywords:
cutaneous lymphoma
;
lymphoma
;
R.E.A.L. Classification
;
skin
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background:The classification of cutaneous lymphomas has beencontroversial. The EORTC has proposed that conventional classification schemesare not suitable for cutaneous lymphomas, and that a unique classificationsystem is required. Design:The authors review the suitability of the R.E.A.L.Classification for cutaneous lymphomas, and compare it with the newly proposedEORTC system. The priniciples of the R.E.A.L. Classification have been adoptedby the WHO committees for the classification of hematopoietic and lymphoidneoplasms. Each disease is defined as a distinct entity based on anintegration of morphology, immunophenotypic and genetic features, clinicalpresentation and course, and normal cellular counterpart. If either primaryor secondary involvement of the skin is a constant factor, this aspect isconsidered integral to disease definition. Results:Organ-specific classification schemes may impede therecognition of common features of diseases involving multiple anatomic sites.For example, cutaneous marginal zone B-cell lymphomas (formerly designatedcutaneous immunocytomas) mirror the features of MALT lymphomas in otheranatomic sites. While the EORTC Classification for cutaneous lymphomasattempts to emphasize certain aspects of these neoplasms of importance todermatologists, the use of multiple classification systems is a step backward,and may lead to confusion among hematologists/oncologists, and dermatologists.Nevertheless, cutaneous lymphomas often have a more indolent natural historythan nodal lymphomas, and may require different therapeutic approaches.Clinical features are an important prognostic factor and should be utilizedin guiding therapy. For cutaneous lymphomas the presence or absence ofsystemic spread is particularly important. Additionally, the site of originis often important in the definition of disease entities. Conclusions:Organ-specific classification schemes, such as theEORTC Classification for cutaneous lymphomas, are not required, and indeed mayimpede the recognition of common features of diseases involving multipleanatomic sites. A common classification system, such as the R.E.A.L./WHOClassification, should be utilized for all lymphomas, regardless of the siteof origin.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008336732086
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