Since Thomas Hodgkin described tumors of the lymph nodes in 1832, morphologic
classification of malignant lymphoma has been studied by various approaches, and
among them, the classification of Rappaport has teen most widely accepted. But his
approach entirely depended on morphology which failed to properly reflect the functional
aspect of the component cells. With the recent development in the immunologic
knowledge of the lymphoreticular system and more acurate definition of various cells by
histochemical methods, Lukes and Collins initiated a new approach to the classification
of the malignant lymphomas taking the functional and histochemical aspects into
consideration in 1974. For its proven usefulness in the clinical prognostication of the
malignant lymphomas, this new concept has been widely disseminated. However, in
korea the old classification of Rappaport is still being used for largely technical reasons.
In view of the recent trends of development in this important field, the author has made
attempts at reclassification of the malignant lymphomas in korea. The material consists
of 142 cases of malignant lymptomas examined at the Department of Pathology, Yonsei
University College of Medicine from January, 1975 through August, 1980. All cases were
subjected to histopathological analysis and review of the clinical records. The paraffin
blocks were sectioned serially at 5 micron thickness and sections were stained with
hematoxylin and eosin and methyl green pyronin (MGP). and were examined by light
microscopy up to the magnification of 1000 times.
1) Among 142 cases of malignant lymphomas, 111 cases(78%) were follicular center
cell type, and of the latter, 40 cases(28.2%) were "large noncleaved" type and 33
cases(23.2%) were "large cleaved'1 type.
2) Of he seventy-semen cases formerly diagnosed as "histiocytic" type according to
Rappaport classifications 23 cases turned out to be "large cleaved" type and 22 cases,
"large non-cleaved" type. Thus 58.4% of the 77 cases proved to be of "large cell" line
by the new approach.
3) There were no cases belonging to Sezary syndrome related to mycosis fungoides
and small lymphocytic lymphomas in this study.
4) Of 130 cases of the malignant lymphomas in which the pattern of cell arrangement
was clearly discernible, 97 cases (74.6%) demonstrated diffuse pattern of lymphomatous
proliferation, and it was noted that all of the cases of plasmacytoid lymphocytic
lymphoulas and "small noncleaved" type, and also most of the cases of convoluted
lymptocytic lymphoma, "large noncleaved" type and immunoblastic sarcoma showed this
diffuse pattern.
5) Convoluted lymphocytic lymphoma predominantly occurred in adolescent and young
adult male characteristically stowing mediastinal sass, and the prognosis was Boor
because of generalized manifestation at the time of clinical diagnosis and the tendency
of conversion to acute lymphoblastic leukemia.
6) While three quarters of the cases of "small cleaved", "large cleaved'1 and "large
non-cleaved" types showed partial or complete remission, most of the cases belonging to
convoluted lymptocytic lymphoma and immunoblastic sarcoma resulted in poor prognosis
clinically.
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