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Annals of Oncology 15:631-637, 2004
© 2004 European Society for Medical Oncology

Original Paper

Use of the WHO lymphoma classification in a population-based epidemiological study

Received 16 October 2003; revised 18 December 2003; accepted 23 December 2003

Background:

Non-Hodgkin’s lymphoma (NHL) is pathologically diverse. Epidemiological investigations into its increasing incidence and aetiology require accurate subtype classification.

Patients and methods:

Available pathology reports of 717 cases aged from 20 to 74 years in an Australian, population-based epidemiological study of NHL were reviewed by one anatomical pathologist to assign a World Health Organization (WHO) classification category. High or low confidence was assigned to the diagnosis of NHL, cell phenotype and WHO category and reasons given for low confidence.

Results:

The most informative biopsy reports were from open tissue biopsy (79% of cases), tissue core biopsy (8%), cytology (4%) and bone marrow (9%); 8% of cases had inadequate biopsies for diagnostic purposes. Immunohistochemistry or flow cytometry reports were available for 96% of cases, gene rearrangement studies for 6% and cytogenetics for 3%. The reviewer assigned high confidence to the diagnosis of NHL in 93% of cases and also the phenotype in 88%. While a WHO classification could be assigned in 91% of cases, confidence was high in only 57.5%; insufficient immunophenotyping was the commonest reason for low confidence.

Conclusions:

Expert pathology review of a population-based sample of NHL can provide a WHO classification category for most cases. A high level of confidence in the classification, however, would require review of diagnostic material and additional phenotyping.

J. J. Turner1,*, A. M. Hughes2, A. Kricker2, S. Milliken3, A. Grulich4, J. Kaldor4 and B. Armstrong2

Departments of 1 Anatomical Pathology and 3 Haematology, St Vincent’s Hospital, Sydney; 2 School of Public Health, University of Sydney, Sydney; 4 National Centre in HIV Epidemiology and Clinical Research, Sydney, Australia

Key words: epidemiology, NHL subtypes, pathology report review, WHO NHL classification


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