REAL classification of malignant lymphomas in the republic of korea

Abstract

BACKGROUND The clinicopathologic characteristics of malignant lymphomas vary according to geography. The aim of this study was to determine the clinical characteristics of malignant lymphomas and the relative frequency in the Republic of Korea of lymphomas belonging to the newly described REAL (revised European‐American lymphoma) classification categories. METHODS The Hematolymphoreticular Study Group of the Korean Society of Pathologists conducted a consensus‐based morphologic review of a nationwide collection of 1548 malignant lymphomas, including Hodgkin's disease (HD), diagnosed at 23 institutes over a recent 2‐year period. Slides stained with hematoxylin and eosin or other immunohistochemical stains were reviewed. All cases were classified according to the histologic criteria proposed by the International Lymphoma Study Group. Clinical data, including age, gender, and site of disease involvement, were reviewed. RESULTS The Republic of Korea had lower rates of HD and follicle center lymphoma and higher rates of extranodal lymphoma, diffuse large B‐cell lymphoma, and angiocentric lymphoma compared with Western countries. The most frequent subtypes of non‐Hodgkin's lymphoma (NHL) were diffuse large B‐cell lymphoma, extranodal marginal zone B‐cell lymphoma, peripheral T‐cell lymphoma, unspecified type, and angiocentric lymphoma, in decreasing order. Compared with a previous nationwide study, the rates for follicular lymphoma and NHL involving the stomach, orbit, and central nervous system were increased. The rate of T‐cell NHL in the current study was much lower than that reported in a previous study for the Republic of Korea and was also lower than that reported for other Far East countries. For HD, the relative frequency of nodular sclerosis subtype was higher compared with that in the previous study, and lymphocyte predominance and lymphocyte depletion were lower. CONCLUSIONS The occurrence rates for various subtypes of malignant lymphoma in the Republic of Korea are distinct from those in Western countries and similar in many ways to those in other countries in the Far East. Compared with other Far East countries, the Republic of Korea has a higher rate of extranodal lymphoma, rare adult T‐cell lymphoma, and a relatively low rate of T‐cell lymphomas. It appears that over time there have been changes in the relative rates for follicular lymphoma, subtypes of Hodgkin's disease, and gastric and orbital lymphoma. The authors attribute these changes primarily to refined criteria for diagnosing new clinicopathologic entities. Cancer 1998;83:806‐812. © 1998 American Cancer Society.

Distributions of major sub-types of lymphoid malignancies among adults in Mashhad, Iran

“…Based on working formula classification, Hodgkin lymphoma in this study shows a frequency like that of Korea, but it is less frequent in comparison with the US [18]. A higher incidence occurs in westernized populations including those who emigrate from lowincidence sites to the United States.…”

“…Our result is like the study in Korea. The median age of their patients was 52 years [18]. The reason may relate to the underlying age structure in both countries, nonetheless, it needs more population-based studies.…”

Clinicopathologic and genotypic study of extranodal nasal-type natural killer/T-cell lymphoma and natural killer precursor lymphoma among Koreans

“…A recent nationwide study of malignant lymphomas among Koreans revealed that angiocentric lymphoma accounted 8.7% of all non-Hodgkin lymphoma and 74.1% of lymphomas arising in the nasal cavity and paranasal sinuses. 16 This tumor shares immunophenotypes of T and NK cells with cCD3 expression. Be- 36 32 cause paraffin reactive antibodies against CD3 recognize the epsilon chain present in T and NK cells, confirmation of T lineage requires demonstration of TCR protein, surface CD3 expression, or a clonal TCR gene rearrangement.…”

Extranodal natural killer/T-cell lymphoma involving the gastrointestinal tract: analysis of clinical features and outcomes from the Asia Lymphoma study group

“…Accordingly, a recent retrospective study showed that the worst treatment outcomes were associated with skin and soft tissue involvement, especially in cases of advanced disease [2]. However, data regarding ENKTL involving the GI tract are relatively scarce [3], although the GI tract is the most common site of extranodal organ involvement in patients with non-Hodgkin lymphoma (NHL) [4,5]. A previous retrospective analysis of 581 patients with intestinal NHL reported a frequency of 3.1% of ENKTL (n = 18) and poorer prognosis than B-cell lymphomas [6].…”