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The Lukes and Collins classification is based on the premise that malignant lymphomas (ML) should be classified on the basis of immunologic markers and that the B, T or „undefined”︁ nature of these tumors can be morphologically recognized. The difficulties of achieving this are discussed in this study. The „undefined”︁ type of these investigators posed a particular problem since it appears to be a heterogeneous group which includes ML currently classified as „histiocytic,”︁ lymphoblastic and undifferentiated. The prognosis appeared to be closely related to cytologic types in both the Rappaport and the Lukes and Collins classifications. In the follicular center cell (FCC) lymphomas the overall median survival of patients with follicular lymphomas was longer than that of patients with diffuse lymphoma (p < 0.0001). Extending this comparison to cell types we found longer median survivals of follicular lymphomas in each subgroup but with variable statistical significance. For all cleaved cell lymphoma the p value was 0.02, for the small cleaved cell type 0.16, for the large cleaved cell type 0.09 and for the large noncleaved cell type 0.1. The lymphomas which we identified as being of the diffuse large cleaved FCC type seemed to have a relatively favorable prognosis in comparison to other diffuse large cell lymphomas (p ρ 0.08). However, within this latter group a morphologic separation into large noncleaved FCC, immunoblastic, and true histiocytic seemed difficult. For the purpose of this study, however, we attempted to apply the designation of immunoblastic sarcoma to tumors composed of large lymphoid cells with plasmacytoid features, but found no differences in survival when comparing it with diffuse large noncleaved FCC tumors.
Nathwani et al. (Sun,) studied this question.