Older Lymphoma Classification and Typing Schemes

There are many types of lymphoma, all classified based on their cell type, cell markers, location of the cancerous mutation, and how they grow. However, the classification systems have changed and evolved over the years as scientists and doctors learn more about the disease.

The different systems used are the Rappaport System, Kiel System, Working Formulation, Revised European-American Classification of Lymphoid Neoplasms (REAL), and the World Health Organization (WHO) Sytem.

WHO Classification

The WHO International Classification of Diseases was first published 1893. The ICD is the international standard diagnostic classification and we regard it as the best current model. Please visit our Lymphoma Classification page for more details.

The Rappaport System

This system was used until the mid 1970's. The classification system divides cells into three categories based on cell differentiation. Cell differentiation is the process in which immature cells become specialized, mature cells. The categories were:

  • Well differentiated cells, or small lymphocytic lymphoma
  • Poorly differentiated cells, or follicular and small cleaved lymphomas
  • Histiocytic cells, or large cell lymphomas
  • It was created prior to the distinction between B-cells and T-cells, and is now rarely used. The only way to tell the cell types apart was by looking under a microscope, and the updated tissue tests available nowadays can categorize cancerous cells much better.

The Kiel System

The Kiel System was popular in Europe and was introduced in 1974. It was based on immunologic tests that identified the proteins that cancer cells made. In the United States, a similar system, called the Lukes and Collins Classification, was the first to classify based on B-cell and T-cell types.

National Cancer Institute's Working Formulation (IWF)

This system was introduced in the 1980's and classified cells based on cell differentiation, cell size, and whether or not the cell was cleaved. This led to the distinction between low-grade and high-grade cancers.

Small lymphocytic lymphoma, follicular small-cleaved cell lymphoma, and follicular mixed small-cleaved and large cell lymphomas were all considered low grade.

Diffuse small cleaved cell, diffuse mixed small and large cell, diffuse large cell, and follicular large cell lymphoma were all considered intermediate grade.

Lymphoblastic, small non-cleaved cell, and large cell immunoblastic lymphomas were all considered high grade.

REAL Classification

These classification systems were revised in the 1990's by the International Lymphoma Study Group. They compiled a consensus of lymphomas in order to study and classify them. This system became the basis of the WHO system in place today.

Dive Deeper

More Articles

More Articles

In non-Hodgkin's lymphoma, you have your B-cell lymphomas and you have your T-cell lymphomas.

Why B...

MALT lymphoma is a rare B-cell non-Hodgkin's lymphoma that typically runs an indolent or slow-growing clinical...

Mantle cell lymphoma (MCL) is a relatively rare B-cell subtype of non-Hodgkin'...

Mantle cell lymphoma (MCL) is just one of 50-60 known B-cell subtypes of...

Lymphomatous meningitis [LM], also known as leukemic meningitis, is an extremely serious peripheral cancer that attacks the tissue that covers the...

Since so many chemotherapy agents can affect a patient’s sex drive and fertility, thinking about these issues prior...

Secondary cancers are cancers that develop as a result of chemotherapy and/or...

One of the greatest fears of lymphoma survivors is that they’ll relapse and have to undergo treatment again. This fear is normal but awful to...

Over the years, various classification systems have been used to differentiate lymphoma types including the Rappaport Classification (used until...

If you are new to this website or are looking for guidance to a specific page, here is a list of links to articles that can help you. The "Main...

Often the one who makes the first diagnosis of Hodgkin's Lymphoma / Disease is the person affected. There are some...

Lymphedema is abnormal swelling due to the presence of excess lymphatic fluid within the tissues. This swelling occurs when the...

There are two types of cancer: benign and malignant. Benign cancers are the kind that don't spread and don't threaten one's life. Malignant...

Advances in the treatment of Hodgkin's lymphoma have resulted in remarkable survival rates, even for...