CAJ | 학술논문

2008年第4版"世界卫生组织造血及淋巴组织肿瘤分类"把该类肿瘤分列为12个项目,对分子生物学进展结合较多,基因、染色体改变均加入分类中.慢性骨髓增生性疾病改为骨髓增生性肿瘤,并将肥大细胞增多症(mastocytosis)归于此栏中.新增了伴有嗜酸细胞增多的髓系及淋巴细胞系恶性肿瘤及异常的PDDFRA、PDDFRB或FGFR1基因一栏.在骨髓增生异常综合征/骨髓增生性肿瘤(MDS/MPN)一栏中增加了伴环形铁粒幼细胞再生障碍性贫血并显著的血小板增多(RARS-T)(可能为一单独性疾病).在骨髓增生异常综合征(MDS)一栏中分为一系或多系增生异常伴有一系或多系血细胞减少,并增添了儿童MDS.在急性髓系白血病及其有关前体细胞恶性肿瘤中,把髓系肉瘤(myeloid sarcoma)单独分类;新增加了唐氏综合征(Down syndrome)伴有的髓系增生疾病;新增加了母细胞性浆细胞样树突细胞肿瘤(blastic plasmacytoid dendretic cell neoplasm).把系列不明的白血病(acute leukemia of ambiguous lineage)单列为一个项目,含6种白血病.在前体淋巴系肿瘤中分为B系及T系,淋巴母细胞性白血病/淋巴母细胞性淋巴瘤,其区别点在于骨髓中淋巴母细胞＞25%,则诊断为淋巴细胞白血病[和急性髓系白血病(AML)不同,不设下限为20%].成熟B淋巴细胞系肿瘤分为39种,包括慢性淋巴细胞白血病、骨髓瘤、重链病、Burkitt淋巴瘤等,但不包括移植后淋巴细胞增生性疾病(PTLD).成熟T淋巴细胞系和NK细胞系肿瘤栏目下列举了22种成熟T淋巴细胞系和NK细胞系恶性肿瘤.霍奇金淋巴瘤栏目下列举了6种霍奇金淋巴瘤.组织细胞和树突状细胞恶性肿瘤包括7种恶性肿瘤及播散性幼年型黄肉芽肿.移植后淋巴细胞增生性疾病(PTLD)被单独分类在一个栏目中,又分为5种类型.
2008년제4판"세계위생조직조혈급림파조직종류분류"파해류종류분렬위12개항목,대분자생물학진전결합교다,기인、염색체개변균가입분류중.만성골수증생성질병개위골수증생성종류,병장비대세포증다증(mastocytosis)귀우차란중.신증료반유기산세포증다적수계급림파세포계악성종류급이상적PDDFRA、PDDFRB혹FGFR1기인일란.재골수증생이상종합정/골수증생성종류(MDS/MPN)일란중증가료반배형철립유세포재생장애성빈혈병현저적혈소판증다(RARS-T)(가능위일단독성질병).재골수증생이상종합정(MDS)일란중분위일계혹다계증생이상반유일계혹다계혈세포감소,병증첨료인동MDS.재급성수계백혈병급기유관전체세포악성종류중,파수계육류(myeloid sarcoma)단독분류;신증가료당씨종합정(Down syndrome)반유적수계증생질병;신증가료모세포성장세포양수돌세포종류(blastic plasmacytoid dendretic cell neoplasm).파계렬불명적백혈병(acute leukemia of ambiguous lineage)단렬위일개항목,함6충백혈병.재전체림파계종류중분위B계급T계,림파모세포성백혈병/림파모세포성림파류,기구별점재우골수중림파모세포＞25%,칙진단위림파세포백혈병[화급성수계백혈병(AML)불동,불설하한위20%].성숙B림파세포계종류분위39충,포괄만성림파세포백혈병、골수류、중련병、Burkitt림파류등,단불포괄이식후림파세포증생성질병(PTLD).성숙T림파세포계화NK세포계종류란목하열거료22충성숙T림파세포계화NK세포계악성종류.곽기금림파류란목하열거료6충곽기금림파류.조직세포화수돌상세포악성종류포괄7충악성종류급파산성유년형황육아종.이식후림파세포증생성질병(PTLD)피단독분류재일개란목중,우분위5충류형.
In introduced the 4th edition(2008)of WHO classification of tumors of haematopoietic and lymphoid tissues.They are divided into 12 columns,which includes myeloproliferative neoplasms;myeloid and lymphoid neoplasms with eosinophilia and abnormalities of PDDFRA,PDDFRB or FGFR1;myelodysplastic/myeloproliferative neoplasms;myelodysplastic syndromes;acute myeloid leukemia(AML)and related precursor neoplasms;acute leukemia of ambiguous lineage;precursor lymphoid neoplasms;mature Bcell neoplasms;mature T-cell and NK-cell neoplasms;Hodgkin lymphoma;histocytic and dendritic cell neoplasms;post-transplant lymphoproliferative disorders(PTLD).Accroding to the progression of the molecular biology,the new classifications combines a lot of the new knowledge with gene, chromosome,immunophenotypes,morphology,histocytology et al.The chronic myeloproliferative disorders changes into myeloproliferative neoplasms(MPN),mastocytosis included in this column of MPN.There are three subdivisions in the column of myeloid and lymphoid neoplasms with eosinophilia and abnormalities of genes.Refractory anemia with ring sideroblasts associated with marked thrombocytosis(RARS-T)in the column of MDS/MPN.In the column of MDS,MDS in children is added.Myeloid sarcoma,Down syndrome with myeloid proliferation and blastic plasmacytoid dendritic cell neoplasm were added in the column of AML and related precursor neoplasms.Acute leukemia of ambiguous lineage includes 6 kinds neoplasms.Precursor lymphoid neoplasms (B & T cells)includes leukemias and lymphomas,the bone marrow lymphoblasts＞25% is defined as leukemia(no lower limit 20% as AML).Mature B-cell(39 neoplasms),T/NK cell neoplasms(22 neoplasms),Hodgkin lymphoma (6 neoplasms),histocytic and dendritic cell neoplasms (7 neoplasms).Post transplant lymphoproliferative disorders(PTLD)forms a new colunlns(5 neoplasms).