Non-Hodgkin lymphoma historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Preeti Singh, M.B.B.S.[2]


In 1864 and 1865, Virchow and Cohnheim independently described non-Hodgkin lymphoma and called it lymphosarcoma and psedoleukemia respectively. In 1997, FDA approved rituximab, to treat patients with B-cell non-Hodgkin lymphoma that did not responds to other treatments Since then, tremendous efforts of many scientists have been continuing to provide more precise and comprehensive with pathology, staging, and treatment of Hodgkin's lymphoma.


  • In 1864, Virchow, a German physician, described lymph node enlargement not related to leukemia as lymphosarcoma (a subdivision of aleukimic type of leukemias).
  • In 1865, Cohnheim, a German-Jewish physician, used the term pseudolukemia to describe all common lymphadenopathy and splenomegaly.
  • In 1871, Bilroth, a Prussian-born Austrian surgeon, was the first to described a case of non-Hodgkin lymphoma, and coined the term malignant lymphoma.[1]
  • In 1958, Denis Parsons Burkitt, an Irish surgeon, first discovered Burkitt's lymphoma while working in Africa.[2]
  • In 1925, follicular lymphoma was described by Brill and Symmers, independently.[3]
  • In 1956, Henry Rappaport and his colleagues proposed the Rappaport classification, based on cellular morphology. This became the first widely accepted classification of non-Hodgkin lymphomas.
  • In 1966, Armed Forces Institute of Pathology (AFIP) modified the the Rappaport classification in the "Tumors of the Hematopoietic System".[4]
  • In 1982, National Cancer Institute introduced the working formulation, an amalgamation translating all previous classifications, which defined three grades of non-Hodgkin lymphoma.[5]
  • In 1992, Banks first coined the term mantle cell lymphoma (MCL).[6]
  • In 1994, the Revised European-American Classification of Lymphoid Neoplasms (REAL) classified non-Hodgkin's lymphoma, based on immunologic, genetic and clinical characteristics of the disorders in addition to histopathologic characteristics of the tumor cells.[7]
  • Since 2008 the World Health Organisation (WHO) has been starting a project with committees of international hematopathologists and oncologists, who have developed lists and definitions of disease entities to ensure that the classification will be helpful to clinicians. They proposed their first approach in 2008 and after that, the relevant Clinical Advisory Committee (CAC) updates its latest revision every few years.[8][9]
  • The latest revision of classification of neoplastic diseases of the haematopoietic and lymphoid tissues by World Health Organisation (WHO) was done in 2016.[10]

Landmark Events in the Development of Treatment Strategies


  1. Pollock, Raphael (2008). Advanced therapy in surgical oncology. Hamilton, Ontario Lewiston, NY: BC Decker Inc. ISBN 9781550091267.
  2. Burkitt D (1958). "A sarcoma involving the jaws in African children". The British journal of surgery. 46 (197): 218–23. doi:10.1002/bjs.18004619704. PMID 13628987.
  3. van Besien K, Schouten H (February 2007). "Follicular lymphoma: a historical overview". Leuk. Lymphoma. 48 (2): 232–43. doi:10.1080/10428190601059746. PMID 17325883.
  4. Norton, Andrew J. (1996). "1 Classification of non-Hodgkin's lymphomas". Baillière's Clinical Haematology. 9 (4): 641–652. doi:10.1016/S0950-3536(96)80046-1. ISSN 0950-3536.
  5. Bennett, MichaelH.; Farrer-Brown, Geoffrey; Henry, Kristin; Jelliffe, A.M.; Gerard-Marchant, R.; Hamlin, Iris; Lennert, K.; Rilke, F.; Stansfeld, A.G.; Van Unnik, J.A.M. (1974). "CLASSIFICATION OF NON-HODGKIN'S LYMPHOMAS". The Lancet. 304 (7877): 405–408. doi:10.1016/S0140-6736(74)91786-3. ISSN 0140-6736.
  6. Banks PM, Chan J, Cleary ML, Delsol G, De Wolf-Peeters C, Gatter K; et al. (1992). "Mantle cell lymphoma. A proposal for unification of morphologic, immunologic, and molecular data". Am J Surg Pathol. 16 (7): 637–40. PMID 1530105.
  7. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, Delsol G, De Wolf-Peeters C, Falini B, Gatter KC (September 1994). "A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group". Blood. 84 (5): 1361–92. PMID 8068936.
  8. N. L. Harris, E. S. Jaffe, J. Diebold, G. Flandrin, H. K. Muller-Hermelink, J. Vardiman, T. A. Lister & C. D. Bloomfield (2000). "The World Health Organization classification of neoplastic diseases of the haematopoietic and lymphoid tissues: Report of the Clinical Advisory Committee Meeting, Airlie House, Virginia, November 1997". Histopathology. 36 (1): 69–86. PMID 10632755. Unknown parameter |month= ignored (help)
  9. Jaffe ES (2009). "The 2008 WHO classification of lymphomas: implications for clinical practice and translational research". Hematology Am Soc Hematol Educ Program: 523–31. doi:10.1182/asheducation-2009.1.523. PMID 20008237.
  10. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, Advani R, Ghielmini M, Salles GA, Zelenetz AD, Jaffe ES (May 2016). "The 2016 revision of the World Health Organization classification of lymphoid neoplasms". Blood. 127 (20): 2375–90. doi:10.1182/blood-2016-01-643569. PMC 4874220. PMID 26980727.
  11. Grillo-López AJ, White CA, Dallaire BK, Varns CL, Shen CD, Wei A, Leonard JE, McClure A, Weaver R, Cairelli S, Rosenberg J (July 2000). "Rituximab: the first monoclonal antibody approved for the treatment of lymphoma". Curr Pharm Biotechnol. 1 (1): 1–9. PMID 11467356.

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