Diagnosis and Classification

  • Thierry Jo MolinaEmail author


Non-Hodgkin lymphomas (NHL) are typical tumors for the pediatric pathologist to be familiar with as they represent around 7–10% of pediatric malignancies, the fourth most common one in children, being more frequent between 15 and 19 years of age (Minard-Colin et al. J Clin Oncol 33(27):2963–2974, 2015; Bollard et al. Pediatr Blood Cancer 60(6):979–984, 2013; Sandlund and Martin Hematology Am Soc Hematol Educ Program. 2016:589–597, 2016). These lymphomas could arise in any tissue, nodal or extranodal, and the pathologist should be prepared to diagnose its histological type according to the updated revised 2016 WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues (Swerdlow et al. WHO classification of tumours of haematopoietic and lymphoid tissues, revised 4th edition. IARC, Lyon, 2017).


WHO Classification-Needle biopsy-open wedge biopsy-Comparative Genomic Hybridization-FISH-Circulating Tumor DNA 



Acknowledgments to Julie Bruneau, Danielle Canioni, Josette Brière, Sophie Kaltenbach, Isabelle Radford Weiss, Serge Romana, Elizabeth MacIntyre, Vahid Asnafi, Ludovic Lhermitte, and Chantal Brouzes for the fruitful and constant laboratory interaction in the multidisciplinary approach of pediatric lymphoid disorders diagnosis as well as Véronique Minard, Laurence Brugières, Bénédicte Neven, Despinha Moshous, and Comité Lymphome of SFCE for their crucial interaction considering the clinical part of the classification.


  1. 1.
    Minard-Colin V, Brugières L, Reiter A, Cairo MS, Gross TG, Woessmann W, Burkhardt B, Sandlund JT, Williams D, Pillon M, Horibe K, Auperin A, Le Deley MC, Zimmerman M, Perkins SL, Raphael M, Lamant L, Klapper W, Mussolin L, Poirel HA, Macintyre E, Damm-Welk C, Rosolen A, Patte C. Non-Hodgkin lymphoma in children and adolescents: progress through effective collaboration, current knowledge, and challenges ahead. J Clin Oncol. 2015;33(27):2963–74.CrossRefGoogle Scholar
  2. 2.
    Bollard CM, Lim MS, Gross TG, COG Non-Hodgkin Lymphoma Committee. Children’s Oncology Group’s 2013 blueprint for research: non-Hodgkin lymphoma. Pediatr Blood Cancer. 2013;60(6):979–84.CrossRefGoogle Scholar
  3. 3.
    Sandlund JT, Martin MG. Non-Hodgkin lymphoma across the pediatric and adolescent and young adult age spectrum. Hematology Am Soc Hematol Educ Program. 2016;2016(1):589–97.CrossRefGoogle Scholar
  4. 4.
    Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Arber DA, Hasserjian RP, Le Beau MM, Orazi A, Siebert R. WHO classification of tumours of haematopoietic and lymphoid tissues, revised. 4th ed. Lyon: IARC; 2017.Google Scholar
  5. 5.
    Attarbaschi A, Carraro E, Abla O, Barzilai-Birenboim S, Bomken S, Brugieres L, Bubanska E, Burkhardt B, Chiang AK, Csoka M, Fedorova A, Jazbec J, Kabickova E, Krenova Z, Lazic J, Loeffen J, Mann G, Niggli F, Miakova N, Osumi T, Ronceray L, Uyttebroeck A, Williams D, Woessmann W, Wrobel G, Pillon M, European Intergroup for Childhood Non-Hodgkin Lymphoma (EICNHL) and the International Berlin-Frankfur t-Münster (i-BFM) Study Group. Non-Hodgkin lymphoma and pre-existing conditions: spectrum, clinical characteristics and outcome in 213 children and adolescents. Haematologica. 2016;101(12):1581–91.CrossRefGoogle Scholar
  6. 6.
    Citrin R, Horowitz JP, Reilly AF, Li Y, Huang YS, Getz KD, Seif AE, Fisher BT, Aplenc R. Creation of a pediatric mature B-cell non-Hodgkin lymphoma cohort within the Pediatric Health Information System Database. PLoS One. 2017;12(10):e0186960.CrossRefGoogle Scholar
  7. 7.
    Deeney S, Stewart C, Treece AL, Black JO, Lovell MA, Garrington T, Karrer F, Bruny J. Diagnostic utility of core needle biopsy versus open wedge biopsy for pediatric intraabdominal solid tumors: Results of a prospective clinical study. J Pediatr Surg. 2017;52(12):2042–6.CrossRefGoogle Scholar
  8. 8.
    Blondiaux E, Laurent M, Audureau E, Boudjemaa S, Sileo C, Lenoir M, Dainese L, Garel C, Coulomb A, Ducou le Pointe H. Factors influencing the diagnostic yield and accuracy of image-guided percutaneous needle biopsy of pediatric tumors: single-center audit of a 26-year experience. Pediatr Radiol. 2016;46(3):372–82.CrossRefGoogle Scholar
  9. 9.
    Rohde M, Bonn BR, Zimmermann M, Lange J, Möricke A, Klapper W, Oschlies I, Szczepanowski M, Nagel I, Schrappe M, MMML-MYC-SYS Project, ICGC MMML-Seq Project, Loeffler M, Siebert R, Reiter A, Burkhardt B. Relevance of ID3-TCF3-CCND3 pathway mutations in pediatric aggressive B-cell lymphoma treated according to the non-Hodgkin Lymphoma Berlin-Frankfurt-Münster protocols. Haematologica. 2017;102(6):1091–8.CrossRefGoogle Scholar
  10. 10.
    Bobée V, Ruminy P, Marchand V, Viailly PJ, Abdel Sater A, Veresezan L, Drieux F, Bérard C, Bohers E, Mareschal S, Dubois S, Jais JP, Leroy K, Figeac M, Picquenot JM, Molina TJ, Salles G, Haioun C, Tilly H, Jardin F. Determination of molecular subtypes of diffuse large B-cell lymphoma using a reverse transcriptase multiplex ligation-dependent probe amplification classifier: a CALYM Study. J Mol Diagn. 2017;19(6):892–904.CrossRefGoogle Scholar
  11. 11.
    Scherer F, Kurtz DM, Newman AM, Stehr H, Craig AF, Esfahani MS, Lovejoy AF, Chabon JJ, Klass DM, Liu CL, Zhou L, Glover C, Visser BC, Poultsides GA, Advani RH, Maeda LS, Gupta NK, Levy R, Ohgami RS, Kunder CA, Diehn M, Alizadeh AA. Distinct biological subtypes and patterns of genome evolution in lymphoma revealed by circulating tumor DNA. Sci Transl Med. 2016;8(364):364ra155.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PathologyHôpital Universitaire Necker-Enfants Malades, EA 7324, Université Paris DescartesParisFrance

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