Abstract
A reclassification according to the criteria of the Kiel (KC) and the Rappaport classifications (RC) was undertaken by three pathologists on 92 out of 427 patients with non-Hodgkin lymphomas (NHL) of the years 1946–1977 where the tissue sections and/or blocks were still available, and were brought in relation with clinical data and life expectancy. The sections of 12 patients, originally defined as NHL, were variously defined as lymphoepithelial carcinoma Schmincke-Regeaud and as diffuse histiocytic lymphoma of the RC or immunoblastic lymphoma of the KC respectively. The disease concepts of the old histopathological nomenclature do not represent disease entities but groups of different natural history and prognosis. They are unsuitable for clinical judgement. The Kiel and Rappaport classifications offer comparable judgements on the clinic of the lymphomas whereby the degree of correspondence in the KC is often and partly also significantly better than in the RC. The concepts of the RC and KC correspond imperfectly. None of the concepts of the one classification coincides completely with a corresponding concept of the other. In a comparison of both the principal sub-groups of low malignancy of the KC and good prognosis of the RC in the formulation given by Rosenberg and Kaplan, or the groups of high malignancy of the KC and poor prognosis of the RC, the concepts do not correspond in a quarter of the cases. This divergence is not fundamentally changed by the adoption of a third sub-group of intermediate malignancy or prognosis respectively. The research undertaken confirms to a certain extent the clinical value of the Ann Arbor classification, especially when the histological degree of malignancy and the subdivision of Stage II into a Stage II(1) with infestation of 2 contiguous regions and II(2) of more than 2 contiguous regions are taken into consideration at the same time. 22% of all patients judged uniformly as lymphomas and 35% of these patients with whom a full remission was attained were potentially cured.