I have been "listening" to the discussion about the confusion between terms like "follicular lymphoma" and specific immunophenotypes with interest because this is a topic of interest to me for many years. At the risk of offending some of my good friends on this list I would like to add my two cents to the discussion and maybe expand it somewhat. I think that we are all gratified that the continual evolution in lymphoma classification has begun to utilize immunophenotypic descriptions more and more - this is long overdue. However, we must remember that all of the historical classifications, especially those including such terms as "follicular", "mantle", etc. are based on (highly subjective in my view) morphology. We now seem to be in a transition phase between morphologic descriptions and immunophenotypic and genetic definitions of these diseases. We are asking for a lot of confusion, and we are doing ourselves a disservice, if we keep trying to align morphologic descriptions with specific immunophenotypes. In my view, it is especially unfortunate when we create new disease entities based not upon clinical criteria but upon variations in our own classification systems. For example: is a CD10 positive follicular lymphoma a different disease than CD10 negative follicular lymphoma? We shouldn't mistake a failure of our multiple classification systems for new diseases! This may a lengthy restatement of the obvious, but I needed to say it - and I feel better now! Ken Ault
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