Lymph Node REAL Classification of Lymphoid Neoplasm

REAL classification is Revised European – American classification of lymphoid neoplasm.

It includes :

1. Lymphocytic leukemia
2. Non – Hodgkin’s lymphoma
3. Plasma cell tumors.

REAL classification is into 4 broad categories based on the immunophenotype.

1. Precursor B – cell neoplasm (Neoplasm of mature B – lymphocytes).
2. Peripheral B – lymphocyte neoplasm (Neoplasm of mature B – lymphocytes).
3. Precursor T – lymphocyte neoplasm (Neoplasm of immature T – lymphocyte).
4. Peripheral T – lymphocyte neoplasm (Neoplasm of mature T – lymphocyte)

Precursor B – lymphocyte = Precursor B – cell lymphoblastic leukemia/lymphoma.

Precursor T – lymphocyte = Precursor T – cell lymphoblastic leukemia/lymphoma.

Peripheral B – lymphocyte gives rise to:

1. Chronic lymphocytic leukemia / small lymphocytic lymphoma.
2. Lymphoplasmacytic lymphoma.
3. Mantle cell lymphoma.
4. Follicular lymphoma.
5. Marginal zone lymphoma.
6. Hairy cell leukemia.
7. Plasmacytoma/plasma cell myeloma.
8. Diffuse large cell (B) lymphoma.
9. Burkitt’s lymphoma.

Peripheral T – cell and NK –  neoplasm give rise to:

1. T cell chronic lymphocytic leukemia.
2. Large granular lymphocytic leukemia.
3. Angioimmunoblastic T – Cell lymphoma.
4. Angiocentric lymphoma (NK – T – cell lymphoma).
5. Intestinal T – cell lymphoma.
6. Adult T – cell leukemia/lymphoma.
7. Anaplastic large cell lymphoma.