THE REVISED EUROPEAN-AMERICAN CLASSIFICATION OF LYMPHOID NEOPLASMS (REAL) - A NEW PERSPECTIVE FOR THE CLASSIFICATION OF CUTANEOUS LYMPHOMAS

Differing classification schemes for malignant lymphomas have been use d in Europe and the United States. Attempts to translate between the p rinciple classifications have been unsuccessful and historically it ha s been difficult to arrive at an unified approach. In addition, many n ew lymphoma entities have been recognized in recent years that are not delineated in any of the existing classification schemes. To provide a unified international basis for clinical and investigative work in t his field, in 1994 the International Lymphoma Study Group (ILSG) propo sed a new classification termed Revised European-American Classificati on of lymphoid Neoplasms (REAL). This review discusses the REAL classi fication, especially as it pertains to cutaneous lymphomas, and provid es insight into the clinicopathologic features of lymphoproliferative disease involving the skin. The premise of the REAL classification is that a classification scheme should be based on the delineation of dis ease entities, utilizing pathologic, immunophenotypic, genetic, and cl inical features. Therefore, if cutaneous involvement is an integral as pect of any lymphoma subtype, this clinical information is included in the definition of that neoplasm. We conclude that the principles of t he REAL classification are applicable to cutaneous lymphomas, as well as lymphomas involving other anatomic sites. (C) Munksgaard 1997.