Follicular NHL grading:'In the proposed schema (system), follicular lymphomas were categorized under “follicle centerlymphomas” with cytologic (cell study) grades referring to the proportion oflarge cells in the follicle.Thus, grades I, II, and IIIform a continuum (gradual change) from follicular small cleaved-cell to large-cellpredominance, without specific recommendations being made about cutoffcriteria between grades.' Aboutmixed large and small cell:'Allfollicle center cell lymphomas contain centrocytes, which are small,cleaved follicle center cells, and centroblasts, which are largernoncleaved cells.The centroblasts are usually in the minority;however, the variability seen in the proportions of cell typesdetermines the grade of the tumor.' GradingDefines how aggressive or slow growing the malignant cells arelikely to be. This is sometimes called histologicgrade, which is determined by the appearance of cells under themicroscope.' Follicular lymphoma isclassified into grades Grade 1, 2, and 3 based on the number ofcentroblasts in neoplastic follicles.However, the accuracy of manually counting centroblasts islimited because certain cells mimic or look very much likecentroblasts.('morphology' is the study of the shape and form of things in general).The reproducibility of follicular lymphoma grading is dependentupon observer experience; therefore, significant variations occur.'
The two main types of malignant lymphoma are Hodgkin lymphoma (also known as Hodgkin disease) and NHL. The two types spread in different ways and respond differently to treatment.