Lipford et al described a grading scheme for patients with lymphomatoid granulomatosis. The authors are from the National Cancer Institute and National Institutes of Health in Bethesda, Maryland.
General features:
(1) angiocentric and angiodestructive lymphoid proliferations affecting small arteries and veins
(2) may occur in the lung or any anatomic site but usually does not involve lymph nodes
(3) polymorphous infiltrates consist of lymphocytes, plasma cells, and histiocytes, with or without eosinophils
Large Lymphoid Cells or Immunoblasts
Cytologic Atypia
Necrosis
Grade
rare
none or minimal
usually absent
I
occasional
some but not marked
some present
II
common, with monomorphic lymphoma
marked, present in small and large lymphocytes
usually prominent
III
where:
• Grade III lesions = angiocentric lymphoma
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