Comparison of WHO fourth and WHO fifth edition classification of PTLD
| Aspect . | WHO fourth edition (2017) . | WHO fifth edition (2022) . |
|---|---|---|
| Status of PTLD | Recognized as a separate entity | No longer a separate entity; incorporated into broader category of immunodeficiency and dysregulation–associated lymphoproliferative disorders |
| Terminology for early lesions | Early lesions (plasmacytic hyperplasia, infectious mononucleosis-like PTLD) | Nondestructive LPD (plasmacytic hyperplasia, florid follicular hyperplasia, infectious mononucleosis-like lesions) |
| Polymorphic PTLD | Polymorphic PTLD (destructive, not fulfilling lymphoma criteria) | Polymorphic LPD (same definition, broader context) |
| Monomorphic PTLD | Monomorphic PTLD (meets criteria for a lymphoma/plasma cell neoplasm subtype: DLBCL, BL, plasma cell neoplasms, T/NK-cell lymphomas, and leukemias) | Monomorphic LPD (same, but now under immunodeficiency-associated LPD umbrella; occurs in transplant, iatrogenic, primary immunodeficiency, or HIV) |
| Classic Hodgkin-type PTLD | Must meet the stringent criteria established for cHL in immunocompetent individuals. | cHL-type LPD (same diagnostic criteria but included under immunodeficiency-associated LPD) |
| Contextual scope | Posttransplant setting only | Multiple immunodeficiency contexts: posttransplant, iatrogenic, primary immunodeficiency, HIV |
| Aspect . | WHO fourth edition (2017) . | WHO fifth edition (2022) . |
|---|---|---|
| Status of PTLD | Recognized as a separate entity | No longer a separate entity; incorporated into broader category of immunodeficiency and dysregulation–associated lymphoproliferative disorders |
| Terminology for early lesions | Early lesions (plasmacytic hyperplasia, infectious mononucleosis-like PTLD) | Nondestructive LPD (plasmacytic hyperplasia, florid follicular hyperplasia, infectious mononucleosis-like lesions) |
| Polymorphic PTLD | Polymorphic PTLD (destructive, not fulfilling lymphoma criteria) | Polymorphic LPD (same definition, broader context) |
| Monomorphic PTLD | Monomorphic PTLD (meets criteria for a lymphoma/plasma cell neoplasm subtype: DLBCL, BL, plasma cell neoplasms, T/NK-cell lymphomas, and leukemias) | Monomorphic LPD (same, but now under immunodeficiency-associated LPD umbrella; occurs in transplant, iatrogenic, primary immunodeficiency, or HIV) |
| Classic Hodgkin-type PTLD | Must meet the stringent criteria established for cHL in immunocompetent individuals. | cHL-type LPD (same diagnostic criteria but included under immunodeficiency-associated LPD) |
| Contextual scope | Posttransplant setting only | Multiple immunodeficiency contexts: posttransplant, iatrogenic, primary immunodeficiency, HIV |
Since the 2017 WHO classification, EBV-positive extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type is considered a form of PTLD.
LPD, lymphoproliferative disorder.