《肿瘤瞭望》：根据2008年WHO对DLBCL的新分类，DLBCL包括14种类型，而其中我们仅仅对DLBCL非特指型的有预后分级的方法。对于其他类型的DLBCL，如原发渗出性DLBCL是否有预后分级？

Swerdlow教授：一些特定亚型的诊断基于多项指标。对于一些检查结果，病理医师可以通过染色或者分子学研究来把握，但是临床表现还是非常重要。因此为了明确诊断，我们需要明确患者的所有临床表现。

The diagnosis for some of those specific subtypes is based on multiple parameters. Some are parameters that a pathologist can control like doing stains or molecular studies， but the clinical findings are also very important. So to make some of those diagnoses， we really need to know the whole clinical situation.

《肿瘤瞭望》：WHO关于T细胞淋巴瘤的分类中除了ALK阳性间变大细胞淋巴瘤预后较好外，哪些T细胞淋巴瘤预后较好？

Swerdlow教授：一些皮肤T细胞淋巴瘤预后较好。然而，大多数样肉芽肿病和一些新的亚型，如CD4⁺小/中T细胞淋巴瘤预后好。新的CD8⁺T细胞淋巴瘤预后也不错。一些ALK-间变性大细胞淋巴瘤和大颗粒细胞淋巴瘤也还好。

Some of the cutaneous T-cell lymphomas have a good prognosis. Even most cases of mycosis fungoides and some of the newer subtypes like the CD4^-positive small/medium T-cell lymphomas do well. The new CD8-positive T-cell lymphomadoes well. There are some subsets of ALK-negative anaplastic large cell lymphoma that also do well and the large granular lymphocyte leukemias.

《肿瘤瞭望》：细胞淋巴瘤绝大部分都有明确的B细胞起源，而T细胞淋巴瘤的分类却没有，您认为随着以后对T细胞的研究逐渐深入，我们是否有可能也像B细胞淋巴瘤一样有明确的按T细胞分化的方式去定义？

Swerdlow教授：这是一个不错的问题，大家也正在尝试着去做。对于某些疾病，例如在滤泡辅助性T细胞淋巴瘤，我认为我们可以做的更多。尽管我们还不能实现，这比想像的更为复杂，例如同一种淋巴瘤可以有不同T细胞亚群组成，但我们终究将找到答案。

That’s an excellent question. People are trying to do that and for some of them， we are able to do more， for example， in subsets of follicular helper T-cell lymphomas. But we are still not up to that and for whatever reason， it seems to be much more complicated. You can have the same lymphoma composed of different T-cell subtypes.

《肿瘤瞭望》：如何区分淋巴结转移至骨和原发骨淋巴瘤？

Swerdlow教授：大多时候这和患者的临床表现相关。很多情况下，我们对结外淋巴瘤的定义是基于主要病变部位。如果患者的主要病变部位在骨，同时伴有局部淋巴结肿大，则称为骨淋巴瘤。相反，皮肤淋巴瘤完全不同，如果患者存在皮肤以外的侵犯，这被称作原发于皮肤的淋巴瘤。

For most sites， it relates to the clinical findings. Most people define the extranodal lymphomas based on the dominant lesion. If you have a dominant bone lesion with some regional adenopathy， they are willing to call it a bone lymphoma. The situation with the skin lymphomas is totally different. If you do have extracutaneous involvement then it is not considered primary in the skin.