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Article Tools SPECIAL DEPARTMENTS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2000.18.14.2788 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 10894880 P. KochxP. KochSearch for articles by this author , W.E. BerdelxW.E. BerdelSearch for articles by this author , N. WillichxN. WillichSearch for articles by this author , M. TiemanxM. TiemanSearch for articles by this author , R. ParwareschxR. ParwareschSearch for articles by this author N.L. HarrisxN.L. HarrisSearch for articles by this author , E.S. JaffexE.S. JaffeSearch for articles by this author , H.K. Mueller-HermelinkxH.K. Mueller-HermelinkSearch for articles by this author , Jacques DieboldxJacques DieboldSearch for articles by this author , A.K. ListerxA.K. ListerSearch for articles by this author , C.A. BloomfieldxC.A. BloomfieldSearch for articles by this author , Peter IsaacsonxPeter IsaacsonSearch for articles by this author Show More Medical Department A University Münster MünsterGermanyDepartment of Radiotherapy University Münster MünsterGermanyLymphnode Registry University Kiel KielGermanyMassachusetts General Hospital BostonMANational Institutes of Health BethesdaMDUniversity of Wurzburg WurzburgGermanyHopital Hotel-Dieu ParisFranceSt. Bartholomew’s Hospital LondonUnited KingdomOhio State University Comprehensive Cancer Center ColumbusOHUniversity College and Middlesex School of Medicine LondonUnited Kingdom https://doi.org/10.1200/JCO.2000.18.14.2788 First Page Full Text PDF Figures and Tables © 2000 by American Society of Clinical OncologyjcoJ Clin OncolJournal of Clinical OncologyJCO0732-183X1527-7755American Society of Clinical OncologyResponse14072000In Reply:We believe that Koch et al have not correctly interpreted our recommendations concerning grading of extranodal marginal-zone/mucosa-associated lymphoid tissue (MALT) lymphoma.1 When both low-grade and high-grade lymphoma are present in the same specimen, the recommendation of the World Health Organization classification is that both diagnoses be made separately (eg, (1) diffuse large B-cell lymphoma; (2) extranodal marginal-zone B-cell lymphoma of MALT type). The pathologist is advised to comment further on the relative proportions of each component of the tumor present in the specimen. We believe that this recommendation is identical to the suggestion of Koch et al, who suggest that a simultaneous low-grade component should always be noted in the diagnosis of high-grade lymphoma of the stomach. However, the Clinical Advisory Committee report concluded that grading of extranodal marginal-zone lymphoma (low-grade lymphoma of MALT type) according to the relative proportion of large cells scattered within the low-grade component is not warranted at present, until further information is available regarding its prognostic significance. The data presented by Koch et al do not address this issue.Additionally, we do not believe that a special terminology for de novo diffuse gastric large B-cell lymphomas (without a low-grade component) is warranted, as the site itself is sufficient to identify these lymphomas for subset analysis and further clinical and biologic studies.REFERENCE2. Harris NI, Jaffe ES, Diebold J, et al: World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissue: Report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997. J Clin Oncol 17::3835,1999-3849, Link, Google Scholar