Follicular lymphoma

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Revision as of 19:41, 10 November 2021 by Mikael Häggström (talk | contribs) (Grading: Compared)
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Author: Mikael Häggström [note 1]

Microscopic evaluation

Usual follicular lymphoma has at least partial follicular (nodular) distribution.[1]

Differential diagnosis

  • Follicular hyperplasia, also having prominent follicular centers. Compared to follicular lymphoma, it is more prevalent at younger age, has lower follicular density (typically not having back-to-back arrangement) and not typically having diffuse nodal effacement.[2] Further information: Follicular hyperplasia

Grading

File:Centrocyte, centroblast and follicular dendritic cell in a follicular lymphoma.jpg
Histologic comparison of cell types in a germinal center, H&E stain:
- Centrocytes are small to medium size with angulated, elongated, cleaved, or twisted nuclei.
- Centroblasts are larger cells containing vesicular nuclei with one to three basophilic nuclei apposing the nuclear membrane.
- Follicular dendritic cells have round nuclei, centrally located nucleoli, bland and dispersed chromatin, and flattening of adjacent nuclear membrane.

Follicular lymphoma is graded as follows:[3]

  • Grade 1: follicles have <5 centroblasts per high-power field (hpf).
  • Grade 2: follicles have 6 to 15 centroblasts per hpf.
  • Grade 3: follicles have >15 centroblasts per hpf.
    • Grade 3A: Grade 3 in which the follicles contain predominantly centrocytes.
    • Grade 3B: Grade 3 in which the follicles consist almost entirely of centroblasts.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. Mahsa Khanlari, M.D., Jennifer Chapman, M.D.. Lymphoma & related disorders - Mature B cell neoplasms - Follicular lymphoma - Follicular-usual. Topic Completed: 26 February 2020. Minor changes: 16 June 2021
  2. Weiss, Lawrence M; O'Malley, Dennis (2013). "Benign lymphadenopathies ". Modern Pathology 26 (S1): S88–S96. doi:10.1038/modpathol.2012.176. ISSN 0893-3952. 
  3. Weissmann, David. Follicular Lymphomas. University of Medicine and Dentistry of New Jersey.

Image sources