Follicular lymphoma
Author:
Mikael Häggström [note 1]
In suspected follicular lymphoma:
Comprehensiveness
On this resource, the following formatting is used for comprehensiveness:
- Minimal depth
- (Moderate depth)
- ((Comprehensive))
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
- 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 nucleoli 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.
Immunohistochemistry
The following panel of immunohistochemitry is recommended for confirmation and evaluation of follicular lymphoma:[4]
- Suspected follicular lymphoma, grades 1 to 3a: CD20, CD21, CD10, BCL2, and cyclin D1
- Suspected follicular lymphoma, grade 3b: CD20, CD21, BCL6, BCL2, MUM1, and cyclin D1
(Describe the pattern of CD21 staining of follicular dendritic cells:[5])
Notes
- ↑ 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
- ↑ 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
- ↑ Weiss, Lawrence M; O'Malley, Dennis (2013). "Benign lymphadenopathies ". Modern Pathology 26 (S1): S88–S96. doi:. ISSN 0893-3952.
- ↑ Weissmann, David. Follicular Lymphomas. University of Medicine and Dentistry of New Jersey.
- ↑ Disanto MG, Ambrosio MR, Rocca BJ, Ibrahim HA, Leoncini L, Naresh KN (2016). "Optimal Minimal Panels of Immunohistochemistry for Diagnosis of B-Cell Lymphoma for Application in Countries With Limited Resources and for Triaging Cases Before Referral to Specialist Centers. ". Am J Clin Pathol 145 (5): 687-95. doi:. PMID 27247372. Archived from the original. .
- ↑ 5.0 5.1 Kurshumliu F, Sadiku-Zehri F, Qerimi A, Vela Z, Jashari F, Bytyci S (2019). "Divergent immunohistochemical expression of CD21 and CD23 by follicular dendritic cells with increasing grade of follicular lymphoma.
". World J Surg Oncol 17 (1): 115. doi:. PMID 31269981. PMC: 6610797. Archived from the original. .
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