Follicular lymphoma classification: Difference between revisions
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==Overview== | ==Overview== | ||
Follicular lymphoma may be classified according to WHO criteria into low grade follicular lymphoma, high grade follicular lymphoma and diffuse large B cell lymphoma. Pediatric-type follicular lymphoma, primary intestinal follicular lymphoma, other extranodal follicular lymphomas and follicular lymphoma “in situ” (FLIS) are the other variants that are included under follicular lymphoma. | Follicular lymphoma may be classified according to WHO criteria into 3 groups: low grade follicular lymphoma, high grade follicular lymphoma and diffuse large B cell lymphoma. Pediatric-type follicular lymphoma, primary intestinal follicular lymphoma, other extranodal follicular lymphomas and follicular lymphoma “in situ” (FLIS) are the other variants that are included under follicular lymphoma. | ||
==Classification== | ==Classification== | ||
1 | ====1-According to the WHO criteria, the disease is morphologically graded into:<ref name="urlFollicular Lymphomas">{{cite web |url=http://pleiad.umdnj.edu/hemepath/follicular/follicular.html |title=Follicular Lymphomas |work= |accessdate=2008-07-26}}</ref>==== | ||
* Grade 1 (<5 centroblasts per high-power field (hpf)) | * Grade 1 (<5 centroblasts per high-power field (hpf)) | ||
* Grade 2 (6–15 centroblasts/hpf) | * Grade 2 (6–15 centroblasts/hpf) | ||
| Line 24: | Line 24: | ||
:* Often cured with minimal therapy. | :* Often cured with minimal therapy. | ||
====B-Primary intestinal follicular lymphoma==== | ====B-Primary intestinal follicular lymphoma==== | ||
:* Common in the small intestine with the | :* Common in the small intestine with the majority in the duodenum. | ||
:* The morphology, immunophenotype, and genetic features are similar to those of nodal follicular lymphoma. | :* The morphology, immunophenotype, and genetic features are similar to those of nodal follicular lymphoma. | ||
:* Most patients have clinically indolent and localized disease. | :* Most patients have clinically indolent and localized disease. | ||
| Line 30: | Line 30: | ||
====C-Other extranodal follicular lymphoma==== | ====C-Other extranodal follicular lymphoma==== | ||
:* The morphology, immunophenotype, and genetic features are similar to those of nodal follicular lymphoma. | :* The morphology, immunophenotype, and genetic features are similar to those of nodal follicular lymphoma. | ||
:* | :* Usually have localized disease and systemic relapses are rare. | ||
====D-Follicular Lymphoma “in situ”==== | ====D-Follicular Lymphoma “in situ”==== | ||
:* | :* Rare occurrence | ||
:* Preservation of the lymph node architecture | :* Preservation of the lymph node architecture | ||
:* | :* Focal strongly positive staining for BCL2 (restricted to germinal centers) and CD10 in the involved follicles | ||
:* The detection of t(14;18) by FISH. | :* The detection of t(14;18) by FISH. | ||
Revision as of 14:31, 25 August 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Follicular lymphoma may be classified according to WHO criteria into 3 groups: low grade follicular lymphoma, high grade follicular lymphoma and diffuse large B cell lymphoma. Pediatric-type follicular lymphoma, primary intestinal follicular lymphoma, other extranodal follicular lymphomas and follicular lymphoma “in situ” (FLIS) are the other variants that are included under follicular lymphoma.
Classification
1-According to the WHO criteria, the disease is morphologically graded into:[1]
- Grade 1 (<5 centroblasts per high-power field (hpf))
- Grade 2 (6–15 centroblasts/hpf)
- Grade 3 (>15 centroblasts/hpf)
- Grade 3A (centrocytes still present)
- Grade 3B (the follicles consist almost entirely of centroblasts)
2-The WHO 2008 update classifies
- Grades 1 and 2 now as low grade follicular lymphoma
- Grade 3A as high grade follicular lymphoma
- Grade 3B as diffuse large B cell lymphoma.
3- Other variants that are included under follicular lymphoma. [2]
A-Pediatric-type follicular lymphoma
- Rare variant of follicular lymphoma
- Characterized by lack of BCL2 rearrangement and t(14,18)
- Better prognosis than adult follicular lymphoma
- Often cured with minimal therapy.
B-Primary intestinal follicular lymphoma
- Common in the small intestine with the majority in the duodenum.
- The morphology, immunophenotype, and genetic features are similar to those of nodal follicular lymphoma.
- Most patients have clinically indolent and localized disease.
- Survival appears to be excellent even without treatment.
C-Other extranodal follicular lymphoma
- The morphology, immunophenotype, and genetic features are similar to those of nodal follicular lymphoma.
- Usually have localized disease and systemic relapses are rare.
D-Follicular Lymphoma “in situ”
- Rare occurrence
- Preservation of the lymph node architecture
- Focal strongly positive staining for BCL2 (restricted to germinal centers) and CD10 in the involved follicles
- The detection of t(14;18) by FISH.
Other extranodal follicular lymphomas occur in almost any extranodal site. Patients usually have localized extranodal disease and systemic relapses are rare. Testicular follicular lymphoma are reported with increased frequency in children, but also are reported in adults.
References
- ↑ "Follicular Lymphomas". Retrieved 2008-07-26.
- ↑ "Non-Hodgkin's Lymphomas (NCCN.org)" (PDF).