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==Laboratory Findings==
The diagnosis is easily established on histological grounds, but immunophenotyping is encouraged to distinguish follicular lymphoma from a nodular MCL or SLL.
*Diagnosis is established by immunophenotyping using IHC and/or flow cytometry for cell surface marker analysis.
*Follicular lymphoma has a characteristic immunophenotype, which includes CD20+, CD10+, BCL2+, CD23+/-, CD43-, CD5-, CCND1- and BCL6+. Occasional cases of FL may be CD10- or BCL2-.*In patients with BCL2-negative localized disease, the diagnosis of pediatric-type follicular lymphoma may be considered.
*Low-grade follicular lymphoma with a high proliferation index (as determined by Ki-67 immunostaining) has been shown to be associated with an aggressive clinical behavior.
:*There is no evidence, however, that high Ki-67 should guide the selection of therapy.
:*Molecular genetic analysis to detect BCL2 rearrangement, cytogenetics or FISH to identify t(14;18), and immunohistochemistry for Ki-67 may be useful under certain circumstances.


===Use of Immunophenotyping/Genetic Testing in Differential Diagnosis of Mature B-Cell and NK/T-Cell Neoplasms===
===Use of Immunophenotyping/Genetic Testing in Differential Diagnosis of Mature B-Cell and NK/T-Cell Neoplasms===
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===Classification of large cells based on Immunophenotypic/Genetic testing <ref>{{cite web | title = Non-Hodgkin's Lymphomas (NCCN.org) | url = http://www.nccn.org/professionals/physician_gls/PDF/nhl.pdf }}</ref>===
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
*Diffuse large B-cell lymphoma (DLBCL),NOS
|+ '''Hodgkins lymphoma classification'''
:*T-cell/histocyte-rich large B-cell lymphoma (THRLBCL)
! style="background: #FFA07A; color:#FFF;" | Name
:*Primary DLBCL of the CNS
! style="background: #FFA07A; color:#FFF;" | Description
:*Primary cutaneous DLBCL, leg type
|-
:*EBV-positive DLBCL of the elderly (EBV + DLBCL)
| style="padding: 5px 5px; background: #FFDAB9;" | Nodular sclerosing Hodgkins lymphoma
*DLBCL associated with chronic inflammation
| style="padding: 5px 5px; background: #FFDAB9;" | Most common subtype and is composed of large [[tumor]] nodules showing scattered lacunar classical Reed–Sternberg cells set in a background of reactive [[lymphocytes]], [[eosinophils]], and [[plasma cells]] with varying degrees of collagen [[fibrosis]]/[[sclerosis]].
*Lymphoid granulomatosis
|-
*Primary mediastinal (thymic) large B-cell Lymphoma (PMBL)
| style="padding: 5px 5px; background: #FFDAB9;" | Mixed-cellularity subtype
*Intravascular large B-cell lymphoma
| style="padding: 5px 5px; background: #FFDAB9;" |
*ALK-positive large B-cell lymphoma
|-
*Plasmablastic lymphoma
| style="padding: 5px 5px; background: #FFDAB9;" | Lymphocyte-rich
*Large B-cell lymphoma arising in HHV8-assciated multicentric Castleman disease (LBCL in HHV8 + MCD)
| style="padding: 5px 5px; background: #FFDAB9;" |
*Primary effusion lymphoma
|-
*B-cell lymphoma unclassifiable, intermediate between DLBCL(U-DLBCL) and classical Hodgkins lymphoma(CHL)
| style="padding: 5px 5px; background: #FFDAB9;" | Lymphocyte depleted
*Mantle cell Lymphoma(MCL),pleomorphic variant
| style="padding: 5px 5px; background: #FFDAB9;" |
|-
| style="padding: 5px 5px; background: #FFDAB9;" | Unspecified
| style="padding: 5px 5px; background: #FFDAB9;" |
|}

Revision as of 20:38, 3 September 2015

 
 
 
 
 
 
 
 
 
B-cell neoplasms
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CD5+
 
 
 
 
 
 
 
CD5-
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CCND1+
 
 
 
CCND1-
 
 
 
 
DLBCL
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pleomorphic MCL
 
 
 
DLBCL, NOS CD5+
 
CD10+
 
 
 
 
 
 
 
CD10-
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
DLBCL, NOS GCB type
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
BCL6+ IRF4/MUM1-
 
BCL6+ IRF4/MUM1+
 
BCL6- IRF4/MUM1+
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
DLBCL, NOS GCB type
 
Non-GCB
 
Post-GCB
 
 



Use of Immunophenotyping/Genetic Testing in Differential Diagnosis of Mature B-Cell and NK/T-Cell Neoplasms


 
 
 
 
 
 
 
 
 
B-cell neoplasms
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CD5+
 
 
 
 
 
 
 
CD5-
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CCND1+
 
 
 
CCND1-
 
 
 
 
DLBCL
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pleomorphic MCL
 
 
 
DLBCL, NOS CD5+
 
CD10+
 
 
 
 
 
 
 
CD10-
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
DLBCL, NOS GCB type
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
BCL6+ IRF4/MUM1-
 
BCL6+ IRF4/MUM1+
 
BCL6- IRF4/MUM1+
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
DLBCL, NOS GCB type
 
Non-GCB
 
Post-GCB
 
 
Hodgkins lymphoma classification
Name Description
Nodular sclerosing Hodgkins lymphoma Most common subtype and is composed of large tumor nodules showing scattered lacunar classical Reed–Sternberg cells set in a background of reactive lymphocytes, eosinophils, and plasma cells with varying degrees of collagen fibrosis/sclerosis.
Mixed-cellularity subtype
Lymphocyte-rich
Lymphocyte depleted
Unspecified
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