Sandbox sowminya
| 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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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
| 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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Classification of large cells based on Immunophenotypic/Genetic testing [1]
- Diffuse large B-cell lymphoma (DLBCL),NOS
- T-cell/histocyte-rich large B-cell lymphoma (THRLBCL)
- Primary DLBCL of the CNS
- Primary cutaneous DLBCL, leg type
- EBV-positive DLBCL of the elderly (EBV + DLBCL)
- DLBCL associated with chronic inflammation
- Lymphoid granulomatosis
- Primary mediastinal (thymic) large B-cell Lymphoma (PMBL)
- Intravascular large B-cell lymphoma
- ALK-positive large B-cell lymphoma
- Plasmablastic lymphoma
- Large B-cell lymphoma arising in HHV8-assciated multicentric Castleman disease (LBCL in HHV8 + MCD)
- Primary effusion lymphoma
- B-cell lymphoma unclassifiable, intermediate between DLBCL(U-DLBCL) and classical Hodgkins lymphoma(CHL)
- Mantle cell Lymphoma(MCL),pleomorphic variant