Canterbury DHB

Context

Diagnosis and Grading

In This Section

Morphology of the Lymph Node

Other Laboratory Features

Management

Morphology of the Lymph Node

Morphology still forms the basis of the classification of follicular lymphoma. This is shown in the following table.

Follicular Lymphoma (WHO Classification)

Grading:

 

Grade 1:

0-5 centroblasts/HPF*

Grade 2:

6-15 centroblasts/HPF

Grade 3:

>15 centroblasts/HPF

Grade 3a:

>15 centroblasts, but centrocytes are still present

Grade 3b:

centroblasts form solid sheets with no residual centrocytes

Variants:

 

Cutaneous follicle center lymphoma

Diffuse follicle center lymphoma

Grade 1:

0-5 centroblasts/HPF

Grade 2:

6-15 centroblasts/HPF

* HPF = high power field

Other Laboratory Features

The immunophenotype usually shows surface Ig+, BCL2+, CD10+, CD5-, CD43_. The cells express the B cell antigens 19, 20, 22 and 79a. Ig heavy and light chains are rearranged. Most cases of FL have cytogenetic abnormalities; t(14;18) is the commonest at 70-80%. This juxtaposes the BCL-2 gene to the Ig heavy chain gene with resultant over-expression of BCL-2. Other changes include +7 (20%), +18 (20%), 3q 27-28 (15%), 6q 23-26 (15%), 17p (15%). BCL6 may be rearranged.

Management

RCHOP, RBenda, RCVP, Radiation, and Watch and wait are all used depending on circumstances. Autologous transplant as part of second or later line therapy may prolong PFS.

LOW GRADE

About this Canterbury DHB document (6750):

Document Owner:

Peter Ganly (see Who's Who)

Issue Date:

November 2018

Next Review:

November 2021

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 6750