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Pathology - Follicular lymphoma
Definition: A mature B-cell neoplasm consisting of germinal center cells (centrocytes and centroblasts).
Epidemiology • Represents approximately 20% of all non-Hodgkin lymphomas. • Primarily impacts individuals aged 50 to 60.
Aetiology: Unknown. Genetics: 90% of cases exhibit a distinctive t(14;18) translocation, leading to the fusion of the BCL2 gene with the IGH locus. Deregulated synthesis of the anti-apoptotic Bcl-2 protein leads to clonal proliferation.
Presentation: Extensive lymphadenopathy and splenomegaly. • Patients are often asymptomatic.
Histopathology Nodal architecture is supplanted by contiguous neoplastic follicles. Neoplastic follicles are devoid of mantle zones and consist of haphazardly arranged neoplastic centroblasts and centrocytes. Tangible body macrophages are typically lacking. • Neoplastic cells typically exhibit interfollicular dissemination. Bone marrow involvement is defined by paratrabecular clusters of malignant centrocytes and centroblasts. Immunophenotype PAX5, CD20, and CD79a, which are B-cell markers, exhibit positivity. Bcl-2, Bcl-6, and CD10 are furthermore positive. • CD5, CD23, and cyclin D1 are absent.
Prognosis is contingent upon the severity of the disease and the grade of the tumor. Approximately 25% progression into a high-grade lymphoma, typically diffuse large B-cell lymphoma, correlating with a swift clinical deterioration and mortality.
Definition: A mature B-cell neoplasm consisting of germinal center cells (centrocytes and centroblasts).
Epidemiology • Represents approximately 20% of all non-Hodgkin lymphomas. • Primarily impacts individuals aged 50 to 60.
Aetiology: Unknown. Genetics: 90% of cases exhibit a distinctive t(14;18) translocation, leading to the fusion of the BCL2 gene with the IGH locus. Deregulated synthesis of the anti-apoptotic Bcl-2 protein leads to clonal proliferation.
Presentation: Extensive lymphadenopathy and splenomegaly. • Patients are often asymptomatic.
Histopathology Nodal architecture is supplanted by contiguous neoplastic follicles. Neoplastic follicles are devoid of mantle zones and consist of haphazardly arranged neoplastic centroblasts and centrocytes. Tangible body macrophages are typically lacking. • Neoplastic cells typically exhibit interfollicular dissemination. Bone marrow involvement is defined by paratrabecular clusters of malignant centrocytes and centroblasts. Immunophenotype PAX5, CD20, and CD79a, which are B-cell markers, exhibit positivity. Bcl-2, Bcl-6, and CD10 are furthermore positive. • CD5, CD23, and cyclin D1 are absent.
Prognosis is contingent upon the severity of the disease and the grade of the tumor. Approximately 25% progression into a high-grade lymphoma, typically diffuse large B-cell lymphoma, correlating with a swift clinical deterioration and mortality.
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