FlowCytometry Net
(Flow Cytometry Based Knowledge Portal)
Follicular lymphoma
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Follicular lymphoma is the second most common B-cell NHL, accounting for approximately 35% of all cases. Follicular lymphoma is composed of both small centrocytes (cleaved follicle center cells) and large centroblasts (noncleaved follicle center cells). Follicular lymphoma is assigned a grade based upon the percentage of centroblasts present. Follicular lymphoma is classified as grade I when there are 5 or fewer centroblasts per high-power field (HPF), grade II when there are 6 to 15 centroblasts per HPF, and grade III when there are more than 15 centroblasts per HPF.
Most cases of follicular lymphoma exhibit a t(14;18) chromosomal translocation, which results in deregulation of expression of the BCL2 proto-oncogene on chromosome 18.
Immunophenotyping:
Positive for CD10, CD19, CD20 (strong), CD79a, BCL2 within follicles, BCL6 , CD30+ cells in 30% , CD10 frequently is weak / negative in interfollicular infiltrates and in grade III follicular lymphomas , CD10 is sensitive and specific for follicular lymphoma among small B cell lymphomas, positivity may vary (CD11c, CD23, CD25, CD43) and Negative for CD5 , cyclin D1
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Case-1
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Above case shows positivity for kappa,CD20, CD10, CD19 dim and negativity for CD5, CD23, CD3
Reference:
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Liu Q, Fayad L, Cabanillas F, Hagemeister FB, Ayers GD, Hess M,et al. Improvement of overall and failure-free survival in stageIV follicular lymphoma: 25 years of treatment experience atThe University of Texas M.D. Anderson Cancer Center. J ClinOncol. 2006;24(10):1582-9.
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Federico M, Bellei M, Marcheselli L, Luminari S, Lopez-GuillermoA, Vitolo U, et al. Follicular lymphoma international prognosticindex 2: a new prognostic index for follicular lymphoma developedby the international follicular lymphoma prognostic factorproject. J Clin Oncol. 2009;27(27):4555-62.
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Brice P, Bastion Y, Lepage E, Brousse N, Haïoun C, Moreau P, etal. Comparison in low-tumor-burden follicular lymphomasbetween an initial no-treatment policy, prednimustine, orinterferon alfa: a randomized study from the Groupe d'Etude desLymphomes Folliculaires. Groupe d'Etude des Lymphomes del'Adulte. J Clin Oncol. 1997;15(3):1110-7.
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