Follicular lymphoma: Difference between revisions

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==Overview==
==Overview==
'''Follicular lymphoma''' (FL) is the most common of the indolent [[non-Hodgkin's lymphoma]]s. It is defined as a [[lymphoma]] of [[follicle]] center [[B-cells]] (centrocytes and centroblasts), which has at least a partially follicular pattern. It is positive for [[CD10]].<ref>[http://pleiad.umdnj.edu/hemepath/follicular/follicular.html Overview at University of Medicine and Dentistry of New Jersey]</ref>
'''Follicular lymphoma''' (FL) is the most common of the indolent [[non-Hodgkin's lymphoma]]s. It is defined as a [[lymphoma]] of [[follicle]] center [[B-cells]] (centrocytes and centroblasts), which has at least a partially follicular pattern. It is positive for [[CD10]].<ref>[http://pleiad.umdnj.edu/hemepath/follicular/follicular.html Overview at University of Medicine and Dentistry of New Jersey]</ref>


==Morphology==
==Pathophysiology==
The [[tumor]] is composed of follicle center cells, usually a mixture of centrocytes (cleaved follicle center cells, "small cells") and centroblasts (large noncleaved follicle center cells, "[[large cells]]"). Centrocytes typically predominate; centroblasts are usually in the minority, but by definition are always present. Rare lymphomas with a follicular growth pattern consist almost entirely of centroblasts. Occasional cases may show plasmacytoid differentiation of foci of [[marginal zone]] or [[monocytoid]] B-cells.
The [[tumor]] is composed of follicle center cells, usually a mixture of centrocytes (cleaved follicle center cells, "small cells") and centroblasts (large noncleaved follicle center cells, "[[large cells]]"). Centrocytes typically predominate; centroblasts are usually in the minority, but by definition are always present. Rare lymphomas with a follicular growth pattern consist almost entirely of centroblasts. Occasional cases may show [[plasmacytoid]] differentiation of foci of [[marginal zone]] or [[monocytoid]] B-cells.


==Causes==
==Causes==
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==Treatment==
==Treatment==
There is no consensus regarding the best treatment [[algorithm]], but watch-and-wait policies, alkylators, anthracycline-containing regimens (eg. [[CHOP]]), [[rituximab]], autologous and allogeneic [[hematopoietic stem cell transplantation]] have all been applied. The disease is regarded as incurable (although allogeneic stem cell transplanation may be curative, the [[death|mortality]] from the procedure is too high to be a first line option). The exception is localised disease, which can be cured by local [[irradiation]]. The typical pattern is one of good responses from treatment, followed by relapses some years later. [[Median]] survival is around 10 years, but the range is wide, from less than one year, to more than 20 years. Some patients may never need treatment.
There is no consensus regarding the best treatment [[algorithm]], but watch-and-wait policies, [[alkylators]], [[anthracycline]]-containing regimens (eg. [[CHOP]]), [[rituximab]], [[autologous]] and [[allogenic]] [[hematopoietic stem cell transplantation]] have all been applied. The disease is regarded as incurable (although allogenic stem cell transplantation may be curative, the [[death|mortality]] from the procedure is too high to be a first line option). The exception is localized disease, which can be cured by local [[irradiation]]. The typical pattern is one of good responses from treatment, followed by relapses some years later. [[Median]] survival is around 10 years, but the range is wide, from less than one year, to more than 20 years. Some patients may never need treatment.


==References==
==References==
<references/>
<references/>
==External links==
* http://www.LymphomaSurvival.com Strategies for Long-Term Survival
* [http://www.lymphomation.org/type-follicular.htm Follicular Lymphoma Resource page] - Patients Against Lymphoma
* [http://www.lymphomainfo.net/nhl/follicular.html Lymphoma information network]


[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Oncology]]
[[Category:Oncology]]
[[Category:Needs content]]
{{Hematological malignancy histology}}
{{Hematological malignancy histology}}



Revision as of 18:34, 17 September 2012

Follicular lymphoma
ICD-10 C82
ICD-9 202.0
ICD-O: M9690/3
MeSH D008224

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Follicular lymphoma (FL) is the most common of the indolent non-Hodgkin's lymphomas. It is defined as a lymphoma of follicle center B-cells (centrocytes and centroblasts), which has at least a partially follicular pattern. It is positive for CD10.[1]

Pathophysiology

The tumor is composed of follicle center cells, usually a mixture of centrocytes (cleaved follicle center cells, "small cells") and centroblasts (large noncleaved follicle center cells, "large cells"). Centrocytes typically predominate; centroblasts are usually in the minority, but by definition are always present. Rare lymphomas with a follicular growth pattern consist almost entirely of centroblasts. Occasional cases may show plasmacytoid differentiation of foci of marginal zone or monocytoid B-cells.

Causes

A translocation between chromosome 14 and 18 results in the overexpression of the bcl2 gene. This overexpression causes a blockage of apoptosis, or programmed cell death. This translocation has been associated with the development of Follicular lymphoma.

Treatment

There is no consensus regarding the best treatment algorithm, but watch-and-wait policies, alkylators, anthracycline-containing regimens (eg. CHOP), rituximab, autologous and allogenic hematopoietic stem cell transplantation have all been applied. The disease is regarded as incurable (although allogenic stem cell transplantation may be curative, the mortality from the procedure is too high to be a first line option). The exception is localized disease, which can be cured by local irradiation. The typical pattern is one of good responses from treatment, followed by relapses some years later. Median survival is around 10 years, but the range is wide, from less than one year, to more than 20 years. Some patients may never need treatment.

References

de: Follikuläres Lymphom

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