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==Laboratory Findings==
 
The diagnosis is easily established on histological grounds, but immunophenotyping is encouraged to distinguish follicular lymphoma from a nodular MCL or SLL.
===Use of Immunophenotyping/Genetic Testing in Differential Diagnosis of Mature B-Cell and NK/T-Cell Neoplasms===
*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.
<div style="font-size: 80%;"><BR>
*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.
{{Familytree/start}}
:*There is no evidence, however, that high Ki-67 should guide the selection of therapy.
{{Familytree|boxstyle=border: 0;| | | | | | | | | | A01 | | | | | | | | | | |A01={{F1|B-cell neoplasms}}}}
:*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.
{{Familytree|boxstyle=border: 0;| | | | | |,|-|-|-|-|^|-|-|-|-|.| | | | | | |}}
{{Familytree|boxstyle=border: 0;| | | | | B01 | | | | | | | | B02 | | | | | |B01={{F1|CD5+}}|B02={{F1|CD5-}}}}
{{Familytree|boxstyle=border: 0;| | |,|-|-|^|-|-|.| | | | | | |!| | | | | | |}}
{{Familytree|boxstyle=border: 0;| | C01 | | | | C02 | | | | | C03 | | | | | |C01={{F1|CCND1+}}|C02={{F1|CCND1-}}|C03={{F1|DLBCL}}}}
{{Familytree|boxstyle=border: 0;| | |!| | | | | |!| | | |,|-|-|^|-|-|-|-|-|-|.| | | |}}
{{Familytree|boxstyle=border: 0;| | D01 | | | | D02 | | D03 | | | | | | | | D04 | | |D01={{F2|Pleomorphic MCL}}|D02={{F2|DLBCL, NOS CD5+}}|D03={{F1|CD10+}}|D04={{F1|CD10-}}}}
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | |!| | | | | | | | | |!| | | |}}
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | E01 | | | | |,|-|-|-|+|-|-|-|.| | | |E01={{F2|DLBCL, NOS GCB type}}}}
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | | | | | | | F01 | | F02 | | F03 | | |F01={{F1|BCL6+ IRF4/MUM1-}}|F02={{F1|BCL6+ IRF4/MUM1+}}|F03={{F1|BCL6- IRF4/MUM1+}}}}
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | | | | | | | |!| | | |!| | | |!| | | |}}
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | | | | | | | G01 | | G02 | | G03 | | |G01={{F2|DLBCL, NOS GCB type}}|G02={{F2|Non-GCB}}|G03={{F2|Post-GCB}}}}
{{Familytree/end}}
</div>

Latest revision as of 20:06, 23 March 2016

 
 
 
 
 
 
 
 
 
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
 
 



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
 
 
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