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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.
*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.
*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.
:*There is no evidence, however, that high Ki-67 should guide the selection of therapy.
:*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.

Revision as of 16:51, 22 August 2015

 
 
 
 
 
 
 
 
 
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
 
 


Laboratory Findings

The diagnosis is easily established on histological grounds, but immunophenotyping is encouraged to distinguish follicular lymphoma from a nodular MCL or SLL.

  • 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.
  • 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.
  • There is no evidence, however, that high Ki-67 should guide the selection of therapy.
  • 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.