Laurent Camille, Cook James R
Department of Pathology, Toulouse University Hospital Center, Cancer Institute University of Toulouse-Oncopole, INSERM, France.
Department of Laboratory Medicine, Robert J. Tomsich Institute of Pathology and Laboratory Medicine, Cleveland Clinic, Cleveland, OH.
Adv Anat Pathol. 2025 May 1;32(3):195-207. doi: 10.1097/PAP.0000000000000481. Epub 2025 Jan 17.
Follicular lymphoma (FL) is a mature B cell neoplasm classically characterized by B cells harboring the t(14;18) IGH::BCL2 leading to the overexpression of BCL2 in most cases. Conventional FL occurs in lymph nodes and typically shows a follicular B-cell proliferation expressing at least one germinal center marker. Two early lesions closely related to conventional FL are recognized as variants, namely in situ follicular neoplasia (ISFN), and duodenal-type follicular lymphoma (DTFL). FL lacking BCL2 rearrangement ( BCL2 -R negative) accounts for around 10% to 15% of FLs and constitutes a heterogeneous group of FLs. Most of these alternative forms of FL are considered as distinct entities separate from conventional FL in the 2022 International Consensus Classification. This review aims to summarize the key pathologic and diagnostic features of FL conventional and its alternative forms as well as further emphasize the increasing role of molecular studies in the diagnostic work-up.
滤泡性淋巴瘤（FL）是一种成熟B细胞肿瘤，其典型特征是B细胞携带t(14;18)IGH::BCL2，在大多数情况下导致BCL2过表达。传统FL发生于淋巴结，通常表现为滤泡性B细胞增殖，表达至少一种生发中心标志物。两种与传统FL密切相关的早期病变被认为是变异型，即原位滤泡性肿瘤（ISFN）和十二指肠型滤泡性淋巴瘤（DTFL）。缺乏BCL2重排（BCL2-R阴性）的FL约占FL的10%至15%，构成一组异质性FL。在2022年国际共识分类中，这些FL的大多数替代形式被视为与传统FL不同的独立实体。本综述旨在总结传统FL及其替代形式的关键病理和诊断特征，并进一步强调分子研究在诊断检查中日益重要的作用。
