摘要

Follicular lymphoma (FL) is one of the most frequently diagnosed lymphomas in the United States and Europe. The definition of and basic approach to diagnosis and grading of FL is essentially unchanged in the recently updated revision of the World Health Organization (WHO) classification. FL is a biologically and histopathologically heterogeneous disease. Although there is an improved understanding of some FL variants and specific subtypes, there are cases whose recognition is particularly challenging, either because they have unusual features or represent examples of new or rare variants. Herein, we share a series of unusual and difficult to recognize FLs with the goal of increasing awareness of the expanding histopathologic variability in FL. Unusual FL discussed here include: FL with Castleman-like changes, FL with plasmacytic differentiation, and immunoglobulin G4-positive plasma cells in the setting of immunoglobulin G4-related disease, FL with marginal zone differentiation and involving mucosa-associated lymphoid tissue sites, diffuse FL variant expressing CD23 with STAT6 mutation, large B-cell lymphoma with IRF4 rearrangement, CD10-negative and MUM1-positive aggressive FL, and Epstein-Barr virus-positive FL.

译文

滤泡性淋巴瘤 (FL) 是美国和欧洲最常诊断的淋巴瘤之一。FL 诊断和分级的定义和基本方法在最近更新的世卫组织分类修订中基本没有改变。FL 是一种生物学上和组织病理学上的异质性疾病。虽然对一些 FL 变异和特定亚型的理解有所提高，但有些病例的识别特别具有挑战性，要么是因为它们具有不寻常的特征，要么是因为它们代表了新的或罕见变异的例子。在此，我们分享了一系列不寻常且难以识别的 FLs，目的是提高对 FL 中不断扩大的组织病理学变异性的认识。这里讨论的不寻常的 FL 包括: 具有 Castleman 样变化的 FL，具有浆细胞溶解分化的 FL，以及免疫球蛋白 G4-positive 疾病背景下的浆细胞 G4-related 免疫球蛋白, FL 与边缘区分化并涉及粘膜相关淋巴组织部位，弥漫 FL 变异表达 CD23 与 STAT6 突变，大 b细胞淋巴瘤与 IRF4 重排,CD10-negative 和 MUM1-positive 侵袭性 FL，以及 Epstein-Barr 病毒阳性 FL。