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[Complex diagnosis of follicular lymphomas]
Erika Tóth1, Tamás Schneider, Zsombor Melegh
1Molekuláris Patológiai Osztály, Országos Onkológiai Intézet, Budapest 1122, Hungary. terika@oncol.hu
Magyar Onkologia
|October 27, 2005
Summary
Histopathology alone is insufficient for diagnosing follicular lymphoma (FL). Immunohistochemistry and molecular pathology, including bcl-2 gene rearrangement, are crucial for accurate FL diagnosis and grading.
Area of Science:
- Hematology
- Oncology
- Pathology
Context:
- Follicular lymphoma (FL) is the second most common non-Hodgkin's lymphoma in the West.
- FL incidence is increasing in Hungary, currently at 15-20%.
Purpose:
- To re-evaluate FL diagnoses from 1990-1995 at the National Institute of Oncology.
- To assess the diagnostic utility of histology, immunohistochemistry, and gene rearrangement detection (IgH, bcl-2).
Summary:
- Histological re-examination of 53 cases revealed 37 FLs, 11 diffuse large B-cell lymphomas, and other lymphoid neoplasms.
- Immunohistochemistry (CD20, CD3, bcl-2, CD10, bcl-6, CD5, p53, cyclin D1, Ki-67) and bcl-2 gene rearrangement analysis were performed.
- FL grade correlated with CD10, bcl-2 expression, and Ki-67 proliferation index. bcl-2 gene rearrangement was detected in 55% of FLs.
Impact:
- Histology alone is insufficient for accurate FL diagnosis.
- Immunohistochemistry resolved 90% of diagnoses.
- Molecular pathology (gene rearrangements) aided diagnosis in 10% of cases, improving diagnostic accuracy for follicular lymphoma.