Common misdiagnoses in lymphomas and avoidance strategies

Area of Science:

• Hematology
• Pathology
• Oncology

Background:

• Lymphoma diagnosis relies on integrated clinical, morphological, immunophenotypic, and molecular features per WHO classifications.
• Accurate lymphoma diagnosis is challenging due to mimicry by reactive lesions and overlapping features with certain lymphoma subtypes.
• Distinguishing between specific lymphoma types and reactive conditions, or between different lymphoma subtypes, presents significant classification difficulties.

Purpose of the Study:

• To provide pathologists and clinicians with a concise overview of diagnostic pitfalls in lymphoma classification.
• To outline strategies for avoiding misdiagnosis of lymphomas and reactive lymphoid proliferations.
• To emphasize the importance of multidisciplinary collaboration in complex lymphoma cases.

Main Methods:

• Review of diagnostic criteria for lymphomas and reactive lymphoid lesions.
• Analysis of potential misinterpretations in immunophenotyping and molecular genetic testing.
• Discussion of differential diagnoses for challenging lymphoma cases.

Main Results:

• Reactive lesions (e.g., Kikuchi lymphadenitis, infectious mononucleosis) can be mistaken for lymphoma.
• Certain anaplastic large-cell lymphoma and classical Hodgkin's lymphoma variants may be misdiagnosed as reactive disorders.
• Aberrant antigen expression and technical limitations in molecular tests complicate lymphoma diagnosis.

Conclusions:

• Accurate lymphoma diagnosis necessitates careful integration of all available data.
• Awareness of mimickers and potential interpretation issues is crucial for avoiding diagnostic errors.
• Close collaboration among clinicians, histopathologists, and molecular biologists is essential for optimal lymphoma diagnosis and patient management.