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Primary Lymphoid Organs01:16

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Primary lymphoid organs are pivotal in the formation, development, and maturation of lymphocytes, the white blood cells that serve as the backbone of our immune system. This crucial function underscores their fundamental role in maintaining our overall health and immunity. The two primary lymphoid organs of prime importance are the red bone marrow and the thymus.
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Secondary organs, including lymph nodes, the spleen, and mucosa-associated lymphoid tissue (MALT), work harmoniously to protect us from disease and infection.
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Follicular lymphoma: updates for pathologists.

Mahsa Khanlari1, Jennifer R Chapman2

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|December 24, 2021
PubMed
Summary

Follicular lymphoma (FL) is a common indolent B-cell cancer originating in germinal centers. Diagnosis requires histopathology, and while survival is prolonged, relapses are frequent, necessitating diverse treatments.

Keywords:
CytogeneticsFollicular lymphomaImmunohistochemistryMolecularPrognosisTreatment

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Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • Follicular lymphoma (FL) is the most prevalent indolent B-cell lymphoma, originating from germinal center B-cells.
  • Tumorigenesis involves early genetic alterations in bone marrow precursor B-cells, followed by acquisition of further abnormalities during lymph node maturation.
  • FL exhibits significant clinicopathologic heterogeneity, often presenting as indolent peripheral lymphadenopathy with potential involvement of spleen, bone marrow, and peripheral blood.

Purpose of the Study:

  • To provide a comprehensive overview of follicular lymphoma, encompassing its origin, pathogenesis, diagnostic criteria, and clinical characteristics.
  • To highlight the diagnostic challenges posed by the biologic and histopathologic variability of FL, including morphologic variants and interpretation pitfalls.
  • To discuss the current treatment landscape, including chemotherapy, immunotherapy, and targeted therapy.

Main Methods:

  • Histopathologic identification of B-cell proliferation in a follicular pattern.
  • Immunophenotyping to confirm germinal center-associated antigen expression.
  • Review of clinicopathologic features, genetic abnormalities, and treatment modalities.

Main Results:

  • FL originates from germinal center B-cells and is characterized by the t(14;18) translocation.
  • Diagnosis relies on histopathology and immunophenotyping, though morphologic variants can mimic other malignancies.
  • Most FL patients have prolonged survival, but frequent relapses necessitate ongoing treatment strategies.

Conclusions:

  • Follicular lymphoma is a heterogeneous indolent lymphoma requiring careful diagnosis due to its variability.
  • Accurate diagnosis involves understanding morphologic variants and potential pitfalls in ancillary studies.
  • The treatment of FL has evolved to include immunotherapy and targeted therapies alongside traditional chemotherapy, improving patient outcomes despite frequent relapses.