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Three practice updates in non-Hodgkin lymphoma for 2026.

Rebecca L King1, Sarah J Ondrejka2, James R Cook2

  • 1Division of Hematopathology, Mayo Clinic, Rochester, MN, USA.

Human Pathology
|December 13, 2025
PubMed
Summary

Navigating lymphoid neoplasms requires distinguishing between various non-Hodgkin lymphomas using morphology and ancillary studies. This review updates classifications for follicular lymphoma, high-grade B-cell lymphomas, and nodal T-cell lymphomas.

Keywords:
Follicular lymphomaHigh grade B-Cell lymphomaInternational consensus classificationNon-Hodgkin lymphomaT-cell lymphoma

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Area of Science:

  • Hematology
  • Pathology
  • Oncology

Background:

  • Lymphoid neoplasms pose diagnostic challenges in surgical pathology.
  • Distinguishing non-Hodgkin lymphoma subtypes requires morphology and ancillary studies.
  • Current practice uses both the World Health Organization (5th ed.) and International Consensus Classification systems.

Purpose of the Study:

  • Provide practical updates on classifying challenging lymphoid neoplasms.
  • Offer guidance on follicular lymphoma, high-grade B-cell lymphomas, and nodal T-cell lymphomas.
  • Advise on ancillary studies and navigating current classification systems.

Main Methods:

  • Review of current literature and classification systems.
  • Focus on morphologic evaluation and ancillary studies (immunohistochemistry, flow cytometry, NGS).
  • Comparative analysis of classification approaches for specific lymphoma types.

Main Results:

  • Detailed evaluation strategies for follicular lymphoma subtypes.
  • Current approaches to high-grade B-cell lymphomas, including double-hit and NOS variants.
  • Features of common nodal T-cell lymphomas (T-follicular helper, anaplastic large cell, PTCL-NOS).

Conclusions:

  • Accurate classification of lymphoid neoplasms is crucial for patient management.
  • Understanding differences between classification systems aids diagnostic accuracy.
  • Ancillary studies are essential for definitive diagnosis and subtyping.