Three practice updates in non-Hodgkin lymphoma for 2026

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.