[Precision medicine era: a molecular pathological diagnostic pathway for B-cell lymphomas]

The pathological diagnosis of B-cell lymphomas is transitioning from traditional morphologic assessment to a multidimensional model that integrates histomorphology, immunophenotype, and genetic alterations. Establishing a standardized, stepwise clinical diagnostic pathway has become an urgent priority in precision medicine. This article systematically delineates a "four-step" integrated diagnostic pathway​ for B-cell lymphomas: step 1: initial screening and phenotyping, utilizing immunohistochemistry and flow cytometry to determine lineage and establish a preliminary classification; step 2: definitive diagnosis and differential diagnosis, employing gene rearrangement assays and in situ hybridization to verify clonality and identify characteristic genetic abnormalities; step 3: precision diagnostics, applying high-throughput sequencing for molecular subtyping, prognostic stratification, and targeted therapy guidance; and step 4: frontier exploration, leveraging single-cell and spatial multi-omics technologies along with artificial intelligence to address complex diagnostic challenges. It aims to help pathologists develop hierarchically structured and logically consistent​ molecular diagnostic approaches, promoting the translation of integrated lymphoma diagnosis from theory into clinical practice.