Sclerosing variants of follicular center cell lymphomas presenting in the retroperitoneum

A study of 22 patients with sclerosing variants of follicular center cell lymphoma (FCCL) presenting as a retroperitoneal mass is reported. These FCCL variants comprise 74% of retroperitoneal non-Hodgkin's lymphoma presentations. A partial intranodal follicular growth pattern was present in each case, and marked sclerosis of a distinctive pattern was associated with extensive perinodal lymphomatous infiltration. Small cleaved cells (SCC) predominated in five cases, large cleaved cells (LCC) in 14, and large noncleaved cells (LNCC) in three. Eighty percent of patients with SCC predominance were Stage I-II, compared to 50% of those with LCC predominance; all three LNCC cases were Stage IV. High stage was attained primarily by renal invasion or infiltration out the mesenteric root into gut or omentum; only three patients had biopsy proven extraabdominal disease. Combined modality therapy achieved an 88% complete or partial remission rate in patients with SCC and LCC predominance; all three LNCC patients died.