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Follicular immunoblastic lymphoma: a clinicopathologic and immunohistochemical study of a case
Xuanqiu He1, Lei Yang, Yanqing Ding
1First Clinical Medical College, Department of Pathology, Southern Medical University, Guangzhou 510515, China. lmsh815@163.com
Insights
Primary follicular immunoblastic lymphoma (FIBL) is a rare cancer. This case report details its features, diagnosis, and poorer prognosis compared to follicular lymphoma.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Primary follicular immunoblastic lymphoma (FIBL) is an exceedingly rare type of lymphoma.
- Understanding its clinicopathologic and immunohistochemical features is crucial for accurate diagnosis and management.
Observation:
- This report details a rare case of FIBL in a Chinese female patient.
- PET-CT imaging was utilized to assess systemic lymph node metastasis.
- Differential diagnosis from follicular lymphoma (FL) and reactive follicular hyperplasia (RFH) was discussed.
Findings:
- FIBL is characterized by a neoplastic proliferation of intrafollicular immunoblasts.
- Positive CD10 expression suggests a germinal center origin, while CD138 positivity indicates plasmablastic differentiation.
- FIBL exhibits a higher propensity for transformation into diffuse large B-cell lymphoma.
Implications:
- Accurate identification of FIBL is essential for appropriate patient management.
- Recognizing FIBL's potential for transformation impacts prognostic assessment.
- This case contributes to the understanding of a rare lymphoma variant.
Abstract:
Primary follicular immunoblastic lymphoma (FIBL) is an extremely rare lymphoma. The positive expression of CD10 suggests the lymphoma originating from germinal centers (GC) and CD138-positive expression generally indicates plasmablastic or plasmacytic differentiation. We report such a rare case in a Chinese female patient and analyze the clinicopathologic and immunohistochemical features of this disease. PET-CT examination was performed to detect signs of systemic lymph node metastasis. We also discussed the differential diagnosis of FIBL from follicular lymphoma (FL) and reactive follicular hyperplasia (RFH). As a rare variant of human follicular lymphoma, FIBL is featured by a neoplastic overgrowth of intrafollicular immunoblasts. Compared with FL, FIBL has a greater chance to evolve into diffuse large B-cell lymphoma with therefore a poorer prognosis.
