Indolent pediatric lymphomas/lymphoproliferative disorders: a report of the 2024 EA4HP/SH lymphoma workshop

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Leonie Frauenfeld1,2, Maurilio Ponzoni3, Gorana Gasljevic4

  • 1Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.

Virchows Archiv : an International Journal of Pathology
|July 23, 2025
PubMed

Insights

This study revises indolent pediatric lymphoid neoplasms, highlighting pediatric-type follicular lymphoma (PTFL) and rare extranodal lymphomas. Findings aim to improve diagnosis and prevent overtreatment of childhood lymphoid disorders.

Area of Science:

  • Hematopathology
  • Pediatric Oncology
  • Lymphoid Neoplasms

Background:

  • Distinguishing indolent neoplastic from reactive lymphoproliferations in children is challenging.
  • The 2024 European Association for Haematopathology/Society for Hematopathology workshop addressed indolent pediatric lymphoid neoplasms.
  • Forty-one pediatric cases were reviewed to clarify diagnostic criteria.

Purpose of the Study:

  • To revise the classification of indolent pediatric lymphoid neoplasms.
  • To delineate the morphologic spectrum of pediatric-type follicular lymphoma (PTFL).
  • To compare pediatric indolent lymphomas with their adult counterparts to prevent misdiagnosis.

Main Methods:

  • Review of 41 submitted pediatric lymphoid neoplasm cases.
  • Morphological analysis of pediatric-type follicular lymphoma (PTFL) with and without marginal zone differentiation (MZD).
  • Comparison of testicular follicular lymphomas with literature data and review of atypical lymphoid hyperplasia criteria.

Main Results:

  • PTFL exhibits a spectrum of features, including unusual relapses and extranodal involvement.
  • Rare pediatric follicle center-derived neoplasms like primary testicular follicular lymphoma were characterized.
  • Extranodal marginal zone lymphomas (MZL) and pediatric plasmacytic proliferations were also discussed.

Conclusions:

  • Clarifying the spectrum of indolent pediatric lymphomas is crucial for accurate diagnosis.
  • Distinguishing these from adult counterparts helps avoid misdiagnosis and overtreatment.
  • The workshop provided updated insights into challenging pediatric lymphoid neoplasms.

Keywords:
Atypical lymphoid hyperplasiaMarginal zone lymphomaPediatric lymphomasPediatric-type follicular lymphoma

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