16. Follicular lymphoma

Page created on March 6, 2019. Last updated on April 25, 2019 at 19:42

Staining: HE

Organ: Lymph node with perinodal fat


Abnormal follicles are visible. These follicles are made up of tumor cells and are therefore called neoplastic follicles. The tumor cells show only mild atypia/pleiomorphism. The neoplastic follicles have broken mantle zone and shows no “starry sky” pattern. The neoplastic follicles infiltrate the perinodal fat tissue.

The tissue between the neoplastic follicles appears compressed.

Diagnosis: Follicular lymphoma


  • t(14;18) translocation – fusion of BCL2 and IgH genes


The translocation of the IgH gene (with its highly active promoter region) into the BCL2 (an antiapoptotic protein) on chromosome 18 causes the BCL2 gene to be overexpressed. These cells therefore have high antiapoptotic activity. Due to this is there no apoptosis in the follicles, so the “starry sky” pattern not visible.

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6 thoughts on “16. Follicular lymphoma”

  1. hey greek.doctor/G-cobra
    i need a favor (so sorry about it) ,can you please list the tumors which have centroblast, centrocytoid cells and centrocytes? it,s confusing for me . also it would be great if you explain why we see this type of cells in different tumors.
    thanks alot.

    1. Nothing to apologize for.

      Tumour cells are not healthy cells, so it’d be wrong to say that a tumour has centroblasts or centrocytes. However, some tumour cells resemble centroblasts or centrocytes, in which case they’re centroblastoid/centroblastic or centrocytoid/centrocytic. From what I can tell, CLL and SLL contain “centrocytoid” cells while DLBCL may contain “centroblastoid” cells.
      It’s kind of hard to answer why we see this type of cells in different tumours. Lymphomas generally originate from B-cells, so it’s not that weird that some of the cancer cells resemble centroblasts and centrocytes.

  2. On the 2nd picture, there is an incomplete mantle zone (the darker lymphocytes surrounding the germinal center.) In follicular lymphoma the mantle zone can be either incomplete or absent 🙂

    1. I can’t find any sources to back up your claim, but I’m inclined to believe that you’re right. Do you have any sources?
      I’ll change it anyway. You appear to know your shit.

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