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From epathologies.com – What is the diagnosis?

Nice case with multiple fields and images at epathologies.com.

Make sure to check out the pdf presentation as well.

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An interesting case with classic histology. Although I would like to see a BCL-2 immunostain (t(14;18)), the histologic appearance (back to back follicles with an absence of tingle body macrophages) is highly suggestive of follicular lymphoma. The number of centroblasts in the high powered field shown above is clearly > 15, so this would be classified as grade 3. The pressence of centrocytes could further be used to grade this as 3a (vs. 3b – no centrocytes).

The utility of grading follicular lymphoma is debated.

http://www.nature.com/bjc/journal/v89/n1/full/6601006a.html
http://www.nature.com/bmt/journal/v40/n11/abs/1705864a.html

Perhaps other molecular markers for outcome may prove to be more useful in the future:

http://www.ncbi.nlm.nih.gov/pubmed/19224853
http://www.ncbi.nlm.nih.gov/pubmed/16825494
http://www.ncbi.nlm.nih.gov/pubmed/18223287

Nice case – thanks for the post.