Follicular large cleaved cell (centrocytic) lymphoma: an unrecognized variant of follicular lymphoma

Radwa El Behery; Javier A. Laurini; Dennis D. Weisenburger; Lynette M. Smith; Bhavana J. Dave; Jane Yuan; Kai Fu; Wing C. Chan; Bharat N. Nathwani; Phillip J. Bierman; Robert G. Bociek; Julie M. Vose; James O. Armitage; Timothy C. Greiner; Patricia Aoun

doi:10.1016/j.humpath.2017.11.002

Follicular large cleaved cell (centrocytic) lymphoma: an unrecognized variant of follicular lymphoma

Radwa El Behery, Javier A. Laurini, Dennis D. Weisenburger, Lynette M. Smith, Bhavana J. Dave, Jane Yuan, Kai Fu, Wing C. Chan, Bharat N. Nathwani, Phillip J. Bierman, Robert G. Bociek, Julie M. Vose, James O. Armitage, Timothy C. Greiner, Patricia Aoun

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

The World Health Organization classification of lymphoma recommends the subdivision of follicular lymphoma (FL) into 3 grades (FL1-3) based on the average number of centroblasts per high-power field in the neoplastic follicles, but does not recognize a form of FL characterized by a predominance of large cleaved cells (centrocytes) without enough centroblasts to meet the World Health Organization criteria for FL3. We have classified such cases as follicular large cleaved cell lymphoma (FLC) and, herein, describe the pathologic and clinical features of 72 cases of this entity. The features of FLC include a follicular growth pattern with pale follicles at low magnification and frequent follicular and/or interfollicular fibrosis. Cytologically, the cells are predominantly large cleaved cells with moderately coarse to fine chromatin, absent or inconspicuous nucleoli, and small to moderate amounts of pale cytoplasm. The mean nuclear diameter of the large cleaved cells was 10.1 μ approximately twice that of small lymphocytes and similar to centroblasts. The t(14;18) was present in 83% of the cases, and a high proportion expressed BCL2 (84%), BCL6 (100%), and CD10 (88%) and had high Ki67 proliferation (81%). The clinical features of patients with FLC were similar to those with other types of FL, and survival was excellent with anthracycline-based chemotherapy plus rituximab. FLC is a variant of follicular lymphoma, which should be recognized in future lymphoma classifications because the diagnosis of FLC may be important for the selection of therapy.

Original language	English (US)
Pages (from-to)	180-190
Number of pages	11
Journal	Human Pathology
Volume	72
DOIs	https://doi.org/10.1016/j.humpath.2017.11.002
State	Published - Feb 2018
Externally published	Yes

Keywords

Follicular large cleaved cell lymphoma
Follicular lymphoma
Large centrocyte
Large cleaved cell
Non-Hodgkin lymphoma

ASJC Scopus subject areas

Pathology and Forensic Medicine

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10.1016/j.humpath.2017.11.002

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El Behery, R., Laurini, J. A., Weisenburger, D. D., Smith, L. M., Dave, B. J., Yuan, J., Fu, K., Chan, W. C., Nathwani, B. N., Bierman, P. J., Bociek, R. G., Vose, J. M., Armitage, J. O., Greiner, T. C., & Aoun, P. (2018). Follicular large cleaved cell (centrocytic) lymphoma: an unrecognized variant of follicular lymphoma. Human Pathology, 72, 180-190. https://doi.org/10.1016/j.humpath.2017.11.002

El Behery, R, Laurini, JA, Weisenburger, DD, Smith, LM, Dave, BJ, Yuan, J, Fu, K, Chan, WC, Nathwani, BN, Bierman, PJ, Bociek, RG, Vose, JM, Armitage, JO, Greiner, TC & Aoun, P 2018, 'Follicular large cleaved cell (centrocytic) lymphoma: an unrecognized variant of follicular lymphoma', Human Pathology, vol. 72, pp. 180-190. https://doi.org/10.1016/j.humpath.2017.11.002

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title = "Follicular large cleaved cell (centrocytic) lymphoma: an unrecognized variant of follicular lymphoma",

abstract = "The World Health Organization classification of lymphoma recommends the subdivision of follicular lymphoma (FL) into 3 grades (FL1-3) based on the average number of centroblasts per high-power field in the neoplastic follicles, but does not recognize a form of FL characterized by a predominance of large cleaved cells (centrocytes) without enough centroblasts to meet the World Health Organization criteria for FL3. We have classified such cases as follicular large cleaved cell lymphoma (FLC) and, herein, describe the pathologic and clinical features of 72 cases of this entity. The features of FLC include a follicular growth pattern with pale follicles at low magnification and frequent follicular and/or interfollicular fibrosis. Cytologically, the cells are predominantly large cleaved cells with moderately coarse to fine chromatin, absent or inconspicuous nucleoli, and small to moderate amounts of pale cytoplasm. The mean nuclear diameter of the large cleaved cells was 10.1 μ approximately twice that of small lymphocytes and similar to centroblasts. The t(14;18) was present in 83% of the cases, and a high proportion expressed BCL2 (84%), BCL6 (100%), and CD10 (88%) and had high Ki67 proliferation (81%). The clinical features of patients with FLC were similar to those with other types of FL, and survival was excellent with anthracycline-based chemotherapy plus rituximab. FLC is a variant of follicular lymphoma, which should be recognized in future lymphoma classifications because the diagnosis of FLC may be important for the selection of therapy.",

keywords = "Follicular large cleaved cell lymphoma, Follicular lymphoma, Large centrocyte, Large cleaved cell, Non-Hodgkin lymphoma",

author = "{El Behery}, Radwa and Laurini, {Javier A.} and Weisenburger, {Dennis D.} and Smith, {Lynette M.} and Dave, {Bhavana J.} and Jane Yuan and Kai Fu and Chan, {Wing C.} and Nathwani, {Bharat N.} and Bierman, {Phillip J.} and Bociek, {Robert G.} and Vose, {Julie M.} and Armitage, {James O.} and Greiner, {Timothy C.} and Patricia Aoun",

note = "Publisher Copyright: {\textcopyright} 2017 Elsevier Inc.",

year = "2018",

month = feb,

doi = "10.1016/j.humpath.2017.11.002",

language = "English (US)",

volume = "72",

pages = "180--190",

journal = "Human Pathology",

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TY - JOUR

T1 - Follicular large cleaved cell (centrocytic) lymphoma

T2 - an unrecognized variant of follicular lymphoma

AU - El Behery, Radwa

AU - Laurini, Javier A.

AU - Weisenburger, Dennis D.

AU - Smith, Lynette M.

AU - Dave, Bhavana J.

AU - Yuan, Jane

AU - Fu, Kai

AU - Chan, Wing C.

AU - Nathwani, Bharat N.

AU - Bierman, Phillip J.

AU - Bociek, Robert G.

AU - Vose, Julie M.

AU - Armitage, James O.

AU - Greiner, Timothy C.

AU - Aoun, Patricia

PY - 2018/2

Y1 - 2018/2

N2 - The World Health Organization classification of lymphoma recommends the subdivision of follicular lymphoma (FL) into 3 grades (FL1-3) based on the average number of centroblasts per high-power field in the neoplastic follicles, but does not recognize a form of FL characterized by a predominance of large cleaved cells (centrocytes) without enough centroblasts to meet the World Health Organization criteria for FL3. We have classified such cases as follicular large cleaved cell lymphoma (FLC) and, herein, describe the pathologic and clinical features of 72 cases of this entity. The features of FLC include a follicular growth pattern with pale follicles at low magnification and frequent follicular and/or interfollicular fibrosis. Cytologically, the cells are predominantly large cleaved cells with moderately coarse to fine chromatin, absent or inconspicuous nucleoli, and small to moderate amounts of pale cytoplasm. The mean nuclear diameter of the large cleaved cells was 10.1 μ approximately twice that of small lymphocytes and similar to centroblasts. The t(14;18) was present in 83% of the cases, and a high proportion expressed BCL2 (84%), BCL6 (100%), and CD10 (88%) and had high Ki67 proliferation (81%). The clinical features of patients with FLC were similar to those with other types of FL, and survival was excellent with anthracycline-based chemotherapy plus rituximab. FLC is a variant of follicular lymphoma, which should be recognized in future lymphoma classifications because the diagnosis of FLC may be important for the selection of therapy.

AB - The World Health Organization classification of lymphoma recommends the subdivision of follicular lymphoma (FL) into 3 grades (FL1-3) based on the average number of centroblasts per high-power field in the neoplastic follicles, but does not recognize a form of FL characterized by a predominance of large cleaved cells (centrocytes) without enough centroblasts to meet the World Health Organization criteria for FL3. We have classified such cases as follicular large cleaved cell lymphoma (FLC) and, herein, describe the pathologic and clinical features of 72 cases of this entity. The features of FLC include a follicular growth pattern with pale follicles at low magnification and frequent follicular and/or interfollicular fibrosis. Cytologically, the cells are predominantly large cleaved cells with moderately coarse to fine chromatin, absent or inconspicuous nucleoli, and small to moderate amounts of pale cytoplasm. The mean nuclear diameter of the large cleaved cells was 10.1 μ approximately twice that of small lymphocytes and similar to centroblasts. The t(14;18) was present in 83% of the cases, and a high proportion expressed BCL2 (84%), BCL6 (100%), and CD10 (88%) and had high Ki67 proliferation (81%). The clinical features of patients with FLC were similar to those with other types of FL, and survival was excellent with anthracycline-based chemotherapy plus rituximab. FLC is a variant of follicular lymphoma, which should be recognized in future lymphoma classifications because the diagnosis of FLC may be important for the selection of therapy.

KW - Follicular large cleaved cell lymphoma

KW - Follicular lymphoma

KW - Large centrocyte

KW - Large cleaved cell

KW - Non-Hodgkin lymphoma

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U2 - 10.1016/j.humpath.2017.11.002

DO - 10.1016/j.humpath.2017.11.002

M3 - Article

C2 - 29170017

AN - SCOPUS:85040369562

SN - 0046-8177

VL - 72

SP - 180

EP - 190

JO - Human Pathology

JF - Human Pathology

ER -

Follicular large cleaved cell (centrocytic) lymphoma: an unrecognized variant of follicular lymphoma

Abstract

Keywords

ASJC Scopus subject areas

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