Abstract
Background: Follicular lymphoma is an indolent B Non Hodgkin lymphoma which has a characteristic follicular growth pattern and immunohistochemical expression. The neoplastic cells express CD20, CD10, BCL2 and are negative for CD5, CD23 and Cyclin D1. CD5 is a useful marker in the differentiation of various B cell lymphomas. Small cell lymphoma and mantle cell lymphoma express CD5. Some of the follicular lymphomas express CD5 which results in diagnostic confusion. Methods: 52 cases of lymphoma were diagnosed over a period of 2 years in a tertiary care centre in south India. Among these, 9 cases were diagnosed as follicular lymphoma based on the morphological abd immunohistochemical study. A panel of antibodies were chosen based on the morphological diagnosis.The panel used for small cell lymphomas include CD20, CD3, CD5 CD23, Cyclin D1, CD10, BCL2 and Ki67. Result: Of the nine cases of follicular lymphoma, three were CD5 positive. Two showed bone marrow involvement. There was no significant morphological difference between CD5 positive and CD5 negative follicular lymphoma. Conclusion: The expression of CD5 by follicular lymphomas could be problematic when the follicular lymphoma as such lacks its characteristic follicular pattern and there are no molecular studies available. Eventhough rare , follicular lymphoma is to be considered in the differential diagnosis of CD5 positive follicular lymphomas. DOI: 10.21276/APALM.1364
Highlights
Follicular lymphoma (FL) is the second most common Non Hodgkin lymphoma (NHL) in India
Follicular lymphoma is to be considered in the differential diagnosis of CD5 positive lymphomas
We describe morphologic and immunohistochemical features of 3 such cases of CD5 positive FL
Summary
Follicular lymphoma (FL) is the second most common Non Hodgkin lymphoma (NHL) in India. It is an indolent lymphoma derived from germinal centre derived B cells. The hallmark of FL is t(14;18)q(32;q21) which has been detectable in a significant number of cases accounting to about 80% This genetic alteration is responsible for the deregulated expression of BCL2 which can be detected using immunohistochemistry. FL do not express CD5, a T cell marker that has a key role in the differential diagnosis of small B cell Non Hodglkin lymphomas. Follicular lymphoma is an indolent B Non Hodgkin lymphoma which has a characteristic follicular growth pattern and immunohistochemical expression. Some of the follicular lymphomas express CD5 which results in diagnostic confusion
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