The Fellow on Call: The Heme/Onc Podcast Episode 136: Introduction to Follicular Lymphoma
May 21, 2025
Explore the challenges of managing follicular lymphoma as the hosts discuss accurate biopsy techniques and the importance of tissue sampling. Discover the nuances of diagnosing various lymphoma types, particularly focusing on CD10 positivity. Delve into the classification of follicular lymphoma subtypes, including rare variants and their treatment implications. The discussion also highlights the significance of imaging techniques like PET-CT scans and effective staging systems that are critical for tailored treatment strategies.
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Biopsy Types in Lymphoma
- For lymphoma diagnosis, excisional biopsy is the gold standard as it preserves lymph node architecture.
- Use FNA for suspected carcinoma and core biopsy selectively; notify pathologists to send samples in RPMI for flow cytometry if lymphoma is suspected.
Communicate Biopsy Intent Clearly
- Communicate clinical suspicion of lymphoma to proceduralists to ensure correct biopsy handling.
- This prevents samples from being fixed improperly, enabling flow cytometry and accurate diagnosis.
CD10 and Cell Size in Diagnosis
- CD10 positivity indicates germinal center origin, suggesting follicular lymphoma, DLBCL, or Burkitt lymphoma.
- Increased forward scatter indicates large cells and usually more aggressive lymphoma, aiding early differential diagnosis.