!
WOLFRAM(KLAPPER((KIEL)(
(
DIAGNOSTICS(
!
The!diagnosis!of!Follicular!lymphoma!(FL)!is!mostly!dependent!on!histopathology!analysis!of!
tissue! biopsies.! Flow! cytometry! of! blood! mostly! fails! since! FL! rarely! presents! as! leukemic!
disease.! Even! in! cases! with! bone! marrow! infiltration,! aspiration! and! flow! cytometry!
frequently!fails!to!detect!the!disease!since!sclerosis!of!prevents!aspiration!of!the!neoplastic!
cells.1! However,! FL! diagnosis! is! very! reliable! diagnosis! when! made! by! sufficient! tissue!
biopsies.2! Notable! exceptions! are! blast! rich! variants! of! FL! (Grade! 3A! and! 3B)! as! well! as!
transfromation!to!Diffuse!large!B>cell!lymphoma!(DLBCL).2!The!prnciple!of!diagnosis,!grading!
and!detection!of!transformation!will!be!discussed.!The!distinction!of!Grad!3A!and!Grade!3B!
FL!is!clinically!relevant!and!related!to!different!therapeutic!approaches.!We!will!discuss!that!
both!types!of!lymphomas!differ!stricingly!in!their!biological!properties!and!their!pattern!of!
conincidence! with! other! grades! of! lymphoma.! I! will! stress,! that! Grade! 1,! 2! and! 3A! of! FL!
present! a! biological! and! clinical! continuum,! whereas! FL! Grade! 3B! differs! stricingly.3!
Nevertheless,!FL!Grad!3A!and!3B!are!diagnosis!with!the!highest!inter>observer!variability.3!!
Furthermore,!we!will!analyze!simplified!pathology!reports!in!order!to!discuss,!what!analysis!
a!hemato>oncologist!should!expect!to!be!provided!by!the!pathologist.!We!will!discuss!that!
most!scientifically!established!bio>markers!of!prognosis!are!not!suited!for!patient!care!and!
patient!individual!decisson!making.!Furthermore,!we!will!briefly!touch!variants!of!FL!which!
are!not!solely!defined!by!histopathology!but!represent!clinico>pathological!subtypes!which!
can!be!recognized!by!combining!pathology!analysis!and!clinical!features,!e.g.!the!duodenal!
type!of!FL4!and!FL!in!young!patients.5!
!
References:(
1.! Schmidt! B,! Kremer! M,! Gotze! K,! et! al.! Bone! marrow! involvement! in! follicular! lymphoma:!
comparison! of! histology! and! flow! cytometry! as! staging! procedures.! Leuk( Lymphoma.!
2006;47(9):1857>1862.!
2.! Laurent! C,! Baron! M,! Amara! N,! et! al.! Impact! of! Expert! Pathologic! Review! of! Lymphoma!
Diagnosis:!Study!of!Patients!From!the!French!Lymphopath!Network.!J(Clin(Oncol.!2017;35(18):2008>
2017.!
3.! Koch! K,! Hoster! E,! Ziepert! M,! et! al.! Clinical,! pathological! and! genetic! features! of! follicular!
lymphoma! grade! 3A:! a! joint! analysis! of! the! German! low>grade! and! high>grade! lymphoma! study!
groups!GLSG!and!DSHNHL.!Ann(Oncol.!2016;27(7):1323>1329.!
4.! Hellmuth! JC,! Louissaint! A,! Jr.,! Szczepanowski! M,! et! al.! Duodenal! type! and! nodal! follicular!
lymphoma! differ! by! their! immune! microenvironment! rather! than! their! mutation! profiles.! Blood.!
2018.!
5.! Louissaint! A,! Jr.,! Ackerman! AM,! Dias>Santagata! D,! et! al.! Pediatric>type! nodal! follicular!
lymphoma:!an!indolent!clonal!proliferation!in!children!and!adults!with!high!proliferation!index!and!
no!BCL2!rearrangement.!Blood.!2012;120(12):2395>2404.!
! !
SCIENTIFIC PROGRAMME
SESSION I
HODGKIN’S DISEASE
DEBATE I
IS THERE STILL A ROLE
FOR COMBINED MODALITY
THERAPY FOR EARLY
STAGE CHL?
SESSION II
T-CELL LYMPHOMA
ROUNDTABLE I
FUTURE DIRECTIONS IN
T-CELL LYMPHOMA
SESSION III
FOLLICULAR LYMPHOMA
DEBATE II
CAN WE AVOID
CHEMOTHERAPY IN
THE MANAGEMENT OF
FOLLICULAR LYMPHOMA?
SESSION IV
RARE LYMPHOMAS –
MARGINAL ZONE
LYMPHOMA AND
WALDENSTRÖM M
ACROGLOBULINEMIA
ROUNDTABLE II – WHERE
TO GO IN RARE B-CELL
LYMPHOMAS
SESSION V
MANTLE CELL LYMPHOMA
SESSION VI
DIFFUSE LARGE B-CELL
LYMPHOMA
DEBATE III
DO WE STILL NEED ASCT
IN MCL?
SESSION VII
NOVEL THER APEUTIC
CONCEPTS IN B-CELL
LYMPHOMAS
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES