Table 3

Differential features between in situ and partial involvement by follicular and mantle cell lymphoma

In situ FL/intrafollicular neoplasia* 
    Preserved general architecture 
    Centrocytes strongly positive for BCL2 and CD10 within GC 
    BCL-2 staining in centrocytes usually stronger than in mantle cells or reactive T cells 
    Involved follicles usually scattered, not confluent 
    GCs normal in size and often not completely replaced by BCL-2+ cells 
Partial involvement by FL 
    Partial effacement of the architecture 
    Affected follicles usually restricted to a limited region of the lymph node 
    Tumor cells may be present in interfollicular areas 
    GCs expanded in size and completely replaced by tumor cells 
In situ MCL* 
    Preserved general architecture 
    Mantle zones usually not expanded 
    Cyclin D1+ cells restricted to the mantle zones of reactive follicles with only scattered positive cells in interfollicular areas 
    Cyclin D1+ cells tend to accumulate in the inner layers of the mantle zone; not all mantle cells are positive 
Mantle zone pattern in MCL 
    Architecture preserved or focally effaced 
    Mantle zones usually expanded 
    Cyclin D1+ cells replace virtually all the mantle zone of reactive follicles 
    Focal extension of clusters of tumor cells into interfollicular areas may be seen 
In situ FL/intrafollicular neoplasia* 
    Preserved general architecture 
    Centrocytes strongly positive for BCL2 and CD10 within GC 
    BCL-2 staining in centrocytes usually stronger than in mantle cells or reactive T cells 
    Involved follicles usually scattered, not confluent 
    GCs normal in size and often not completely replaced by BCL-2+ cells 
Partial involvement by FL 
    Partial effacement of the architecture 
    Affected follicles usually restricted to a limited region of the lymph node 
    Tumor cells may be present in interfollicular areas 
    GCs expanded in size and completely replaced by tumor cells 
In situ MCL* 
    Preserved general architecture 
    Mantle zones usually not expanded 
    Cyclin D1+ cells restricted to the mantle zones of reactive follicles with only scattered positive cells in interfollicular areas 
    Cyclin D1+ cells tend to accumulate in the inner layers of the mantle zone; not all mantle cells are positive 
Mantle zone pattern in MCL 
    Architecture preserved or focally effaced 
    Mantle zones usually expanded 
    Cyclin D1+ cells replace virtually all the mantle zone of reactive follicles 
    Focal extension of clusters of tumor cells into interfollicular areas may be seen 

FL indicates follicular lymphoma; MCL, mantle cell lymphoma; and GC, germinal center.

*

The terms “FL-like B cells” or “MCL-like B cell of uncertain significance” are recommended as alternatives to “FL in situ” and “MCL in situ” for clinical use in the future.

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