NCCN Guidelines for Patients® | Follicular Lymphoma Grade 1-2

13 NCCN Guidelines for Patients ® : Follicular Lymphoma, Grade 1–2, 2017 1 Follicular lymphoma basics Diagnosis large within nodes but do not spread far. The cancer grade is typically grade 1-2. IRF4 (AKA MUM1) rearrangements Rarely, follicular lymphomas have an IRF4 gene rearrangement. Instead, this rearrangement is usually present in diffuse large B-cell lymphomas. When present in follicular lymphoma, the grade is 3B. The cancer grows fast but responds well to treatment. Methods There is more than one type of genetic test. Molecular analysis is used to detect antigen receptor and BCL2 gene rearrangements. A karyotype and FISH ( f luorescence i n s itu h ybridization) are tests that detect translocations, BCL6 and IRF4/MUM1 rearrangements, and 1p36 deletions. Pathology report All lab results are recorded in a pathology report. A report will be written each time tissue is removed from your body and tested. These reports are vital to diagnosis and planning treatment. Review your pathology report(s) with your doctor. Ask questions if you don’t understand. This information can be complex. It’s also a good idea to get a copy of your pathology report(s) and take notes. Figure 4 CD20 protein Follicular lymphoma cells have a common pattern of proteins in their membrane. This pattern includes the presence of CD10, CD20, BCL2, and BCL6 and no CD5, CD43, and cyclin D1. CD23 is found on some but not all cells. Immunophenotyping is the process of identifying the proteins in cells’ membranes. Derivative work of Rituximab Binding to CD20 on a B Cell Surface by NIAID available at commons. Rituxima_Binding_to_CD20_on_a_B_Cell_Surface_(6830897205).jpg under a Creative Commons Attribution 2.0 Generic license