Follicular Lymphoma

Grading of follicular lymphoma is a contentious issue but it is now agreed that grading should be carried out according to the method proposed by Berard,27 which described 3 grades based on the number of large cells (centroblasts) per high-power field. Grade 3 follicular lymphoma is divided into 3a and 3b, the latter used for tumors comprising sheets of centroblasts. In practice, only grade 3 (greater than 15 centroblasts per highpower field) is clinically significant being indicative of more aggressive disease that may require doxorubicin-containing therapy.28 The presence and percentage of diffuse areas should also be commented on although the clinical significance of this point is not yet clear.

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