Follicular Helper T-cell Lymphomas: Disease Spectrum, Relationship with Clonal Hematopoiesis, and Mimics. A Report of the 2022 EA4HP/SH Lymphoma Workshop

Overview

Journal Virchows Arch

Specialties Cell Biology
Molecular Biology
Pathology

Date 2023 Jul 27

PMID 37500795

Authors

Sarah L Ondrejka

Catalina Amador

Fina Climent

Siok-Bian Ng

Lorinda Soma

Alberto Zamo

Stefan Dirnhofer

Leticia Quintanilla-Martinez

Andrew Wotherspoon

Lorenzo Leoncini

Laurence de Leval

Affiliations

Soon will be listed here.

Abstract

Follicular helper T-cell lymphomas (TFH lymphomas) were discussed in session V of the lymphoma workshop of the European Association for Haematopathology (EA4HP)/Society for Hematopathology (SH) 2022 meeting in Florence, Italy. The session focused on the morphologic spectrum of TFH lymphoma, including its three subtypes: angioimmunoblastic-type (AITL), follicular-type, and not otherwise specified (NOS). The submitted cases encompassed classic examples of TFH lymphoma and unusual cases such as those with early or indolent presentations, associated B-cell proliferations, or Hodgkin/Reed-Sternberg-like cells. The relationship between TFH lymphoma and clonal hematopoiesis was highlighted by several cases documenting divergent evolution of myeloid neoplasm and AITL from shared clonal mutations. The distinction between TFH lymphoma and peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS), was stressed, and many challenging examples were presented. Various cases highlighted the difficulties of differentiating TFH lymphoma from other established types of lymphoma and reactive conditions. Cutaneous T-cell lymphoma expressing TFH markers, particularly when resulting in lymph node involvement, should be distinguished from TFH lymphomas. Additional immunophenotyping and next-generation sequencing studies were performed on various cases in this session, highlighting the importance of these technologies to our current understanding and classification of TFH lymphomas.

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