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molecular analysis of follicular lymphoma

  • evaluate for chromosomal abnormalities using karyotyping or fluorescence in situ hybridization (FISH); look for
    • BCL2 or BCL6 rearrangements
    • translocation 👉 t(14:18)
    • 1p36 deletion (follicular lymphoma with 1p36 deletion associated with inguinal node involvement, typically grade 1-2 with good prognosis)
    • IRF4/MUM1 rearrangement
    • IRF4 translocations often seen with diffuse large B-cell lymphoma but possible for both diagnosis to be present
    • if purely follicular lymphoma, often presents as grade 3b
  • evaluate for immunoglobulin gene rearrangements (possible predictive marker of histological disease transformation)
  • look for EZH2, TNFRSF14, and STAT6 mutations, for targeted therapy options and further diagnostic information, by next generation sequencing (NGS)