Evolution in the Definition of Follicular Lymphoma and Diffuse Large B-Cell Lymphoma: A Model for the Future of Personalized Medicine

The definitions of follicular lymphoma (FL) and diffuse large B-cell (DLBCL) are evolving in the era personalized medicine. Early stages evolution FL have been recognized. Two histological manifestations early lesions situ neoplasia duodenal type FL. Additionally, frequently undergoes transformation, most common form being DLBCL. High-grade with double hit, translocations involving BCL2 MYC important clinically. Rarer forms transformation include classic Hodgkin (CHL) histiocytic sarcoma. In addition to conventional associated translocation, alternative BCL2-negative observed. These heterogenous clinically genetically. A distinctive group lymphomas follicle cell derivation arise young patients pediatric FL, testicular a IRF4 rearrangement. Historically DLBCL was separated into only two variants, centroblastic immunoblastic. 2017 WHO classification recommended (1) segregation activated B germinal center derived DLBCL, (2) identification high-grade (3) recognition an aggressive that may resemble Burkitt lymphoma, currently designated International Consensus Classification as Large 11q aberration. Today we appreciate greater genomic complexity among lymphomas. Recent studies NGS mutational profiling identified significant genetic subgroups. It is hoped these data ultimately will lead targeted therapy based on profile.