A Case of Floral Variant of Follicular Lymphoma

Abstract

Floral variant of follicular lymphoma is uncommon and it shows floral appearance caused by atypical lymphocytes that irregularly invade and invaginate into the germinal center. [I1]A 59 year-old man presented with incidentally found peribronchial lymph node by chest X-ray. It had been hard to biopsy so the patient received lobectomy of the left lower lung. Microscopic findings were similar to lymphoepithelioma-like carcinoma or metastatic carcinoma in lymph nodes. The tumor showed irregularly shaped germinal center-like lesion, which look like progressive transformation of germinal center. Immunohistochemical stains showed positive for CD20, bcl-6, CD 10 and negative for CD3, CD5 and bcl-2. We treated this patient with CHOP chemotherapy regimen. Initial CT scan revealed an enlarged lymph node at the medial basal segment of the left lower lobe of the lung. Follow[W사2] up chest CT scan after treatment revealed complete resolution of the tumor mass. Floral variant of follicular lymphoma was first described in 1987 by Osborne and Butler. [I3]The histologic features are similar to those of progressive transformation of germinal center (PTGC) and nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). Clinical presentation and subsequent clinical course of the floral variant of follicular lymphoma are not different to usual cases of follicular lymphoma.[I4] Our case was diagnosed as a floral variant of follicular lymphoma by histologic feature. It was treated by excisional biopsy and chemotherapy.