Lymphoma & related disorders

General

WHO 2022 & ICC-B cell



Last author update: 21 March 2023
Last staff update: 30 April 2023

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PubMed Search: B cell lymphoma classification

Pichayut Nithagon, M.D.
Patricia Tsang, M.D., M.B.A.
Cite this page: Nithagon P, Tsang P. WHO 2022 & ICC-B cell. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphomaWHOHAEM5ICCBcell.html. Accessed December 22nd, 2024.
Definition / general
  • 2 new classification systems for B cell lymphoid neoplasms have emerged in 2022:
  • Evolution from the 2016 WHO revised 4th edition (WHO HAEM4R) classification system to the new version reflects advancements in genomic profiling and evidence based clinical data
  • Updates include newly defined subtypes, more encompassing umbrella terms, deletion of old entities and modified nomenclature
  • Putative new entities with limited data are designated as provisional in WHO HAEM4 and ICC but no provisional designation exists in WHO HAEM5 (see tables 1 and 2)
Major updates
  • Certain newly added categories are specific to only one classification system (table 1), e.g.:
    • Newly included nonneoplastic tumor-like lesions in WHO HAEM5 include IgG4 related disease and 2 additional types of Castleman disease (unicentric and idiopathic multicentric)
    • EBV+ polymorphic B cell lymphoproliferative disorder, NOS is a new entity under ICC to describe EBV+ B cell lesions with altered nodal architecture that are not diagnostic of lymphoma
    • Multiple myeloma (MM) is categorized by ICC into MM with recurrent genetic abnormalities (based on interphase FISH) and MM, NOS
  • B prolymphocytic leukemia (B PLL) is no longer defined as an entity in WHO HAEM5 based on the notion that it represents prolymphocytoid transformation of various small B cell lymphoma entities (Ann Diagn Pathol 2021;54:151790)
    • Under WHO HAEM5, previous cases of B PLL are categorized as one of the following entities:
      • Mantle cell lymphoma with IGH::CCND1
      • CD5 positive nonmantle B cell neoplasm with elevated prolymphocytes in peripheral blood or bone marrow
      • Splenic B cell lymphoma / leukemia with prominent nucleoli
    • ICC continues to recognize B PLL as a neoplasm after excluding transformation from other B cell entities
  • Splenic B cell lymphoma / leukemia with prominent nucleoli (SBLPN):
    • Corresponds to hairy cell leukemia (HCL) variant (rare, provisional entity) in WHO HAEM4R and ICC
    • Newly created terminology under WHO HAEM5 reflects its biologic distinction from typical hairy cell leukemia (Expert Rev Hematol 2021;14:355)
    • Includes previous cases of CD5 negative B PLL under WHO HAEM4R
  • Marginal zone lymphomas:
    • WHO HAEM5 and ICC both recognize pediatric nodal marginal zone lymphoma (pNMZL) as a separate entity from nodal marginal zone lymphoma (NMZL)
    • WHO HAEM5 and ICC both recognize primary cutaneous marginal zone lymphoma / lymphoproliferative disorder as distinct from extranodal marginal zone lymphoma of MALT of other sites
  • Follicular lymphoma:
    • WHO HAEM5 recognizes 3 subsets of follicular lymphoma based on BCL2 gene rearrangement:
      • Classic follicular lymphoma (cFL) with BCL2 rearrangement
      • Follicular large B cell lymphoma (FLBL) without BCL2 rearrangement
      • Follicular lymphoma with uncommon features (uFL) without BCL2 rearrangement
      • Histologic grading of cFL is no longer mandatory
    • ICC proposes a new provisional entity based on absence of BCL2 rearrangement
      • BCL2 rearrangement negative, CD23 positive follicle center lymphoma (provisional): often diffuse
      • Continues with grading of follicular lymphoma with emphasis on 3A and 3B
    • ICC recognizes testicular follicular lymphoma as a new entity that is distinct from pediatric type follicular lymphoma
  • New large B cell lymphoma entities:
    • Fibrin associated large B cell lymphoma (both WHO HAEM5 and ICC)
    • Fluid overload associated large B cell lymphoma (WHO HAEM5) overlaps with HHV8 and EBV negative primary effusion based lymphoma (provisional entity in ICC); distinct from primary effusion lymphoma that is HHV8 associated
  • Primary large B cell lymphomas of immune privileged site:
    • New umbrella term in WHO HAEM5 encompassing diffuse large B cell lymphoma (DLBCL) of the following extranodal sites: CNS, vitreoretina compartment and testis
    • ICC maintains that each should remain as distinct entities to facilitate further research
  • Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL):
    • Known as NLPHL in WHO HAEM4R, it has been renamed under ICC as nodular lymphocyte predominant B cell lymphoma (NLPBL), in recognition of its overlap with T cell / histiocyte rich large B cell lymphoma (Pathology 2020;52:142)
    • Under WHO HAEM5, the terminology remains unchanged and continues to list NLPHL under the family of Hodgkin lymphoma to avoid potential disruption of clinical trials
    • However, WHO HAEM5 also recognizes it may be more accurately called nodular lymphocyte predominant B cell lymphoma (based on the neoplastic cells having a functional B cell program) and also accepts this term in preparation for future adoption
    • Importance of different morphologic growth patterns (variant histology) in relation to clinical behavior is recognized by both ICC and WHO HAEM5 (Am J Surg Pathol 2003;27:1346)
  • High grade B cell lymphomas (HGBCL):
    • Previously a single entity, HGBCL with MYC and BCL2 or BCL6 rearrangement (double / triple hit lymphomas) has been categorized into 2 entities under WHO HAEM5:
      • B cell lymphomas with dual MYC and BCL2 rearrangements are considered a homogenous entity and have been renamed as diffuse large B cell lymphoma / high grade B cell lymphoma with MYC and BCL2 rearrangements (DLBCL / HGBCL MYC / BCL2)
      • B cell lymphomas with MYC and BCL6 rearrangements are biologically distinct from those with MYC / BCL2 rearrangements and are designated as DLBCL, NOS or HGBCL, NOS based on cytomorphology
    • ICC recognizes 2 subtypes of HGBCL double hit:
      • HGBCL with MYC and BCL2 rearrangements (with or without BCL6), an aggressive lymphoma of germinal center B cell origin
      • HGBCL with MYC and BCL6 rearrangements, a provisional entity that has shown heterogeneous biology based on relatively small sample sizes (J Hematol Oncol 2022;15:26)
  • Burkitt lymphoma:
    • WHO HAEM5 recommends subtyping Burkitt lymphomas based on EBV status rather than epidemiologic context
    • Under ICC, previous rare cases of TdT positive Burkitt lymphomas with IG::MYC translocation should be designated as B lymphoblastic leukemia / lymphoma with MYC rearrangement
  • Burkitt-like lymphoma with 11q aberration:
    • Provisional under WHO HAEM4R; resembling Burkitt lymphoma but lacking MYC rearrangement
    • Under WHO HAEM5: renamed as high grade B cell lymphoma with 11q aberration
    • Under ICC: renamed as large B cell lymphoma with 11q aberration, in recognition of its genetic profile being closer to DLBCL than Burkitt and occasional cases with predominantly large cell morphology
  • Lymphoplasmacytic lymphoma (LPL):
    • MYD88 p.L265P mutation (> 90%)
    • CXCR4 mutations (30 - 40%), associated with drug resistance and increased bone marrow disease (J Clin Oncol 2020;38:1198)
    • WHO HAEM5 recognizes 2 subsets of LPL:
      • IgM LPL / Waldenström macroglobulinemia
      • Non-Waldenström macroglobulinemia (includes IgG / IgA cases, nonsecretory LPL and IgM LPL without bone marrow involvement)
  • IgM monoclonal gammopathy of undetermined significance (MGUS):
    • ICC recognizes 2 distinct subtypes of IgM MGUS:
      • IgM MGUS of plasma cell type (precursor of MM)
      • IgM MGUS, NOS (may show MYD88 mutation or monoclonal B cells)
  • Monoclonal gammopathy of renal significance (MGRS):
    • WHO HAEM5 defines MGRS as a new entity
    • ICC considers MGRS as a clinical description of the underlying MGUS rather than a distinct entity
  • Cold agglutinin disease or primary cold agglutinin disease:
    • A new diagnostic category in both WHO HAEM5 and ICC
    • Clonal B cell proliferation usually of IgM isotype, distinct from IgM MGUS and LGL and lacking MYD88 L265P mutation (Clin Adv Hematol Oncol 2020;18:35)
  • Plasma cell neoplasms with associated paraneoplastic syndrome:
    • WHO HAEM5 recognizes a new syndrome: adenopathy and extensive skin patch overlying a plasmacytoma (AESOP) (Blood Cancer J 2022;12:58)
  • Lymphoid proliferations / lymphomas with immune deficiency or dysregulation:
    • WHO HAEM4R: categorization based on underlying etiology (primary immune disorders, HIV, posttransplant status and iatrogenic agents / immunosuppressants)
    • WHO HAEM5: new integrated approaches with 3 components
      • Histologic diagnosis (hyperplasia, polymorphic lymphoproliferation, mucocutaneous ulcer or lymphoma)
      • Oncologic viral association (EBV or KSHV / HHV8)
      • Immune deficiency / dysregulation (HIV, inborn error of immunity, posttransplant, autoimmune, iatrogenic or immune senescence)
    • ICC: retains posttransplant lymphoproliferative disorders (PTLD) as a subgroup of iatrogenic lymphoid lesions with distinct clinical management
  • B lymphoblastic leukemia / lymphoma (B ALL) (see table 2):
    • WHO HAEM5 uses shorter nomenclature consisting of gene names of molecular drivers but excluding the cytogenetic changes that appeared in the WHO HAEM4R nomenclature (e.g., B ALL with BCR::ABL1 fusion in WHO HAEM5 is equivalent to B ALL with t(9;22)(q34;q11.2); BCR-ABL1 in WHO HAEM4R)
    • Under WHO HAEM5, B ALL with BCR::ABL1-like features is no longer considered a provisional entity as in WHO HAEM4R
    • 2 new entities are recognized in WHO HAEM5:
      • B ALL with ETV6::RUNX1-like features (distinct from B ALL with ETV6::RUNX1 fusion)
      • B ALL with TCF3::HLF fusion (associated with aggressive behavior)
    • No major reclassification of most B ALL entities in WHO HAEM5
WHO (2016), WHO (2022) and ICC (2022)

Table 1: Mature B cell entities - comparison of 3 classification systems
WHO HAEM4R WHO HAEM5 ICC
Tumor-like lesions with B cell proliferation
Not included Reactive B cell rich lymphoid proliferations that can mimic lymphoma
Not included IgG4 related disease
Not included Unicentric Castleman disease
Not included Idiopathic multicentric Castleman disease
Multicentric Castleman disease KSHV / HHV8 associated multicentric Castleman disease Multicentric Castleman disease
Not included EBV positive polymorphic B cell lymphoproliferative disorder, NOS
Neoplastic and preneoplastic small lymphocytic proliferation
Chronic lymphocytic leukemia / small lymphocytic lymphoma (CLL / SLL) Chronic lymphocytic leukemia / small lymphocytic lymphoma (CLL / SLL) Chronic lymphocytic leukemia / small lymphocytic lymphoma (CLL / SLL)
Monoclonal B cell lymphocytosis
  • CLL type
  • Atypical CLL type
  • Non-CLL type
Monoclonal B cell lymphocytosis
  • Low count or clonal B cell expansion
  • CLL / SLL type
  • Non-CLL / SLL type
Monoclonal B cell lymphocytosis
  • CLL type
  • Non-CLL type
B prolymphocytic leukemia (B PLL) Not a distinct entity but heterogeneous B prolymphocytic leukemia (B PLL)
Lymphoplasmacytic lymphoma
  • Waldenström macroglobulinemia
Lymphoplasmacytic lymphoma
  • Waldenström macroglobulinemia
  • Non-Waldenström macroglobulinemia
Lymphoplasmacytic lymphoma
  • Waldenström macroglobulinemia
Marginal zone lymphoma
Nodal marginal zone lymphoma Nodal marginal zone lymphoma Nodal marginal zone lymphoma
Pediatric nodal marginal zone lymphoma* Pediatric nodal marginal zone lymphoma Pediatric nodal marginal zone lymphoma*
Extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (MALT) Extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (MALT) Extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (MALT)
Not included; part of extranodal marginal zone lymphoma of MALT Primary cutaneous marginal zone lymphoma Primary cutaneous marginal zone lymphoproliferative disorder
Splenic B cell lymphoma / leukemia
Splenic marginal zone lymphoma Splenic marginal zone lymphoma Splenic marginal zone lymphoma
Hairy cell leukemia Hairy cell leukemia Hairy cell leukemia
Hairy cell leukemia variant* Splenic B cell lymphoma / leukemia with prominent nucleoli (distinct from HCL and includes all previous CD5 negative B PLL) Hairy cell leukemia variant*
Splenic diffuse red pulp small B cell lymphoma* Splenic diffuse red pulp small B cell lymphoma Splenic diffuse red pulp small B cell lymphoma*
Follicular lymphoma
In situ follicular neoplasia In situ follicular B cell neoplasm In situ follicular neoplasia
Follicular lymphoma (FL) Follicular lymphoma (grading of cFL not mandatory)
  • Classic follicular lymphoma (cFL)
  • Follicular large B cell lymphoma (FLBL)
  • Follicular lymphoma with uncommon features (uFL)
Follicular lymphoma (continue grading FL with emphasis on 3A and 3B)
  • Follicular lymphoma
  • BCL2 rearrangement negative, CD23 positive follicle center lymphoma*
Pediatric type follicular lymphoma Pediatric type follicular lymphoma Pediatric type follicular lymphoma
Not included Testicular follicular lymphoma
Duodenal type follicular lymphoma Duodenal type follicular lymphoma Duodenal type follicular lymphoma
Primary cutaneous follicle center lymphoma Primary cutaneous follicle center lymphoma Primary cutaneous follicle center lymphoma
Mantle cell lymphoma
In situ mantle cell neoplasia In situ mantle cell neoplasia In situ mantle cell neoplasia
Mantle cell lymphoma Mantle cell lymphoma Mantle cell lymphoma
Leukemic nonnodal mantle cell lymphoma Leukemic nonnodal mantle cell lymphoma Leukemic nonnodal mantle cell lymphoma
Aggressive lymphomas transformed from low grade B cell lymphomas
Not included Transformations of indolent B cell lymphomas
Large B cell lymphoma
Diffuse large B cell lymphoma (DLBCL), NOS Diffuse large B cell lymphoma, NOS Diffuse large B cell lymphoma, NOS
EBV positive mucocutaneous ulcer* EBV positive mucocutaneous ulcer EBV positive mucocutaneous ulcer
EBV positive diffuse large B cell lymphoma, NOS EBV positive diffuse large B cell lymphoma EBV positive diffuse large B cell lymphoma, NOS
Diffuse large B cell lymphoma associated with chronic inflammation Diffuse large B cell lymphoma associated with chronic inflammation Diffuse large B cell lymphoma associated with chronic inflammation
Primary large B cell lymphoma of the central nervous system Primary large B cell lymphoma of immune privileged sites (new umbrella term for DLBCL arising in the CNS, vitreoretina and testis) Primary diffuse large B cell lymphoma of central nervous system
Not included Primary diffuse large B cell lymphoma of testis
Primary cutaneous diffuse large B cell lymphoma, leg type Primary cutaneous diffuse large B cell lymphoma, leg type Primary cutaneous diffuse large B cell lymphoma, leg type
Intravascular large B cell lymphoma Intravascular large B cell lymphoma Intravascular large B cell lymphoma
ALK positive large B cell lymphoma ALK positive large B cell lymphoma ALK positive large B cell lymphoma
Plasmablastic lymphoma Plasmablastic lymphoma Plasmablastic lymphoma
Large B cell lymphoma with IRF4 rearrangement Large B cell lymphoma with IRF4 rearrangement Large B cell lymphoma with IRF4 rearrangement
Primary mediastinal large B cell lymphoma Primary mediastinal large B cell lymphoma Primary mediastinal large B cell lymphoma
B cell lymphoma, unclassified with features intermediate between DLBCL and classic Hodgkin lymphoma Mediastinal gray zone lymphoma (cases without mediastinal involvement are classified as DLBCL, NOS) Mediastinal gray zone lymphoma
Not included Fibrin associated large B cell lymphoma Fibrin associated large B cell lymphoma
Not included Fluid overload associated large B cell lymphoma (previously included in primary effusion lymphoma) HHV8 and EBV8 negative primary effusion based lymphoma*
T cell / histiocyte rich large B cell lymphoma T cell / histiocyte rich large B cell lymphoma T cell / histiocyte rich large B cell lymphoma
See Hodgkin lymphomas See Hodgkin lymphomas Nodular lymphocyte predominant B cell lymphoma (renamed from nodular lymphocyte predominant Hodgkin lymphoma)
Lymphomatoid granulomatosis Lymphomatoid granulomatosis Lymphomatoid granulomatosis
KSHV / HHV8 associated B cell lymphoid proliferation / lymphoma
Primary effusion lymphoma Primary effusion lymphoma Primary effusion lymphoma
HHV8 positive diffuse large B cell lymphoma, NOS HHV8 positive diffuse large B cell lymphoma HHV8 positive diffuse large B cell lymphoma, NOS
HHV8 positive germinotropic lymphoproliferative disorder KSHV / HHV8 positive germinotropic lymphoproliferative disorder HHV8 positive germinotropic lymphoproliferative disorder
High grade B cell lymphomas
High grade B cell lymphoma, NOS High grade B cell lymphoma, NOS High grade B cell lymphoma, NOS
High grade B cell lymphoma with MYC and BCL2 or BCL6 rearrangements Diffuse large B cell lymphoma / high grade B cell lymphoma with MYC and BCL2 rearrangements (previous high grade B cell lymphoma with MYC and BCL6 rearrangements is designated as DLBCL, NOS) High grade B cell lymphoma with MYC and BCL2 rearrangements
High grade B cell lymphoma with MYC and BCL6 rearrangements*
Burkitt lymphoma Burkitt lymphoma (EBV status supersedes epidemiologic subtyping) Burkitt lymphoma
Burkitt-like lymphoma with 11q aberration* High grade B cell lymphoma with 11q aberration Large B cell lymphoma with 11q aberration*
Hodgkin lymphomas
Classic Hodgkin lymphoma
  • Nodular sclerosis
  • Lymphocyte rich
  • Mixed cellularity
  • Lymphocyte depleted
Classic Hodgkin lymphoma
  • Nodular sclerosis
  • Lymphocyte rich
  • Mixed cellularity
  • Lymphocyte depleted
Classic Hodgkin lymphoma
  • Nodular sclerosis
  • Lymphocyte rich
  • Mixed cellularity
  • Lymphocyte depleted
Nodular lymphocyte predominant Hodgkin lymphoma Nodular lymphocyte predominant Hodgkin lymphoma Renamed as nodular lymphocyte predominant B cell lymphoma; categorized as non-Hodgkin lymphoma
Plasma cell neoplasms and entities with paraproteins
Solitary plasmacytoma of bone Solitary plasmacytoma of bone Solitary plasmacytoma of bone
Extraosseous plasmacytoma Extraosseous plasmacytoma Extraosseous plasmacytoma
Plasma cell myeloma Plasma cell myeloma Multiple myeloma (MM), NOS
MM with recurrent genetic abnormality
  • MM with CCND family translocation
  • MM with MAF family translocation
  • MM with NSD2 family translocation
  • MM with hyperdiploidy
Plasma cell neoplasm with associated paraneoplastic syndrome
  • POEMS
  • TEMPI
Plasma cell neoplasm with associated paraneoplastic syndrome
  • POEMS
  • TEMPI
  • AESOP (new syndrome)
IgM monoclonal gammopathy of undetermined significance IgM monoclonal gammopathy of undetermined significance IgM monoclonal gammopathy of undetermined significance
  • IgM MGUS, plasma cell type
  • IgM MGUS, NOS
Non-IgM monoclonal gammopathy of undetermined significance Non-IgM monoclonal gammopathy of undetermined significance Non-IgM monoclonal gammopathy of undetermined significance
Not included Monoclonal gammopathy of renal significance Not a separate entity; clinical descriptor of the underlying diagnosis (e.g., MGUS)
Not included Cold agglutinin disease Primary cold agglutinin disease
Primary amyloidosis Immunoglobulin related (AL) amyloidosis Immunoglobulin light chain (AL) amyloidosis
Localized AL amyloidosis
Light chain and heavy chain deposition disease Monoclonal immunoglobulin deposition disease (renamed) Light chain and heavy chain deposition
Mu heavy chain disease Mu heavy chain disease Mu heavy chain disease
Gamma heavy chain disease Gamma heavy chain disease Gamma heavy chain disease
Alpha heavy chain disease Alpha heavy chain disease Alpha heavy chain disease
Lymphoid proliferations / lymphomas with immune deficiency or dysregulation
Nondestructive PTLD Hyperplasias arising in immune deficiency / dysregulation Plasmacytic hyperplasia PTLD
Florid follicular hyperplasia PTLD
Infectious mononucleosis PTLD
Polymorphic PTLD Polymorphic lymphoproliferative disorders arising in immune deficiency / dysregulation (new term that includes various etiologies) Polymorphic PTLD
Other iatrogenic immunodeficiency associated lymphoproliferative disorders Other iatrogenic immunodeficiency associated lymphoproliferative disorders
Monomorphic PTLD Lymphomas arising in immune deficiency / dysregulation (new umbrella term that includes monomorphic PTLD, lymphomas associated with HIV infection, etc.) Monomorphic PTLD
Classic Hodgkin lymphoma PTLD Classic Hodgkin lymphoma PTLD
Lymphomas associated with HIV infection
Lymphoproliferative diseases associated with primary immune disorders Inborn error of immunity associated lymphoid proliferations and lymphomas
Note: asterisk (*) denotes a provisional entity


Table 2: Precursor B cell neoplasms - comparison of WHO 4th and 5th edition classification systems
WHO HAEM4R WHO HAEM5
B lymphoblastic leukemia / lymphoma, NOS B lymphoblastic leukemia / lymphoma, NOS
B lymphoblastic leukemia / lymphoma with hyperdiploidy B lymphoblastic leukemia / lymphoma with high hyperdiploidy
B lymphoblastic leukemia / lymphoma with hypodiploidy B lymphoblastic leukemia / lymphoma with hypodiploidy
B lymphoblastic leukemia / lymphoma with iAMP21 B lymphoblastic leukemia / lymphoma with iAMP21
B lymphoblastic leukemia / lymphoma with t(9;22)(q34;q11.2); BCR-ABL1 B lymphoblastic leukemia / lymphoma with BCR::ABL1 fusion
B lymphoblastic leukemia / lymphoma, BCR-ABL1-like* B lymphoblastic leukemia / lymphoma with BCR::ABL1-like features
B lymphoblastic leukemia / lymphoma with t(12;21)(p13.2;q22.1); ETV6-RUNX1 B lymphoblastic leukemia / lymphoma with ETV6::RUNX1
Not included B lymphoblastic leukemia / lymphoma with ETV6::RUNX1-like feature
B lymphoblastic leukemia / lymphoma with t(1;19)(q23;p13.3); TCF3-PBX1 B lymphoblastic leukemia / lymphoma with TCF3::PBX1 fusion
Not included B lymphoblastic leukemia / lymphoma with TCF3::HLF fusion
B lymphoblastic leukemia / lymphoma with t(v;11q23.3); KMT2A rearranged B lymphoblastic leukemia / lymphoma with KMT2A rearrangement
B lymphoblastic leukemia / lymphoma with t(5;14)(q31.1;q32.1); IGH / IL3 B lymphoblastic leukemia / lymphoma with IGH::IL3 fusion
B lymphoblastic leukemia / lymphoma with other defined genetic abnormalities B lymphoblastic leukemia / lymphoma with other defined genetic abnormalities
Note: asterisk (*) denotes a provisional entity
Microscopic (histologic) images

Contributed by Patricia Tsang, M.D., M.B.A.

Cold agglutinin disease (CAD)

CAD lymphoid aggregate

CAD (CD20)

CAD (CD3)

Board review style question #1

Which of the following is a characteristic of splenic B cell lymphoma / leukemia with prominent nucleoli as defined in the WHO classification of hematolymphoid neoplasms, 5th edition (WHO HAEM5)?

  1. Classified as an immature B cell lymphoid neoplasm
  2. Considered as a subtype of diffuse large B cell lymphoma originating from the spleen
  3. Corresponds to hairy cell leukemia variant under the WHO classification, 4th edition
  4. Shares a similar genetic profile with hairy cell leukemia
  5. Tumor cells characteristically coexpress CD5
Board review style answer #1
C. Corresponds to hairy cell leukemia variant under the WHO classification, 4th edition. This entity is a mature B cell neoplasm that is biologically distinct from both hairy cell leukemia and diffuse large B cell lymphoma and typically lacks CD5 coexpression.

Comment Here

Reference: WHO HAEM5 and ICC-B cell
Board review style question #2
Which of the following is true regarding B cell or plasma cell neoplasms as defined by the International Consensus Classification (ICC) system?

  1. B cell prolymphocytic leukemia is the counterpart of Richter transformation of small lymphocytic lymphoma
  2. Lymphoplasmacytic lymphoma can manifest clinically as primary cold agglutinin disease
  3. Multiple myeloma with recurrent genetic abnormality is a newly added category
  4. Nodular lymphocytic predominant B cell lymphoma is renamed from nodular sclerosis Hodgkin lymphoma
  5. Testicular follicular lymphoma is a provisional subtype of pediatric type follicular lymphoma
Board review style answer #2
C. Multiple myeloma with recurrent genetic abnormality is a newly added category in the International Consensus Classification system.

Comment Here

Reference: WHO HAEM5 and ICC-B cell
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