The heterogeneity of follicular follicle center cell tumors. II. Clinical follow-up of 30 patients.

The Kiel classification for the histology of malignant lymphomas distinguishes the group of follicular lymphomas as low-grade malignancies. Clinically, this proves to be a heterogeneous group. With the aim of establishing parameters giving indications for the prognosis of the patient, a retrospective analysis was made of 30 patients with a histologic diagnosis of follicular follicle center cell tumor (FCC). Neither the immunologic markers of the cells nor the stage of dissemination have prognostic significance for survival. On the basis of the predominating neoplastic cell type, a cytologic subdivision of the lymphomas was made, characterizing the following subgroups: SCC (small centrocytes with occasional centroblasts), CBCC/A (centrocytes with several centroblasts), and CBCC/B (centrocytes with many centroblasts), SLCC (small and large centrocytes), SLCB (small and large centroblasts). The actuarial survival of the total group of 30 patients was 66% after 5 years, but the survival in the cytologic subgroups ranged from 100% in group SCC to 0% in group SLCB. Comparing the groups SCC and CBCC/A with CBCC/B and SLCB gave a significantly worse prognosis for the groups with an increased number of centroblasts (i.e., CBCC/B and SLCB). Therefore it seems justified to treat patients with a predominance of centroblasts aggressively with the aim of reaching a complete remission.