J Hematop. 2026 Mar 03. pii: 8. [Epub ahead of print]19(1):
BACKGROUND: Follicular lymphoma (FL) is a common type of non-Hodgkin lymphoma typically characterized by a nodular growth pattern and the t(14;18) translocation. A rare variant, FL with a predominantly diffuse growth pattern (dFL), lacks this translocation, demonstrates diffuse architecture, and is frequently associated with deletion of 1p36.
CASE PRESENTATION: We report the case of a 43-year-old man who presented with an inguinal mass and was diagnosed with follicular lymphoma showing a predominantly diffuse pattern. Fluorescence in situ hybridization (FISH) analysis was negative for both BCL2 rearrangement and TNFRSF14 (1p36) deletion. Chromosomal microarray (CMA) and next-generation sequencing (NGS) were subsequently performed for further molecular characterization.
RESULTS: CMA revealed copy-neutral loss of heterozygosity (cnLOH) at 1p36 and additional abnormalities involving 16p that were not detectable by FISH. NGS identified a TP53 mutation, a finding not previously reported in dFL and typically associated with more aggressive lymphoma behavior. Although dFL is generally considered an indolent and localized disease, the patient developed axillary recurrence within 1 year, requiring radiation therapy.
CONCLUSION: These findings underscore the importance of comprehensive molecular testing, such as NGS and CMA, to refine prognostic assessment and guide personalized treatment strategies for this rare lymphoma variant.
Keywords:
TP53 mutation; 1p36; Copy-neutral loss of heterozygosity; Diffuse follicular lymphoma