3. FL’s Illusive Nature: The Grade System and Its Complexities
When it comes to follicular lymphoma, categorizing its severity is no simple task. Professionals employ a grade system, splitting FL into different segments based on the number of large cells observed in the tumor. This isn’t a mere counting exercise; it’s an intricate process with profound implications for treatment and prognosis.
While grading, pathologists look out for centroblasts, a type of large cell. Grades are assigned based on their abundance. Grade 1 sees the fewest, while Grade 3B is marked by their dominant presence. Interestingly, Grade 3 is further split into A and B, based on the cells’ characteristics and behavior.
What’s noteworthy is the peculiar nature of FL grades. Unlike other cancers where higher grades typically spell out worse outcomes, FL’s grading doesn’t always directly correlate with its aggressiveness. It’s possible for low-grade FL to transform into a more aggressive form, just as it’s conceivable for high-grade FL to remain indolent. (3)
