A 45-year-old patient has a lymphoma with the following WHO 2022 classification features: CD10+, BCL6+, MUM1−, BCL2 rearrangement present, MYC rearrangement absent, Ki-67 80%. The GCB vs. ABC subtype assignment is best determined by:
- A Gene expression profiling (GEP) as the gold standard ✓
- B Hans algorithm using CD10, BCL6, and MUM1 by IHC
- C FISH for BCL2 and BCL6 translocations
- D Flow cytometry immunophenotyping for surface immunoglobulin
Correct answer: A. Gene expression profiling (GEP) as the gold standard
Explanation
WHO 2022 recognizes that gene expression profiling (GEP) is the gold standard for COO (cell of origin) subtyping of DLBCL into GCB versus ABC/non-GCB; IHC algorithms like Hans (CD10/BCL6/MUM1) have ~80% concordance with GEP but are inferior. FISH detects translocations but does not assign COO. The clinical relevance is that ABC subtype has inferior outcomes with standard R-CHOP and is being targeted with NF-κB inhibitors in clinical trials.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.