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Follicular Lymphoma vs Follicular Hyperplasia

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Follicular hyperplasia: Normal and hyperplastic follicles have a heterogenous appearance due to admixture of centrocytes, centroblasts, reactive T-cells, and follicular dendritic cells. Tingible body macrophages are present creating a starry sky appearance. The follicle interface with the mantle zone is sharply defined.

Neoplastic follicles of follicular lymphoma: The neoplastic follicles lack tingible body macrophages and have a monomorphic appearance due to preponderance of centrocytes. The follicular edge is usually fuzzy as opposed to the sharp demarcation from the mantle zone seen with hyperplastic follicles.

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