CD23-positive, BCL2-negative follicular lymphoma: a case report and review of the literature

CD23-positive, BCL2-negative follicular lymphoma represents a rare and increasingly recognized subtype of follicular lymphoma with distinct clinicopathologic and molecular features. Owing to its overlap with other lymphoid neoplasms, it remains underrecognized and poses significant diagnostic challenges in routine practice. We present a 49-year-old male with right inguinal lymphadenopathy. Histopathological evaluation demonstrated a predominantly follicular growth pattern composed of centrocytes with scattered centroblasts. Immunohistochemical analysis revealed expression of CD20, CD10, BCL6, and CD23, with absence of BCL2 expression, supporting the diagnosis of CD23-positive, BCL2-negative follicular lymphoma. Imaging studies identified additional nodal involvement, and the patient was staged as stage III disease according to the Ann Arbor classification. To better contextualize our findings, we also provide a structured review of previously reported cases and studies. This case reinforces the diagnostic importance of recognizing this rare immunophenotypic profile and highlights key features that aid in distinguishing it from other lymphoid neoplasms. Increased awareness of this entity is essential to prevent misclassification and to guide appropriate clinical management.