Diffuse Large B Cell Lymphoma

Diffuse Large B Cell Lymphoma 

Updated: 05/21/2025

© Jun Wang, MD, PhD

General features
  • Most common non-Hodgkin lymphoma
  • High grade
  • Fast growing, aggressive
  • Either de novo or transformed from other low grade lymphoma
  • Most common testicle tumor in patient older than 65
  • WHO has subclassifications
Clinical presentations
  • Rapid growing mass, nodal or extranodal
  • Systemic "B" symptoms: Fever, weight loss, drenching night sweats
Key pathogenesis
  • Bcl 6 associated NF-kB pathway
Key morphological features of tumor cells
Markers
  • Positive: B cell markers CD19, CD20
  • Negative: T cell markers CD3, CD4, CD8
  • Negative: Epithelial markers: cytokeratin, etc
  • High proliferative index per ki67, but less than 100%
Genetic abnormalities
  • Various
  • Translocations involving bcl2 or bcl 6
Primary CNS lymphoma
  • A type of diffuse large B cell lymphoma arising within CNS or vitreous/retina
  • WHO 2022 (5th edition) classifies as primary LBCL of immune privileged sites
  • EBV+ if HIV+ patients, but EBV- if immunocompetent
  • MYD88 mutation common
  • Neurological presentations depending on site involved: commonly cognitive impairment and balance disorders
  • Identical pathological features and immunoprofile
  • Worse prognosis if immunocompromised


Back to lymphoid neoplasms
Back to contents

Comments

Post a Comment

Popular posts from this blog

Contents

Pathology notes Jun Wang, MD, PhD 1. General information Frequently discussed syndromes Terms of dermatology Terms of hematology 2. Primary immunodeficiency disorders 3. Hemodynamic abnormalities Shock Thrombosis and embolism Bleeding disorders 4.  Benign blood cell disorders Anemia Benign white cell disorders 5. Hematopoietic neoplasms Lymphoid neoplasms Myeloid neoplasms Histiocytic neoplasms: Langerhans cell histiocytosis 6. Cardiovascular system Pulmonary hypertension Cardiovascular system tumors 7. Respiratory tract tumors 8. Gastrointestinal tract Congenital disorders Infectious gastroenteritis Oral cavity Esophagus Stomach Intestinal tumors Salivary glands Exocrine pancreas and gallbladder 9. Urinary system Kidney masses Lower urinary tract 10. Male reproductive system 11. Female genital tract 12. Breast 13. Endocrine organs Pituitary gland Adrenal gland Thyroid gland Parathyroid gland Endocrine pancreas...
Read more

Lymphoid neoplasms

Lymphocytic neoplasms Updated: 05/17/2020 © Jun Wang, MD, PhD Terminology Lymphoma : Proliferations forming discrete tissue masses Leukemia : Widespread involvement of the bone marrow and usually the peripheral blood Any "lymphoma" can present with or evolve to a leukemic picture, and any "leukemia" can occasionally present with a mass lesion Other hematology terms Important risk factors Immunodeficiency (primary or secondary) Autoimmune disorders Viruses (HIV, KSHV/HHV8, HTLV-1) H. pylori infection Radiation Chemotherapy Diagnostic approaches Complete history, especially those with possible epidemic characters, such as Burkitt lymphoma CBC, Bone marrow Morphology/immunohistochemistry Immunofluorescence flow cytometry Cytogenetic studies Molecular studies Commonly used markers All lymphomas: CD45 B-cell neoplasms: CD5, CD10, CD19, CD20, CD79a, CD23, bcl2, bcl6, cyclin D1, light chai...
Read more

Myeloid neoplasms

Myeloid neoplasms Updated: 08/12/2024 © Jun Wang, MD, PhD General features Clonal diseases of hematopoietic stem or progenitor cells of the granulocytic (neutrophil, eosinophil, basophil), monocytic/macrophage, erythroid, megakaryocytic and mast cell lineages 8 large groups Acute myeloid leukemia (AML) Myelodysplastic syndrome (MDS) Myeloproliferative neoplasms (MPN) Myelodysplastic and myeloproliferative neoplasm(MDS/MPN) Mastocytosis Secondary myeloid neoplasms Myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusions Acute leukemias of mixed or ambiguous lineage Diagnostic approaches CBC and differential: Presence of blasts and immature cells, quantity based diagnosis Bone marrow aspiration and biopsy: Morphology and quantity of neoplastic cells and blasts component Immunophenotyping: Multiparameter flow cytometry Histochemical studies: Myeloperoxidase for myeloid Cytogenetics studies: Karyotype, FISH  Molecular studies La...
Read more