B-cell lymphoma diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2]
Overview
B-cell lymphomas include both Hodgkin's lymphomas and most Non-Hodgkin lymphomas. Excisional lymph node biopsy is the gold standard test for the diagnosis of B-cell lymphomas. It is the preferred method to protect the architecture of lymph nodes, which is crucial for pathological evaluation and classification of lymphoma.
Diagnostic Study of Choice
Study of choice
B-cell lymphomas include both Hodgkin's lymphomas and most Non-Hodgkin lymphomas.
- Excisional lymph node biopsy is the gold standard test for the diagnosis of B-cell lymphomas. It is the preferred method to protect the architecture of lymph nodes, which is crucial for pathological evaluation and classification of lymphoma.[1][2][3][4]
- Fine-needle aspiration or core-needle biopsy specimens are usually insufficient because these methods have a low ratio of malignant cells and they do not sufficiently preserve the architecture of lymph nodes.
- Diagnostic studies of B-cell lymphomas include light microscopic evaluation of pathologic sample, as well as an immunophenotypic analysis with immunohistochemistry to determine the subtype.
Diagnostic results
- The following findings on pathological evaluation are confirmatory for Hodgkin's lypmhoma:[4]
- Reed-Sternberg cells (RS)
- Lymphocyte predominant cells (LP)
- The following findings on immunophenotypic analysis are confirmatory for the following types of non-Hodgkin's lypmhoma:[5][2]
- MYC-IGH rearrangement detected by FISH in the presence of a BCL2 negative germinal centres phenotype is definitive for diagnosis of Burkitt lymphoma.
- A disrupted structure of follicle center by sheets of large cells which are positive for pan-B-cell antigens (e.g., CD20, CD79a) is definitive for diagnosis of diffuse large B-cell lymphoma (DLBCL).[6]
- A chromosomal translocation t(11:14) is definitive for diagnosis of mantle cell lymphoma.[7]
References
- ↑ Connors JM, Cozen W, Steidl C, Carbone A, Hoppe RT, Flechtner HH, Bartlett NL (July 2020). "Hodgkin lymphoma". Nat Rev Dis Primers. 6 (1): 61. doi:10.1038/s41572-020-0189-6. PMID 32703953 Check
|pmid=value (help). - ↑ 2.0 2.1 . PMID 27466666. Missing or empty
|title=(help) - ↑ Jiang M, Bennani NN, Feldman AL (May 2017). "Lymphoma classification update: B-cell non-Hodgkin lymphomas". Expert Rev Hematol. 10 (5): 405–415. doi:10.1080/17474086.2017.1318053. PMID 28395545.
- ↑ 4.0 4.1 Kaseb H, Babiker HM. PMID 29763144. Missing or empty
|title=(help) - ↑ Sapkota S, Shaikh H. PMID 32644754 Check
|pmid=value (help). Missing or empty|title=(help) - ↑ Liu Y, Barta SK (May 2019). "Diffuse large B-cell lymphoma: 2019 update on diagnosis, risk stratification, and treatment". Am J Hematol. 94 (5): 604–616. doi:10.1002/ajh.25460. PMID 30859597.
- ↑ Vose JM (August 2017). "Mantle cell lymphoma: 2017 update on diagnosis, risk-stratification, and clinical management". Am J Hematol. 92 (8): 806–813. doi:10.1002/ajh.24797. PMID 28699667.