Diffuse large B cell lymphoma classification: Difference between revisions

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==Overview==
==Overview==
Diffuse large B cell lymphoma may be classified into 14 subtypes based on immunophenotyping/genetic testing.  
Diffuse large B cell lymphoma may be classified into variants, subgroups, subtypes, and entities based on the World Health Organization Classification (WHO).  


==Classification==
==Classification==
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:*One of these well-defined groupings of particular note is Primary mediastinal B-cell lymphoma, which arises within the [[thymus]] or mediastinal lymph nodes.
:*One of these well-defined groupings of particular note is Primary mediastinal B-cell lymphoma, which arises within the [[thymus]] or mediastinal lymph nodes.


B-cell lymphoma, unclassifiable
Diffuse large B-cell lymphoma, not otherwise specified  
*Tumor may share many features intermediate between Diffuse large B-cell lymphoma and [[Burkitt lymphoma]].
*Tumor may share many features intermediate between Diffuse large B-cell lymphoma and Hodgkin’s lymphoma.
 
Diffuse large B-cell lymphoma, not otherwise specified
*When a case of Diffuse large B-cell lymphoma does not conform to any of the well-defined subtypes, and is also not considered unclassifiable.
*When a case of Diffuse large B-cell lymphoma does not conform to any of the well-defined subtypes, and is also not considered unclassifiable.
*The majority of Diffuse large B-cell lymphoma cases fall into this category.  
*The majority of Diffuse large B-cell lymphoma cases fall into this category.  
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:*[[Immunohistochemistry|immunohistochemical]] properties.
:*[[Immunohistochemistry|immunohistochemical]] properties.


===Use of Immunophenotyping/Genetic Testing in Differential Diagnosis of Mature B-Cell and NK/T-Cell Neoplasms===
Diffuse large B-cell lymphoma (DLBCL): variants, subgroups, subtypes, and entities based on the World Health Organization Classification (WHO)
 
===DLBCL, not otherwise specified (DLBCL, NOS)===
<div style="font-size: 80%;"><BR>
* Common morphological variants
{{Familytree/start}}
:* Centroblastic
{{Familytree|boxstyle=border: 0;| | | | | | | | | | A01 | | | | | | | | | | |A01={{F1|B-cell neoplasms}}}}
:* Immunoblastic
{{Familytree|boxstyle=border: 0;| | | | | |,|-|-|-|-|^|-|-|-|-|.| | | | | | |}}
:* Anaplastic
{{Familytree|boxstyle=border: 0;| | | | | B01 | | | | | | | | B02 | | | | | |B01={{F1|CD5+}}|B02={{F1|CD5-}}}}
* Rare morphological variants
{{Familytree|boxstyle=border: 0;| | |,|-|-|^|-|-|.| | | | | | |!| | | | | | |}}
* Molecular subgroups
{{Familytree|boxstyle=border: 0;| | C01 | | | | C02 | | | | | C03 | | | | | |C01={{F1|CCND1+}}|C02={{F1|CCND1-}}|C03={{F1|DLBCL}}}}
:* Germinal center B-cell-like (GCB)
{{Familytree|boxstyle=border: 0;| | |!| | | | | |!| | | |,|-|-|^|-|-|-|-|-|-|.| | | |}}
:* Activated B-cell-like (ABC)
{{Familytree|boxstyle=border: 0;| | D01 | | | | D02 | | D03 | | | | | | | | D04 | | |D01={{F2|Pleomorphic MCL}}|D02={{F2|DLBCL, NOS CD5+}}|D03={{F1|CD10+}}|D04={{F1|CD10-}}}}
* Immunohistochemical subgroups
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | |!| | | | | | | | | |!| | | |}}
:* CD5-positive DLBCL
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | E01 | | | | |,|-|-|-|+|-|-|-|.| | | |E01={{F2|DLBCL, NOS GCB type}}}}
:* Germinal center B-cell-like (GCB)
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | | | | | | | F01 | | F02 | | F03 | | |F01={{F1|BCL6+ IRF4/MUM1-}}|F02={{F1|BCL6+ IRF4/MUM1+}}|F03={{F1|BCL6- IRF4/MUM1+}}}}
:* Non-germinal center B-cell-like (non-GCB)
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | | | | | | | |!| | | |!| | | |!| | | |}}
===DLBCL subtypes===
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | | | | | | | G01 | | G02 | | G03 | | |G01={{F2|DLBCL, NOS GCB type}}|G02={{F2|Non-GCB}}|G03={{F2|Post-GCB}}}}
* T-cell-/histiocyte-rich large B-cell lymphoma  
{{Familytree/end}}
* Primary DLBCL of the central nervous system
</div>
* Primary cutaneous DLBCL  
 
* Leg type EBV-positive DLBCL of the elderly
===Classification of large cells based on Immunophenotypic/Genetic testing <ref>{{cite web | title = Non-Hodgkin's Lymphomas (NCCN.org) | url = http://www.nccn.org/professionals/physician_gls/PDF/nhl.pdf }}</ref>===
===Other lymphomas of large B-cells===
*Diffuse large B-cell lymphoma (DLBCL),NOS
* Primary mediastinal (thymic) large B-cell lymphoma
:*T-cell/histocyte-rich large B-cell lymphoma (THRLBCL)
* Intravascular large B-cell lymphoma
:*Primary DLBCL of the CNS
* DLBCL associated with chronic inflammation
:*Primary cutaneous DLBCL, leg type
* Lymphomatoid granulomatosis
:*EBV-positive DLBCL of the elderly (EBV + DLBCL)
* ALK-positive LBCL
*DLBCL associated with chronic inflammation
* Plasmablastic lymphoma  
*Lymphoid granulomatosis
* Large B-cell lymphoma arising in HHV8-associated multicentric Castleman disease
*Primary mediastinal (thymic) large B-cell Lymphoma (PMBL)
* Primary effusion lymphoma
*Intravascular large B-cell lymphoma
===Borderline cases B-cell lymphoma===
*ALK-positive large B-cell lymphoma
*Unclassifiable, with features intermediate between DLBCL and Burkitt lymphoma B-cell lymphoma,
*Plasmablastic lymphoma
*Unclassifiable, with features intermediate between DLBCL and classical Hodgkin lymphoma
*Large B-cell lymphoma arising in HHV8-assciated multicentric Castleman disease (LBCL in HHV8 + MCD)
*Primary effusion lymphoma
*B-cell lymphoma unclassifiable, intermediate between DLBCL(U-DLBCL) and classical Hodgkins lymphoma(CHL)
*Mantle cell Lymphoma(MCL),pleomorphic variant


==References==
==References==

Revision as of 21:51, 24 August 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Diffuse large B cell lymphoma may be classified into variants, subgroups, subtypes, and entities based on the World Health Organization Classification (WHO).

Classification

Diffuse large B-cell lymphoma encompasses a biologically and clinically diverse set of diseases,[1] many of which cannot be separated from one another by well-defined and widely accepted criteria.

The World Health Organization (WHO) classification system defines more than a dozen subtypes, each of which can be differentiated based on the

  • Location of the tumor
  • Presence of other cells within the tumor (such as T cells)
  • Other illnesses related to diffuse large B-cell lymphoma.
  • One of these well-defined groupings of particular note is Primary mediastinal B-cell lymphoma, which arises within the thymus or mediastinal lymph nodes.

Diffuse large B-cell lymphoma, not otherwise specified

  • When a case of Diffuse large B-cell lymphoma does not conform to any of the well-defined subtypes, and is also not considered unclassifiable.
  • The majority of Diffuse large B-cell lymphoma cases fall into this category.
  • Much research has been devoted to separating this still-heterogeneous group; such distinctions are usually made along lines of

Diffuse large B-cell lymphoma (DLBCL): variants, subgroups, subtypes, and entities based on the World Health Organization Classification (WHO)

DLBCL, not otherwise specified (DLBCL, NOS)

  • Common morphological variants
  • Centroblastic
  • Immunoblastic
  • Anaplastic
  • Rare morphological variants
  • Molecular subgroups
  • Germinal center B-cell-like (GCB)
  • Activated B-cell-like (ABC)
  • Immunohistochemical subgroups
  • CD5-positive DLBCL
  • Germinal center B-cell-like (GCB)
  • Non-germinal center B-cell-like (non-GCB)

DLBCL subtypes

  • T-cell-/histiocyte-rich large B-cell lymphoma
  • Primary DLBCL of the central nervous system
  • Primary cutaneous DLBCL
  • Leg type EBV-positive DLBCL of the elderly

Other lymphomas of large B-cells

  • Primary mediastinal (thymic) large B-cell lymphoma
  • Intravascular large B-cell lymphoma
  • DLBCL associated with chronic inflammation
  • Lymphomatoid granulomatosis
  • ALK-positive LBCL
  • Plasmablastic lymphoma
  • Large B-cell lymphoma arising in HHV8-associated multicentric Castleman disease
  • Primary effusion lymphoma

Borderline cases B-cell lymphoma

  • Unclassifiable, with features intermediate between DLBCL and Burkitt lymphoma B-cell lymphoma,
  • Unclassifiable, with features intermediate between DLBCL and classical Hodgkin lymphoma

References

  1. ↑ Alizadeh, Ash A.; Eisen, Michael B.; Davis, R. Eric; Ma, Chi; Lossos, Izidore S.; Rosenwald, Andreas; Boldrick, Jennifer C.; Sabet, Hajeer; Tran, Truc; Yu, Xin; Powell, John I.; Yang, Liming; Marti, Gerald E.; Moore, Troy; Hudson, James; Lu, Lisheng; Lewis, David B.; Tibshirani, Robert; Sherlock, Gavin; Chan, Wing C.; Greiner, Timothy C.; Weisenburger, Dennis D.; Armitage, James O.; Warnke, Roger; Levy, Ronald; Wilson, Wyndham; Grever, Michael R.; Byrd, John C.; Botstein, David; et al. (2000). "Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling". Nature. 403 (6769): 503–11. Bibcode:2000Natur.403..503A. doi:10.1038/35000501. PMID 10676951. line feed character in |title= at position 78 (help)


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