Diffuse large B cell lymphoma classification
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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 14 subtypes based on immunophenotyping/genetic testing.
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.
B-cell lymphoma, unclassifiable
- 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.
- 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
- cellular morphology
- gene expression
- immunohistochemical properties.
Use of Immunophenotyping/Genetic Testing in Differential Diagnosis of Mature B-Cell and NK/T-Cell Neoplasms
| B-cell neoplasms | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| CD5+ | CD5- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| CCND1+ | CCND1- | DLBCL | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Pleomorphic MCL | DLBCL, NOS CD5+ | CD10+ | CD10- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| DLBCL, NOS GCB type | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| BCL6+ IRF4/MUM1- | BCL6+ IRF4/MUM1+ | BCL6- IRF4/MUM1+ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| DLBCL, NOS GCB type | Non-GCB | Post-GCB | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Classification of large cells based on Immunophenotypic/Genetic testing [2]
- Diffuse large B-cell lymphoma (DLBCL),NOS
- T-cell/histocyte-rich large B-cell lymphoma (THRLBCL)
- Primary DLBCL of the CNS
- Primary cutaneous DLBCL, leg type
- EBV-positive DLBCL of the elderly (EBV + DLBCL)
- DLBCL associated with chronic inflammation
- Lymphoid granulomatosis
- Primary mediastinal (thymic) large B-cell Lymphoma (PMBL)
- Intravascular large B-cell lymphoma
- ALK-positive large B-cell lymphoma
- Plasmablastic 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
- ↑ 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) - ↑ "Non-Hodgkin's Lymphomas (NCCN.org)" (PDF).