Diffuse large B cell lymphoma classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]
Overview
Diffuse large B cell lymphoma may be classified based on location into nodal and extranodal disease and based on molecular, genetic, and immunohistochemical features into more than 20 subgroups.
Classification
Classification Based on Location
Diffuse large B cell lymphoma may be classified based on location:
- Nodal disease
- Extranodal disease
Classification Based on Molecular, Genetic, and Immunohistochemical Features
According to the WHO 2008 classification, diffuse large B cell lymphoma may be classified based on molecular, genetic, and immunohistochemical features into the following:[1]
1. Diffuse large B cell lymphoma, not otherwise specified
A- Morphologic subgroups
- Centroblastic
- Appearance of medium-to-large-sized lymphocytes with scanty cytoplasm
- Prominently visible oval/round nuclei that contian fine chromatin
- Two to four nucleoli within each nucleus
- Tumour may be monomorphic, composed almost entirely of centroblasts
- The majority of cases are polymorphic (mixture of centroblastic and immunoblastic cells)
- Immunoblastic
- Greater than 90% of its cells are immunoblasts
- Significant basophilic cytoplasm and a central nucleolus
- Anaplastic
- Tumour cells which appear very differently from their normal B cell counterparts
- Very large cells with a round, oval, or polygonal shape that may resemble Reed-Sternberg cells of Hodgkin's lymphoma
- Pleomorphic nuclei
- Other
- Does not meet any of the above criteria
B- Immunophenotypic subgroups
- Germinal center-derived B-cell (GCB)
- Activated B-cell-like (ABC)
C- Genetic subgroups
- BCL6
- BCL2
- C-MYC
- Other
D- Immunohistochemical subgroups
- CD5-positive de-novo diffuse large B cell lymphoma
- Germinal center B-cell like (GCB)
- Non-germinal center B-cell-like (non-GCB)
2. Diffuse Large B Cell Lymphoma subtypes
- T-cell/histiocyte-rich large B cell lymphoma
- Primary diffuse large B cell lymphoma of the central nervous system (CNS)
- Epstein-Barr virus positive diffuse large B cell lymphoma of the elderly
3. 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
4. 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
- ↑ Stein H, Chan JKC, Warnke RA (2008). Diffuse large B-cell lymphoma not otherwise specified. In:Swerdlow SH, Campo E, Harris NL, et al. editors. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC. p. 233-7.