What is Diffuse Large B-Cell Lymphoma?

Diffuse large B-cell lymphoma is a neoplasm of large B lymphoid cells with nuclei at least twice the size of a lymphocyte.

What is the Pathology of Diffuse Large B-Cell Lymphoma?

The pathology of diffuse large B-cell lymphoma is:

-Etiology: The cause of diffuse large B-cell lymphoma is due to dysregulation of BCL6, overexpression of BCL2 and mutations in p300 and CREBP.

-Genes involved: BCL6, BCL2, p300 and CREBP genes.

-Pathogenesis: The sequence of events that lead to diffuse large B-cell lymphoma include dysregulation of BCL6, overexpression of BCL2 and mutations in p300 and CREBP.

-Histology: The histology associated with diffuse large B-cell lymphoma shows a relatively large cell size usually 4-5 times the diameter of a small lymphocyte and a diffuse pattern of growth. Tumor cells have a round or oval nucleus that appears vesicular due to margination of chromatin to the nuclear membrane. Cytoplasm is moderately abundant and may be pale or basophilic.

Diffuse Large B-Cell Lymphoma. Morphologic features of DLBCL (hematoxylin and eosin, 440x). Prognostic Significance of Bcl-2 and p53 Protein Expressions and Ki67 Proliferative Index in Diffuse Large B-cell Lymphoma. Küçükzeybek BB, Bener S, Çallı AO, Paksoy TD, Payzin B - Turkish journal of haematology : official journal of Turkish Society of Haematology (2013). Not altered. CC.
Diffuse Large B-Cell Lymphoma. (A) Hematoxylin and eosin (H&E)–stained image showing diffuse large B-cell lymphoma of the right breast. (B) Immunohistochemical staining with positivity for CD20. (C) Gross specimen of the right testis, epididymis, and spermatic cord with an ovoid mass (3.8×2.5×1.6 cm). (D) H&E-stained image consistent with diffuse large B-cell lymphoma of the testis. Diffuse Large B-Cell Lymphoma with Involvement of the Breast and Testis in a Male Patient. Choi E, Jo JC, Yoon DH, Kim S, Lee K, Huh J, Park CS, Lee SW, Suh C - Cancer research and treatment : official journal of Korean Cancer Association (2014). Not altered. CC.
Diffuse Large B-Cell Lymphoma (DLBCL) case showing centroblastic morphology in hematoxylin and eosin (A).The phenotypic profile shows extensive nuclear positivity for MYC (B), FOXP1 (C) and KI-67, with high proliferation fraction (D). Immunoblastic variant of DLBCL (E–H). The majority of cells show prominent central nucleoli in hematoxylin and eosin (E). The phenotypic profile shows extensive positivity for MYC (F) and BCL2 (G) staining. (H) Low magnification of tissue microarray core illustrating the MYC expression. Double-Hit BCL6/MYC DLBCL (I–K). Proliferation of intermediate monotonous population of intermediate-sized to large-sized lymphoid cells (I). FISH for BCL6 (J) and MYC (K) shows translocation of these genes with 1 normal fusion signal and a split signal. Immunohistochemical and molecular characteristics with prognostic significance in diffuse large B-cell lymphoma. Bellas C, García D, Vicente Y, Kilany L, Abraira V, Navarro B, Provencio M, Martín P - PloS one (2014). Not altered. CC.

How does Diffuse Large B-Cell Lymphoma Present?

Patients with diffuse large B-cell lymphoma typically present with a slight male predominance and the median patient age is about 60 years. The symptoms, features, and clinical findings associated with diffuse large B-cell lymphoma typically include a rapidly enlarging mass at a nodal or extranodal site. The Waldeyer ring, oropharyngeal lymphoid tissue that includes the tonsils and adenoids, is involved most commonly. Involvement of the liver and spleen may take the form of a large destructive masses.

How is Diffuse Large B-Cell Lymphoma Diagnosed?

Diffuse large B-cell lymphoma is diagnosed mainly through biopsy of an enlarged lymph node and examining it through a microscope.

How is Diffuse Large B-Cell Lymphoma Treated?

Diffuse large B-cell lymphoma is treated with intensive combination chemotherapy. Adjuvant therapy with anti-CD20 improves both the initial response and overall outcome.

What is the Prognosis of Diffuse Large B-Cell Lymphoma?

The prognosis of diffuse large B-cell lymphoma is fair with remission rate of 60-80% and a cure rate of 40-50% when treated with intensive chemotherapy. DLBCLs are aggressive tumors that are rapidly fatal without treatment.