diffuse large B cell lymphoma

A diagnostic
approach to the mediastinal masses. Primary mediastinal diffuse large B-cell lymphoma in a 19-year-old man. Contrast-enhanced CT scan shows a bulky soft tissue mass in the anterior mediastinum (arrowsin a), which shows heterogeneous CT-attenuation values with cystic changes within (*). Pericardial effusion is also observed (open arrow in b)
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Diffuse large B cell lymphoma is the most common subtype of non-Hodgkin lymphoma.

Epidemiology

Associations

Diffuse large B cell lymphoma is sometimes associated with immunodeficiency, including acquired immunodeficiency syndrome.

Pathology

Classification

In 2016 WHO classification of lymphoid neoplasms, diffuse large B cell lymphoma, not otherwise specified (NOS), is a type of mature B cell neoplasm and includes two molecular subgroups indicating cell of origin:

  • germinal center B cell type
  • activated B cell type

In addition, diffuse large B cell lymphomas with certain molecular/cytogenetic features previously called "double-hit" or "triple-hit" lymphomas as well as those resembling Burkitt lymphoma are now classified together as either of the following entities :

  • high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements 
  • high-grade B-cell lymphoma, not otherwise specified

There are otherwise multiple specified types of diffuse large B cell lymphoma:

Staging

See the article on lymphoma staging.