B-cell lymphoma diagnostic study of choice: Difference between revisions
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=== Study of choice === | === Study of choice === | ||
B-cell lymphomas include both [[Hodgkin's lymphoma]]s and most [[Non-Hodgkin lymphomas]]. | B-cell lymphomas include both [[Hodgkin's lymphoma]]s and most [[Non-Hodgkin lymphomas]]. | ||
*Excisional lymph node biopsy is the gold standard test for the diagnosis of B-cell lymphomas. It is the preferred method to protect the architecture of lymph nodes, which is crucial for pathological evaluation and classification of lymphoma.<ref name="pmid32703953">{{cite journal |vauthors=Connors JM, Cozen W, Steidl C, Carbone A, Hoppe RT, Flechtner HH, Bartlett NL |title=Hodgkin lymphoma |journal=Nat Rev Dis Primers |volume=6 |issue=1 |pages=61 |date=July 2020 |pmid=32703953 |doi=10.1038/s41572-020-0189-6 |url=}}</ref><ref name="pmid27466666">{{cite journal |vauthors= |title= |journal= |volume= |issue= |pages= |date= |pmid=27466666 |doi= |url=}}</ref><ref name="pmid28395545">{{cite journal |vauthors=Jiang M, Bennani NN, Feldman AL |title=Lymphoma classification update: B-cell non-Hodgkin lymphomas |journal=Expert Rev Hematol |volume=10 |issue=5 |pages=405–415 |date=May 2017 |pmid=28395545 |doi=10.1080/17474086.2017.1318053 |url=}}</ref><ref name="pmid29763144">{{cite journal |vauthors=Kaseb H, Babiker HM |title= |journal= |volume= |issue= |pages= |date= |pmid=29763144 |doi= |url=}}</ref> | *Excisional [[lymph node biopsy]] is the gold standard test for the diagnosis of B-cell lymphomas. It is the preferred method to protect the architecture of lymph nodes, which is crucial for pathological evaluation and classification of lymphoma.<ref name="pmid32703953">{{cite journal |vauthors=Connors JM, Cozen W, Steidl C, Carbone A, Hoppe RT, Flechtner HH, Bartlett NL |title=Hodgkin lymphoma |journal=Nat Rev Dis Primers |volume=6 |issue=1 |pages=61 |date=July 2020 |pmid=32703953 |doi=10.1038/s41572-020-0189-6 |url=}}</ref><ref name="pmid27466666">{{cite journal |vauthors= |title= |journal= |volume= |issue= |pages= |date= |pmid=27466666 |doi= |url=}}</ref><ref name="pmid28395545">{{cite journal |vauthors=Jiang M, Bennani NN, Feldman AL |title=Lymphoma classification update: B-cell non-Hodgkin lymphomas |journal=Expert Rev Hematol |volume=10 |issue=5 |pages=405–415 |date=May 2017 |pmid=28395545 |doi=10.1080/17474086.2017.1318053 |url=}}</ref><ref name="pmid29763144">{{cite journal |vauthors=Kaseb H, Babiker HM |title= |journal= |volume= |issue= |pages= |date= |pmid=29763144 |doi= |url=}}</ref> | ||
*Fine-needle aspiration or core-needle biopsy specimens are usually | *[[Fine-needle aspiration]] or core-needle biopsy specimens are usually insufficient because these methods have a low ratio of malignant cells and they do not sufficiently preserve the architecture of lymph nodes. | ||
*Diagnostic studies of B-cell lymphomas include light microscopic evaluation of pathologic sample, as well as an immunophenotypic analysis with immunohistochemistry to determine the subtype. | *Diagnostic studies of B-cell lymphomas include light microscopic evaluation of pathologic sample, as well as an immunophenotypic analysis with [[immunohistochemistry]] to determine the subtype. | ||
===== Diagnostic results ===== | ===== Diagnostic results ===== | ||
*The following findings on pathological evaluation are confirmatory for Hodgkin's lypmhoma:<ref name="pmid29763144">{{cite journal |vauthors=Kaseb H, Babiker HM |title= |journal= |volume= |issue= |pages= |date= |pmid=29763144 |doi= |url=}}</ref> | *The following findings on pathological evaluation are confirmatory for Hodgkin's lypmhoma:<ref name="pmid29763144">{{cite journal |vauthors=Kaseb H, Babiker HM |title= |journal= |volume= |issue= |pages= |date= |pmid=29763144 |doi= |url=}}</ref> | ||
**Reed-Sternberg cells (RS) | **[[Reed-Sternberg cells]] (RS) | ||
**Lymphocyte predominant cells (LP) | **Lymphocyte predominant cells (LP) | ||
*The following findings on immunophenotypic analysis are confirmatory for the following types of non-Hodgkin's lypmhoma:<ref name="pmid32644754">{{cite journal |vauthors=Sapkota S, Shaikh H |title= |journal= |volume= |issue= |pages= |date= |pmid=32644754 |doi= |url=}}</ref><ref name="pmid27466666">{{cite journal |vauthors= |title= |journal= |volume= |issue= |pages= |date= |pmid=27466666 |doi= |url=}}</ref> | *The following findings on immunophenotypic analysis are confirmatory for the following types of [[non-Hodgkin's lypmhoma]]:<ref name="pmid32644754">{{cite journal |vauthors=Sapkota S, Shaikh H |title= |journal= |volume= |issue= |pages= |date= |pmid=32644754 |doi= |url=}}</ref><ref name="pmid27466666">{{cite journal |vauthors= |title= |journal= |volume= |issue= |pages= |date= |pmid=27466666 |doi= |url=}}</ref> | ||
**MYC-IGH rearrangement detected by [[FISH]] in the presence of a [[BCL2]] negative germinal centres phenotype is definitive for the diagnosis of [[Burkitt lymphoma]]. | **MYC-IGH rearrangement detected by [[FISH]] in the presence of a [[BCL2]] negative germinal centres phenotype is definitive for the diagnosis of [[Burkitt lymphoma]]. | ||
**A disrupted structure of [[follicle center]] by sheets of large cells which are positive for pan-B-cell antigens (e.g., [[CD20]], CD79a) is definitive for the diagnosis of [[diffuse large B-cell lymphoma]] (DLBCL).<ref name="pmid30859597">{{cite journal |vauthors=Liu Y, Barta SK |title=Diffuse large B-cell lymphoma: 2019 update on diagnosis, risk stratification, and treatment |journal=Am J Hematol |volume=94 |issue=5 |pages=604–616 |date=May 2019 |pmid=30859597 |doi=10.1002/ajh.25460 |url=}}</ref> | **A disrupted structure of [[follicle center]] by sheets of large cells which are positive for pan-B-cell antigens (e.g., [[CD20]], CD79a) is definitive for the diagnosis of [[diffuse large B-cell lymphoma]] (DLBCL).<ref name="pmid30859597">{{cite journal |vauthors=Liu Y, Barta SK |title=Diffuse large B-cell lymphoma: 2019 update on diagnosis, risk stratification, and treatment |journal=Am J Hematol |volume=94 |issue=5 |pages=604–616 |date=May 2019 |pmid=30859597 |doi=10.1002/ajh.25460 |url=}}</ref> | ||
Revision as of 16:45, 6 May 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2]
Overview
Diagnostic Study of Choice
Study of choice
B-cell lymphomas include both Hodgkin's lymphomas and most Non-Hodgkin lymphomas.
- Excisional lymph node biopsy is the gold standard test for the diagnosis of B-cell lymphomas. It is the preferred method to protect the architecture of lymph nodes, which is crucial for pathological evaluation and classification of lymphoma.[1][2][3][4]
- Fine-needle aspiration or core-needle biopsy specimens are usually insufficient because these methods have a low ratio of malignant cells and they do not sufficiently preserve the architecture of lymph nodes.
- Diagnostic studies of B-cell lymphomas include light microscopic evaluation of pathologic sample, as well as an immunophenotypic analysis with immunohistochemistry to determine the subtype.
Diagnostic results
- The following findings on pathological evaluation are confirmatory for Hodgkin's lypmhoma:[4]
- Reed-Sternberg cells (RS)
- Lymphocyte predominant cells (LP)
- The following findings on immunophenotypic analysis are confirmatory for the following types of non-Hodgkin's lypmhoma:[5][2]
- MYC-IGH rearrangement detected by FISH in the presence of a BCL2 negative germinal centres phenotype is definitive for the diagnosis of Burkitt lymphoma.
- A disrupted structure of follicle center by sheets of large cells which are positive for pan-B-cell antigens (e.g., CD20, CD79a) is definitive for the diagnosis of diffuse large B-cell lymphoma (DLBCL).[6]
- A chromosomal translocation t(11:14) is definitive for the diagnosis of mantle cell lymphoma.[7]
References
- ↑ Connors JM, Cozen W, Steidl C, Carbone A, Hoppe RT, Flechtner HH, Bartlett NL (July 2020). "Hodgkin lymphoma". Nat Rev Dis Primers. 6 (1): 61. doi:10.1038/s41572-020-0189-6. PMID 32703953 Check
|pmid=value (help). - ↑ 2.0 2.1 . PMID 27466666. Missing or empty
|title=(help) - ↑ Jiang M, Bennani NN, Feldman AL (May 2017). "Lymphoma classification update: B-cell non-Hodgkin lymphomas". Expert Rev Hematol. 10 (5): 405–415. doi:10.1080/17474086.2017.1318053. PMID 28395545.
- ↑ 4.0 4.1 Kaseb H, Babiker HM. PMID 29763144. Missing or empty
|title=(help) - ↑ Sapkota S, Shaikh H. PMID 32644754 Check
|pmid=value (help). Missing or empty|title=(help) - ↑ Liu Y, Barta SK (May 2019). "Diffuse large B-cell lymphoma: 2019 update on diagnosis, risk stratification, and treatment". Am J Hematol. 94 (5): 604–616. doi:10.1002/ajh.25460. PMID 30859597.
- ↑ Vose JM (August 2017). "Mantle cell lymphoma: 2017 update on diagnosis, risk-stratification, and clinical management". Am J Hematol. 92 (8): 806–813. doi:10.1002/ajh.24797. PMID 28699667.