Diffuse large B cell lymphoma pathophysiology: Difference between revisions
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{{Diffuse large B cell lymphoma}} | {{Diffuse large B cell lymphoma}} | ||
{{CMG}} | |||
==Overview== | |||
==Microscopic Pathology== | |||
* Three variants are most commonly seen: centroblastic, immunoblastic, and anaplastic. | |||
===Centroblasts=== | |||
* Most cases of are Diffuse large B cell lymphoma centroblastic, having the appearance of medium-to-large-sized [[lymphocyte]]s with scanty [[cytoplasm]]. | |||
* Oval or round [[Cell nucleus|nuclei]] containing fine [[chromatin]] are prominently visible, having two to four [[nucleoli]] within each nucleus. | |||
* Sometimes the tumour may be monomorphic, composed almost entirely of centroblasts. | |||
* However, most cases are polymorphic, with a mixture of centroblastic and immunoblastic cells. | |||
===Immunoblasts=== | |||
* Immunoblasts have significant [[basophilic]] cytoplasm and a central nucleolus. | |||
* A tumour can be classified as immunoblastic if greater than 90% of its cells are immunoblasts. This distinction can be problematic, however, because hematopathologists reviewing the microscope slides may often disagree on whether a collection of cells is best characterized as centroblasts or immunoblasts.<ref name="Harris1994">{{cite journal |pmid=8068936 |year=1994 |last1=Harris |first1=N. L. |title=A revised European-American classification of lymphoid neoplasms: A proposal from the International Lymphoma Study Group |journal=Blood |volume=84 |issue=5 |pages=1361–92 |last2=Jaffe |first2=E. S. |last3=Stein |first3=H |last4=Banks |first4=P. M. |last5=Chan |first5=J. K. |last6=Cleary |first6=M. L. |last7=Delsol |first7=G |last8=De Wolf-Peeters |first8=C |last9=Falini |first9=B |last10=Gatter |first10=K. C. |url=http://www.bloodjournal.org/content/84/5/1361 }}</ref> Such disagreement indicates poor [[inter-rater reliability]]. | |||
===Anaplastic=== | |||
* The third morphologic variant, [[Anaplasia|anaplastic]], consists of tumour cells which appear very differently from their normal B cell counterparts. | |||
* The cells are generally very large with a round, oval, or polygonal shape and [[Pleomorphism (cytology)|pleomorphic]] nuclei, and may resemble [[Hodgkin's lymphoma#Pathology|Hodgkin cells]] or [[Reed–Sternberg cell|Reed-Sternberg cells]]. | |||
==References== | ==References== | ||
Revision as of 22:19, 20 August 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Microscopic Pathology
- Three variants are most commonly seen: centroblastic, immunoblastic, and anaplastic.
Centroblasts
- Most cases of are Diffuse large B cell lymphoma centroblastic, having the appearance of medium-to-large-sized lymphocytes with scanty cytoplasm.
- Oval or round nuclei containing fine chromatin are prominently visible, having two to four nucleoli within each nucleus.
- Sometimes the tumour may be monomorphic, composed almost entirely of centroblasts.
- However, most cases are polymorphic, with a mixture of centroblastic and immunoblastic cells.
Immunoblasts
- Immunoblasts have significant basophilic cytoplasm and a central nucleolus.
- A tumour can be classified as immunoblastic if greater than 90% of its cells are immunoblasts. This distinction can be problematic, however, because hematopathologists reviewing the microscope slides may often disagree on whether a collection of cells is best characterized as centroblasts or immunoblasts.[1] Such disagreement indicates poor inter-rater reliability.
Anaplastic
- The third morphologic variant, anaplastic, consists of tumour cells which appear very differently from their normal B cell counterparts.
- The cells are generally very large with a round, oval, or polygonal shape and pleomorphic nuclei, and may resemble Hodgkin cells or Reed-Sternberg cells.
References
- ↑ Harris, N. L.; Jaffe, E. S.; Stein, H; Banks, P. M.; Chan, J. K.; Cleary, M. L.; Delsol, G; De Wolf-Peeters, C; Falini, B; Gatter, K. C. (1994). "A revised European-American classification of lymphoid neoplasms: A proposal from the International Lymphoma Study Group". Blood. 84 (5): 1361–92. PMID 8068936.