Diffuse large B cell lymphoma classification: Difference between revisions
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Diffuse large B-cell lymphoma encompasses a biologically and clinically diverse set of diseases,<ref name="Alizadeh2000">{{cite journal |doi=10.1038/35000501 |pmid=10676951 |title=Distinct types of diffuse large B-cell lymphoma identified by gene expression | Diffuse large B-cell lymphoma encompasses a biologically and clinically diverse set of diseases,<ref name="Alizadeh2000">{{cite journal |doi=10.1038/35000501 |pmid=10676951 |title=Distinct types of diffuse large B-cell lymphoma identified by gene expression | ||
profiling |journal=Nature |volume=403 |issue=6769 |pages=503–11 |year=2000 |last1=Alizadeh |first1=Ash A. |last2=Eisen |first2=Michael B. |last3=Davis |first3=R. Eric |last4=Ma |first4=Chi |last5=Lossos |first5=Izidore S. |last6=Rosenwald |first6=Andreas |last7=Boldrick |first7=Jennifer C. |last8=Sabet |first8=Hajeer |last9=Tran |first9=Truc |last10=Yu |first10=Xin |last11=Powell |first11=John I. |last12=Yang |first12=Liming |last13=Marti |first13=Gerald E. |last14=Moore |first14=Troy |last15=Hudson |first15=James |last16=Lu |first16=Lisheng |last17=Lewis |first17=David B. |last18=Tibshirani |first18=Robert |last19=Sherlock |first19=Gavin |last20=Chan |first20=Wing C. |last21=Greiner |first21=Timothy C. |last22=Weisenburger |first22=Dennis D. |last23=Armitage |first23=James O. |last24=Warnke |first24=Roger |last25=Levy |first25=Ronald |last26=Wilson |first26=Wyndham |last27=Grever |first27=Michael R. |last28=Byrd |first28=John C. |last29=Botstein |first29=David |last30=Brown |first30=Patrick O. |display-authors=29 |bibcode=2000Natur.403..503A }}</ref> many of which cannot be separated from one another by well-defined and widely accepted criteria. | profiling |journal=Nature |volume=403 |issue=6769 |pages=503–11 |year=2000 |last1=Alizadeh |first1=Ash A. |last2=Eisen |first2=Michael B. |last3=Davis |first3=R. Eric |last4=Ma |first4=Chi |last5=Lossos |first5=Izidore S. |last6=Rosenwald |first6=Andreas |last7=Boldrick |first7=Jennifer C. |last8=Sabet |first8=Hajeer |last9=Tran |first9=Truc |last10=Yu |first10=Xin |last11=Powell |first11=John I. |last12=Yang |first12=Liming |last13=Marti |first13=Gerald E. |last14=Moore |first14=Troy |last15=Hudson |first15=James |last16=Lu |first16=Lisheng |last17=Lewis |first17=David B. |last18=Tibshirani |first18=Robert |last19=Sherlock |first19=Gavin |last20=Chan |first20=Wing C. |last21=Greiner |first21=Timothy C. |last22=Weisenburger |first22=Dennis D. |last23=Armitage |first23=James O. |last24=Warnke |first24=Roger |last25=Levy |first25=Ronald |last26=Wilson |first26=Wyndham |last27=Grever |first27=Michael R. |last28=Byrd |first28=John C. |last29=Botstein |first29=David |last30=Brown |first30=Patrick O. |display-authors=29 |bibcode=2000Natur.403..503A }}</ref> many of which cannot be separated from one another by well-defined and widely accepted criteria. | ||
The [[World Health Organization]] (WHO) classification system defines more than a dozen subtypes, each of which can be differentiated based on the | The [[World Health Organization]] (WHO) classification system defines more than a dozen subtypes, each of which can be differentiated based on the | ||
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:*[[gene expression]] | :*[[gene expression]] | ||
:*[[Immunohistochemistry|immunohistochemical]] properties. | :*[[Immunohistochemistry|immunohistochemical]] properties. | ||
===Use of Immunophenotyping/Genetic Testing in Differential Diagnosis of Mature B-Cell and NK/T-Cell Neoplasms=== | |||
<div style="font-size: 80%;"> | |||
{{Familytree/start}} | |||
{{Familytree|boxstyle=border: 0;| | | | | | | | | | A01 | | | | | | | | | | |A01={{F1|B-cell neoplasms}}}} | |||
{{Familytree|boxstyle=border: 0;| | | | | |,|-|-|-|-|^|-|-|-|-|.| | | | | | |}} | |||
{{Familytree|boxstyle=border: 0;| | | | | B01 | | | | | | | | B02 | | | | | |B01={{F1|CD5+}}|B02={{F1|CD5-}}}} | |||
{{Familytree|boxstyle=border: 0;| | |,|-|-|^|-|-|.| | | | | | |!| | | | | | |}} | |||
{{Familytree|boxstyle=border: 0;| | C01 | | | | C02 | | | | | C03 | | | | | |C01={{F1|CCND1+}}|C02={{F1|CCND1-}}|C03={{F1|DLBCL}}}} | |||
{{Familytree|boxstyle=border: 0;| | |!| | | | | |!| | | |,|-|-|^|-|-|-|-|-|-|.| | | |}} | |||
{{Familytree|boxstyle=border: 0;| | D01 | | | | D02 | | D03 | | | | | | | | D04 | | |D01={{F2|Pleomorphic MCL}}|D02={{F2|DLBCL, NOS CD5+}}|D03={{F1|CD10+}}|D04={{F1|CD10-}}}} | |||
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | |!| | | | | | | | | |!| | | |}} | |||
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | E01 | | | | |,|-|-|-|+|-|-|-|.| | | |E01={{F2|DLBCL, NOS GCB type}}}} | |||
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | | | | | | | F01 | | F02 | | F03 | | |F01={{F1|BCL6+ IRF4/MUM1-}}|F02={{F1|BCL6+ IRF4/MUM1+}}|F03={{F1|BCL6- IRF4/MUM1+}}}} | |||
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | | | | | | | |!| | | |!| | | |!| | | |}} | |||
{{Familytree|boxstyle=border: 0;| | | | | | | | | | | | | | | | | | G01 | | G02 | | G03 | | |G01={{F2|DLBCL, NOS GCB type}}|G02={{F2|Non-GCB}}|G03={{F2|Post-GCB}}}} | |||
{{Familytree/end}} | |||
</div> | |||
Classification of large cells based on Immunophenotypic/Genetic testing <ref>{{cite web | title = Non-Hodgkin's Lymphomas (NCCN.org) | url = http://www.nccn.org/professionals/physician_gls/PDF/nhl.pdf }}</ref> | Classification of large cells based on Immunophenotypic/Genetic testing <ref>{{cite web | title = Non-Hodgkin's Lymphomas (NCCN.org) | url = http://www.nccn.org/professionals/physician_gls/PDF/nhl.pdf }}</ref> | ||
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*B-cell lymphoma unclassifiable, intermediate between DLBCL(U-DLBCL) and classical Hodgkins lymphoma(CHL) | *B-cell lymphoma unclassifiable, intermediate between DLBCL(U-DLBCL) and classical Hodgkins lymphoma(CHL) | ||
*Mantle cell Lymphoma(MCL),pleomorphic variant | *Mantle cell Lymphoma(MCL),pleomorphic variant | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 23:51, 21 August 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Diffuse large B cell lymphoma may be classified according to World Health Organization (WHO) into more than a dozen subtypes based on location of tumor, presence of other cells within the tumor and other illness related to diffuse large B-cell lymphoma.Diffuse large B cell lymphoma can also classified based on Immunophenotypic/Genetic testing.
Classification
Diffuse large B-cell lymphoma encompasses a biologically and clinically diverse set of diseases,[1] many of which cannot be separated from one another by well-defined and widely accepted criteria.
The World Health Organization (WHO) classification system defines more than a dozen subtypes, each of which can be differentiated based on the
- Location of the tumor
- Presence of other cells within the tumor (such as T cells)
- Other illnesses related to diffuse large B-cell lymphoma.
- One of these well-defined groupings of particular note is Primary mediastinal B-cell lymphoma, which arises within the thymus or mediastinal lymph nodes.
B-cell lymphoma, unclassifiable
- Tumor may share many features intermediate between Diffuse large B-cell lymphoma and Burkitt lymphoma.
- Tumor may share many features intermediate between Diffuse large B-cell lymphoma and Hodgkin’s lymphoma.
Diffuse large B-cell lymphoma, not otherwise specified
- When a case of Diffuse large B-cell lymphoma does not conform to any of the well-defined subtypes, and is also not considered unclassifiable.
- The majority of Diffuse large B-cell lymphoma cases fall into this category.
- Much research has been devoted to separating this still-heterogeneous group; such distinctions are usually made along lines of
- cellular morphology
- gene expression
- immunohistochemical properties.
Use of Immunophenotyping/Genetic Testing in Differential Diagnosis of Mature B-Cell and NK/T-Cell Neoplasms
| B-cell neoplasms | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| CD5+ | CD5- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| CCND1+ | CCND1- | DLBCL | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Pleomorphic MCL | DLBCL, NOS CD5+ | CD10+ | CD10- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| DLBCL, NOS GCB type | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| BCL6+ IRF4/MUM1- | BCL6+ IRF4/MUM1+ | BCL6- IRF4/MUM1+ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| DLBCL, NOS GCB type | Non-GCB | Post-GCB | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Classification of large cells based on Immunophenotypic/Genetic testing [2]
- Diffuse large B-cell lymphoma (DLBCL),NOS
- T-cell/histocyte-rich large B-cell lymphoma (THRLBCL)
- Primary DLBCL of the CNS
- Primary cutaneous DLBCL, leg type
- EBV-positive DLBCL of the elderly (EBV + DLBCL)
- DLBCL associated with chronic inflammation
- Lymphoid granulomatosis
- Primary mediastinal (thymic) large B-cell Lymphoma (PMBL)
- Intravascular large B-cell lymphoma
- ALK-positive large B-cell lymphoma
- Plasmablastic lymphoma
- Large B-cell lymphoma arising in HHV8-assciated multicentric Castleman disease (LBCL in HHV8 + MCD)
- Primary effusion lymphoma
- B-cell lymphoma unclassifiable, intermediate between DLBCL(U-DLBCL) and classical Hodgkins lymphoma(CHL)
- Mantle cell Lymphoma(MCL),pleomorphic variant
References
- ↑ Alizadeh, Ash A.; Eisen, Michael B.; Davis, R. Eric; Ma, Chi; Lossos, Izidore S.; Rosenwald, Andreas; Boldrick, Jennifer C.; Sabet, Hajeer; Tran, Truc; Yu, Xin; Powell, John I.; Yang, Liming; Marti, Gerald E.; Moore, Troy; Hudson, James; Lu, Lisheng; Lewis, David B.; Tibshirani, Robert; Sherlock, Gavin; Chan, Wing C.; Greiner, Timothy C.; Weisenburger, Dennis D.; Armitage, James O.; Warnke, Roger; Levy, Ronald; Wilson, Wyndham; Grever, Michael R.; Byrd, John C.; Botstein, David; et al. (2000). "Distinct types of diffuse large B-cell lymphoma identified by gene expression
profiling". Nature. 403 (6769): 503–11. Bibcode:2000Natur.403..503A. doi:10.1038/35000501. PMID 10676951. line feed character in
|title=at position 78 (help) - ↑ "Non-Hodgkin's Lymphomas (NCCN.org)" (PDF).