B-cell lymphoma

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B-cell lymphoma
Micrograph showing a large B cell lymphoma. Field stain.
SpecialtyHematology, oncology

The B-cell lymphomas are types of lymphoma affecting B cells. Lymphomas are "blood cancers" in the lymph nodes. They develop more frequently in older adults and in immunocompromised individuals.

B-cell lymphomas include both Hodgkin's lymphomas and most non-Hodgkin lymphomas. They are typically divided into low and high grade, typically corresponding to indolent (slow-growing) lymphomas and aggressive lymphomas, respectively. As a generalisation, indolent lymphomas respond to treatment and are kept under control (in remission) with long-term survival of many years, but are not cured. Aggressive lymphomas usually require intensive treatments, with some having a good prospect for a permanent cure.[1]

Prognosis and treatment depends on the specific type of lymphoma as well as the stage and grade. Treatment includes radiation and chemotherapy. Early-stage indolent B-cell lymphomas can often be treated with radiation alone, with long-term non-recurrence. Early-stage aggressive disease is treated with chemotherapy and often radiation, with a 70–90% cure rate.[1] Late-stage indolent lymphomas are sometimes left untreated and monitored until they progress. Late-stage aggressive disease is treated with chemotherapy, with cure rates of over 70%.[1]

Types

Hodgkin's lymphoma, a type of B cell lymphoma that is usually considered separate from other B cell lymphomas. Field stain
.
CT scan of primary B cell lymphoma in the left ilium, as diffuse cortical and trabecular thickening of the hemipelvis, mimicking Paget's disease.[2]

There are numerous kinds of lymphomas involving B cells. The most commonly used classification system is the WHO classification, a convergence of more than one, older classification systems.[citation needed]

Common

Five account for nearly three out of four patients with non-Hodgkin lymphoma:[3]

Rare

The remaining forms are much less common:[3]

Other

Additionally, some researchers separate out lymphomas that appear to result from other immune system disorders, such as AIDS-related lymphoma.[citation needed]

Classic

nodular lymphocyte predominant Hodgkin's lymphoma are now considered forms of B-cell lymphoma.[5]

Diagnosis

When a person appears to have a B-cell lymphoma, the main components of a workup (for determining the appropriate therapy and the person's prognosis) are:[6]

  • Establishing the precise subtype: Initially, an incisional or excisional biopsy is preferred. A core needle biopsy is discouraged except in case a lymph node is not easily accessible. Fine-needle aspiration is only acceptable in selected circumstances, in combination with immunohistochemistry and flow cytometry.
  • Determining the extent of the disease (localized or advanced; nodal or extranodal)
  • The person's general health status.
Main immunohistochemistry markers in common types of B-cell lymphoma.[7]
Follicular lymphoma
mucosa-associated lymphatic tissue (MALT) lymphoma
Small lymphocytic lymphoma (SLL) / chronic lymphocytic leukemia
(CLL) 		Mantle cell lymphoma (MCL)
CD5 - - + +
CD10
 + - - -
CD23 - - + -
Cyclin D1 - - - +

Associated chromosomal translocations

Burkitt's lymphoma.[8] In these cases, the immunoglobulin heavy locus forms a fusion protein with another protein that has pro-proliferative or anti-apoptotic abilities. The enhancer element of the immunoglobulin heavy locus, which normally functions to make B cells produce massive production of antibodies, now induces massive transcription of the fusion protein, resulting in excessive pro-proliferative or anti-apoptotic effects on the B cells containing the fusion protein.[citation needed
]

In

c-myc (on chromosome 8) and cyclin D1[9] (on chromosome 11), respectively, which gives the fusion protein pro-proliferative ability. In follicular lymphoma
, the fused protein is Bcl-2 (on chromosome 18), which gives the fusion protein anti-apoptotic abilities.[citation needed]

See also

References

  1. ^ a b c Merck Manual home edition, Non-Hodgkin Lymphomas
  2. ISSN 2328-5249
    .
  3. ^ a b "The Lymphomas" (PDF). The Leukemia & Lymphoma Society. May 2006. p. 12. Archived from the original (PDF) on 2008-07-06. Retrieved 2008-04-07.
  4. PMID 22457704
    .
  5. ^ "HMDS: Hodgkin's Lymphoma". Archived from the original on 4 March 2009. Retrieved 2009-02-01.
  6. ^ Mohammad Muhsin Chisti, Haresh Kumar, Sumeet K Yadav. "B-Cell Lymphoma Workup". Medscape.{{cite web}}: CS1 maint: multiple names: authors list (link) Updated Jul 27, 2020
  7. ISBN 9781316402009
    .
  8. S2CID 10776403
    .
  9. PMID 10329598
    .

External links

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