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{{Short description|A type of non-Hodgkin lymphoma affecting B cells}}
{{Infobox medical condition (new)  
{{Infobox medical condition (new)  
| name            = B-cell lymphoma  
| name            = B-cell lymphoma  
| synonyms        =
| synonyms        = B-cell non-Hodgkin lymphoma, B-NHL
| image          = Large b cell lymphoma - cytology small.jpg  
| image          = Large b cell lymphoma - cytology small.jpg  
| caption        = [[Micrograph]] showing a large B cell lymphoma. [[Field stain]].  
| caption        = [[Micrograph]] showing a large B cell lymphoma. [[Field stain]].  
| pronounce      =
| pronounce      =  
| field          = [[Hematology]], [[oncology]]  
| field          = [[Hematology]], [[Oncology]]  
| symptoms        =  
| symptoms        = Swollen lymph nodes, fever, night sweats, weight loss, fatigue
| complications  =  
| complications  = Immunodeficiency, bone marrow suppression, organ infiltration, secondary cancers
| onset          =  
| onset          = Variable; often middle-aged or older adults
| duration        =  
| duration        = Chronic or progressive if untreated
| types          =  
| types          = [[Diffuse large B-cell lymphoma]], [[Follicular lymphoma]], [[Mantle cell lymphoma]], [[Burkitt lymphoma]], [[Chronic lymphocytic leukemia|CLL]]
| causes          =  
| causes          = Unknown; may involve [[genetic mutations]], [[Epstein-Barr virus]], or [[immunosuppression]]
| risks          =  
| risks          = Family history, age, autoimmune diseases, organ transplantation, HIV/AIDS
| diagnosis      =  
| diagnosis      = [[Lymph node biopsy]], [[Immunophenotyping]], [[Flow cytometry]], [[PET-CT]]
| differential    =  
| differential    = [[T-cell lymphoma]], [[Hodgkin lymphoma]], [[Infectious mononucleosis]], [[Reactive lymphadenopathy]]
| prevention      =  
| prevention      = None specific; managing underlying risk factors may help
| treatment      =  
| treatment      = [[Chemotherapy]], [[Radiation therapy]], [[Immunotherapy]] (e.g. rituximab), [[Stem cell transplantation]]
| medication      =  
| medication      = [[Rituximab]], [[Cyclophosphamide]], [[Doxorubicin]], [[Vincristine]], [[Prednisone]] (R-CHOP regimen)
| prognosis      =  
| prognosis      = Varies by subtype; can range from indolent to aggressive forms
| frequency      =  
| frequency      = Common subtype of [[non-Hodgkin lymphoma]]; over 80% of cases
| deaths          =  
| deaths          = Depends on type and response to treatment; aggressive forms can be fatal without therapy
}}
}}
The '''B-cell lymphomas''' are types of [[lymphoma]] affecting [[B cell]]s. Lymphomas are [[Tumors of the hematopoietic and lymphoid tissues|"blood cancers"]] in the [[lymph node]]s. They develop more frequently in older adults and in immunocompromised individuals.
[[Image:Hodgkin lymphoma cytology large.jpg|thumb|left|[[Micrograph]] showing [[Hodgkin's lymphoma]], a type of B cell lymphoma that is usually considered separate from other B cell lymphomas. [[Field stain]].]]
[[File:CT of primary B-cell lymphoma left ilium.jpg|thumb|left|CT scan of primary B cell lymphoma in the left [[ilium (bone)|ilium]], as diffuse cortical and trabecular thickening of the hemipelvis, mimicking [[Paget's disease of bone|Paget's disease]].]]


B-cell lymphomas include both [[Hodgkin's lymphoma]]s and most [[non-Hodgkin lymphoma]]s. 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#Remission|cure]].<ref name="mmhe">[http://www.merck.com/mmhe/sec14/ch177/ch177c.html Merck Manual home edition], Non-Hodgkin Lymphomas</ref>
'''B-cell lymphoma''' is a type of [[non-Hodgkin lymphoma]] (NHL) that originates in [[B lymphocytes]], which are a type of [[white blood cell]] responsible for producing [[antibodies]]. B-cell lymphomas are the most common form of NHL and can vary significantly in their presentation, behavior, and response to treatment.


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.<ref name="mmhe"/>  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%.<ref name="mmhe"/>
==Classification==
B-cell lymphomas are classified based on their appearance under the microscope, their genetic features, and their clinical behavior. The World Health Organization (WHO) classification system is commonly used to categorize these lymphomas. Major types include:


==Types==
* [[Diffuse large B-cell lymphoma]] (DLBCL)
[[Image:Hodgkin lymphoma cytology large.jpg|thumb|[[Micrograph]] showing [[Hodgkin's lymphoma]], a type of B cell lymphoma that is usually considered separate from other B cell lymphomas. [[Field stain]].]]
[[File:CT of primary B-cell lymphoma left ilium.jpg|thumb|CT scan of primary B cell lymphoma in the left [[ilium (bone)|ilium]], as diffuse cortical and trabecular thickening of the hemipelvis, mimicking [[Paget's disease of bone|Paget's disease]].<ref>{{cite journal|last1=Nguyen|first1=Nghi|last2=Khan|first2=Mujahid|last3=Shah|first3=Muhammad|title=Primary B-cell lymphoma of the pelvic bone in a young patient: Imaging features of a rare case|journal=Cancer Research Frontiers|volume=3|issue=1|year=2017|pages=51–55|issn=23285249|doi=10.17980/2017.51|doi-access=free}}</ref>]]
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.
 
===Common===
Five account for nearly three out of four patients with non-Hodgkin lymphoma:<ref name="The Lymphomas">{{cite web|url=http://www.leukemia-lymphoma.org/attachments/National/br_1161891669.pdf |title=The Lymphomas |accessdate=2008-04-07 |date=May 2006 |publisher=The Leukemia & Lymphoma Society |page=12 |url-status=dead |archiveurl=https://web.archive.org/web/20080706143003/http://www.leukemia-lymphoma.org/attachments/National/br_1161891669.pdf |archivedate=2008-07-06 }}</ref>
 
* [[Diffuse large B-cell lymphoma]] (DLBCL)<ref>{{cite journal|author=Mazen Sanoufa|author2=Mohammad Sami Walid|author3=Talat Parveen|title=B-Cell Lymphoma of the Thoracic Spine Presenting with Spinal Cord Pressure Syndrome|journal= Journal of Clinical Medicine Research|volume=2|issue=1|pages=53–54|year=2010|pmid=22457704|doi=10.4021/jocmr2010.02.258w|pmc=3299178}}</ref>
* [[Follicular lymphoma]]
* [[Follicular lymphoma]]
* [[Marginal zone B-cell lymphoma]] (MZL) or [[MALT lymphoma|Mucosa-Associated Lymphatic Tissue lymphoma]] (MALT)
* [[Chronic lymphocytic leukemia]]/small lymphocytic lymphoma (CLL/SLL)
* [[B-cell chronic lymphocytic leukemia|Small lymphocytic lymphoma]] (also known as chronic lymphocytic leukemia, CLL
* [[Mantle cell lymphoma]]
* [[Mantle cell lymphoma]] (MCL)
* [[Burkitt lymphoma]]
* [[Marginal zone lymphoma]]
* [[Primary mediastinal large B-cell lymphoma]]


===Rare===
==Pathophysiology==
The remaining forms are much less common:<ref name="The Lymphomas"/>
B-cell lymphomas arise from the malignant transformation of B cells at various stages of their development. Genetic mutations, chromosomal translocations, and other molecular abnormalities can lead to uncontrolled proliferation of these cells. For example, the translocation t(14;18) is commonly associated with follicular lymphoma, leading to overexpression of the BCL2 gene, which inhibits apoptosis.
* DLBCL variants or sub-types of
** [[Primary mediastinal (thymic) large B cell lymphoma]]
** [[T cell/histiocyte-rich large B-cell lymphoma]]
** [[Primary cutaneous diffuse large B-cell lymphoma, leg type]] (Primary cutaneous DLBCL, leg type)
** [[EBV positive diffuse large B-cell lymphoma of the elderly]]
** [[Diffuse large B-cell lymphoma associated with chronic inflammation]]
** [[Fibrin-associated diffuse large B-cell lymphoma]]
** [[Primary testicular diffuse large B-cell lymphoma]]
* [[Burkitt's lymphoma]]
* [[Waldenström's macroglobulinemia|Lymphoplasmacytic lymphoma]], which may manifest as [[Waldenström's macroglobulinemia]]
* [[Nodal marginal zone B cell lymphoma]] (NMZL)
* [[Splenic marginal zone lymphoma]] (SMZL)
* Intravascular lymphomas variants
** [[Intravascular lymphoma|Intravascular large B-cell lymphoma]]
** [[Intravascular lymphoma#Intravascular NK/T cell lymphomas|Intravascular NK-cell lymphoma]]
** [[Intravascular lymphoma#Intravascular NK/T cell lymphomas|Intravascular T-cell lymphoma]]
* [[Primary effusion lymphoma]]
* [[Lymphomatoid granulomatosis]]
* [[Primary central nervous system lymphoma]]
* [[ALK+ large B-cell lymphoma]]
* [[Plasmablastic lymphoma]]
* [[Large B-cell lymphoma arising in HHV8-associated multicentric Castleman's disease]]
* [[B-cell lymphoma, unclassifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma]]
* [[B-cell lymphoma, unclassifiable with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma]]


===Other===
==Symptoms==
Additionally, some researchers separate out lymphomas that appear to result from other immune system disorders, such as [[AIDS-related lymphoma]].
The symptoms of B-cell lymphoma can vary depending on the type and stage of the disease. Common symptoms include:


Classic [[Hodgkin's lymphoma]] and [[nodular lymphocyte predominant Hodgkin's lymphoma]] are now considered forms of B-cell lymphoma.<ref name="urlHMDS: Hodgkins Lymphoma">{{cite web|url=http://www.hmds.org.uk/hl.html |title=HMDS: Hodgkin's Lymphoma |accessdate=2009-02-01 |archiveurl=https://web.archive.org/web/20090304001837/http://www.hmds.org.uk/hl.html |archivedate=4 March 2009 |url-status=dead }}</ref>
* [[Lymphadenopathy]] (swollen lymph nodes)
* [[Fever]]
* [[Night sweats]]
* [[Weight loss]]
* [[Fatigue]]
* [[Hepatosplenomegaly]] (enlarged liver and spleen)


==Associated chromosomal translocations==
==Diagnosis==
[[Chromosomal translocation]]s involving the [[immunoglobulin heavy locus]] (IGH@) is a classic cytogenetic abnormality for many B-cell lymphomas, including [[follicular lymphoma]], [[mantle cell lymphoma]] and [[Burkitt's lymphoma]]. 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.
Diagnosis of B-cell lymphoma typically involves a combination of:


In [[Burkitt's lymphoma]] and [[mantle cell lymphoma]], the other protein in the fusion is [[c-myc]] (on chromosome 8) and [[cyclin D1]]<ref name=jy>{{cite journal |vauthors=Li JY, Gaillard F, Moreau A |title=Detection of translocation t(11;14)(q13;q32) in mantle cell lymphoma by fluorescence in situ hybridization |journal=Am. J. Pathol. |volume=154 |issue=5 |pages=1449–52 |date=May 1999 |pmid=10329598 |pmc=1866594 |doi= 10.1016/S0002-9440(10)65399-0|url=|display-authors=etal}}</ref> (on chromosome 11), respectively, which gives the [[fusion protein]] pro-proliferative ability. In [[follicular lymphoma]], the fused protein is
* [[Physical examination]]
[[Bcl-2]] (on chromosome 18), which gives the fusion protein anti-apoptotic abilities.
* [[Blood tests]]
* [[Imaging studies]] such as [[CT scan]] or [[PET scan]]
* [[Lymph node biopsy]]
* [[Immunophenotyping]] and [[flow cytometry]]
* [[Cytogenetic analysis]]


==See also==
==Treatment==
* [[Richter's transformation]]
Treatment options for B-cell lymphoma depend on the specific type and stage of the disease, as well as the patient's overall health. Common treatments include:
* [[T-cell lymphoma]]


==References==
* [[Chemotherapy]]
{{reflist}}
* [[Radiation therapy]]
* [[Immunotherapy]], such as [[rituximab]]
* [[Targeted therapy]]
* [[Stem cell transplantation]]


== External links ==
==Prognosis==
The prognosis for patients with B-cell lymphoma varies widely based on the type of lymphoma, stage at diagnosis, and response to treatment. Some types, like diffuse large B-cell lymphoma, can be aggressive but are often curable with appropriate therapy. Others, like follicular lymphoma, tend to be indolent but may require long-term management.


* [https://web.archive.org/web/20040920021016/http://dave1.mgh.harvard.edu/ViewFilms.cfm?Film_id=40 Overview and video at harvard.edu]
==Related pages==
* [http://www.lymphomas.org.uk Lymphoma Association – Specialist UK charity providing free information and support to patients, their families, friends and carers]
* [[Non-Hodgkin lymphoma]]
* [[Hodgkin lymphoma]]
* [[Leukemia]]
* [[Immunotherapy]]
{{Hematological malignancy histology}}
{{stub}}
{{stub}}
{{Hematological malignancy histology}}
[[Category:Lymphoma]]
[[Category:Lymphoma]]
[[Category:Hematology]]
[[Category:Oncology]]

Latest revision as of 17:56, 24 March 2025

A type of non-Hodgkin lymphoma affecting B cells


B-cell lymphoma
Synonyms B-cell non-Hodgkin lymphoma, B-NHL
Pronounce
Field Hematology, Oncology
Symptoms Swollen lymph nodes, fever, night sweats, weight loss, fatigue
Complications Immunodeficiency, bone marrow suppression, organ infiltration, secondary cancers
Onset Variable; often middle-aged or older adults
Duration Chronic or progressive if untreated
Types Diffuse large B-cell lymphoma, Follicular lymphoma, Mantle cell lymphoma, Burkitt lymphoma, CLL
Causes Unknown; may involve genetic mutations, Epstein-Barr virus, or immunosuppression
Risks Family history, age, autoimmune diseases, organ transplantation, HIV/AIDS
Diagnosis Lymph node biopsy, Immunophenotyping, Flow cytometry, PET-CT
Differential diagnosis T-cell lymphoma, Hodgkin lymphoma, Infectious mononucleosis, Reactive lymphadenopathy
Prevention None specific; managing underlying risk factors may help
Treatment Chemotherapy, Radiation therapy, Immunotherapy (e.g. rituximab), Stem cell transplantation
Medication Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone (R-CHOP regimen)
Prognosis Varies by subtype; can range from indolent to aggressive forms
Frequency Common subtype of non-Hodgkin lymphoma; over 80% of cases
Deaths Depends on type and response to treatment; aggressive forms can be fatal without therapy


Micrograph showing 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.

B-cell lymphoma is a type of non-Hodgkin lymphoma (NHL) that originates in B lymphocytes, which are a type of white blood cell responsible for producing antibodies. B-cell lymphomas are the most common form of NHL and can vary significantly in their presentation, behavior, and response to treatment.

Classification[edit]

B-cell lymphomas are classified based on their appearance under the microscope, their genetic features, and their clinical behavior. The World Health Organization (WHO) classification system is commonly used to categorize these lymphomas. Major types include:

Pathophysiology[edit]

B-cell lymphomas arise from the malignant transformation of B cells at various stages of their development. Genetic mutations, chromosomal translocations, and other molecular abnormalities can lead to uncontrolled proliferation of these cells. For example, the translocation t(14;18) is commonly associated with follicular lymphoma, leading to overexpression of the BCL2 gene, which inhibits apoptosis.

Symptoms[edit]

The symptoms of B-cell lymphoma can vary depending on the type and stage of the disease. Common symptoms include:

Diagnosis[edit]

Diagnosis of B-cell lymphoma typically involves a combination of:

Treatment[edit]

Treatment options for B-cell lymphoma depend on the specific type and stage of the disease, as well as the patient's overall health. Common treatments include:

Prognosis[edit]

The prognosis for patients with B-cell lymphoma varies widely based on the type of lymphoma, stage at diagnosis, and response to treatment. Some types, like diffuse large B-cell lymphoma, can be aggressive but are often curable with appropriate therapy. Others, like follicular lymphoma, tend to be indolent but may require long-term management.

Related pages[edit]

Leukaemias, lymphomas and related disease
Cutaneous lymphoid hyperplasia
General


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