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| {{Infobox medical condition (new) | | {{Short description|A type of non-Hodgkin lymphoma affecting B cells}} |
| | name = B-cell lymphoma | |
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| | image = Large b cell lymphoma - cytology small.jpg
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| | caption = [[Micrograph]] showing a large B cell lymphoma. [[Field stain]].
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| | field = [[Hematology]], [[oncology]]
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| 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.
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| 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. |
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| 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: |
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| ==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]].]] | | * [[Follicular lymphoma]] |
| [[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>]] | | * [[Chronic lymphocytic leukemia]]/small lymphocytic lymphoma (CLL/SLL) |
| 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.
| | * [[Mantle cell lymphoma]] |
| | * [[Burkitt lymphoma]] |
| | * [[Marginal zone lymphoma]] |
| | * [[Primary mediastinal large B-cell lymphoma]] |
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| ===Common=== | | ==Pathophysiology== |
| 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>
| | 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. |
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| * [[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>
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| * [[Follicular lymphoma]]
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| * [[Marginal zone B-cell lymphoma]] (MZL) or [[MALT lymphoma|Mucosa-Associated Lymphatic Tissue lymphoma]] (MALT)
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| * [[B-cell chronic lymphocytic leukemia|Small lymphocytic lymphoma]] (also known as chronic lymphocytic leukemia, CLL
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| * [[Mantle cell lymphoma]] (MCL)
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| ===Rare=== | | ==Symptoms== |
| The remaining forms are much less common:<ref name="The Lymphomas"/> | | The symptoms of B-cell lymphoma can vary depending on the type and stage of the disease. Common symptoms include: |
| * DLBCL variants or sub-types of
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| ** [[Primary mediastinal (thymic) large B cell lymphoma]]
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| ** [[T cell/histiocyte-rich large B-cell lymphoma]]
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| ** [[Primary cutaneous diffuse large B-cell lymphoma, leg type]] (Primary cutaneous DLBCL, leg type)
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| ** [[EBV positive diffuse large B-cell lymphoma of the elderly]]
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| ** [[Diffuse large B-cell lymphoma associated with chronic inflammation]]
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| ** [[Fibrin-associated diffuse large B-cell lymphoma]]
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| ** [[Primary testicular diffuse large B-cell lymphoma]]
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| * [[Burkitt's lymphoma]]
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| * [[Waldenström's macroglobulinemia|Lymphoplasmacytic lymphoma]], which may manifest as [[Waldenström's macroglobulinemia]]
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| * [[Nodal marginal zone B cell lymphoma]] (NMZL)
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| * [[Splenic marginal zone lymphoma]] (SMZL)
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| * Intravascular lymphomas variants
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| ** [[Intravascular lymphoma|Intravascular large B-cell lymphoma]]
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| ** [[Intravascular lymphoma#Intravascular NK/T cell lymphomas|Intravascular NK-cell lymphoma]]
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| ** [[Intravascular lymphoma#Intravascular NK/T cell lymphomas|Intravascular T-cell lymphoma]]
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| * [[Primary effusion lymphoma]]
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| * [[Lymphomatoid granulomatosis]]
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| * [[Primary central nervous system lymphoma]]
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| * [[ALK+ large B-cell lymphoma]]
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| * [[Plasmablastic lymphoma]]
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| * [[Large B-cell lymphoma arising in HHV8-associated multicentric Castleman's disease]]
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| * [[B-cell lymphoma, unclassifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma]]
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| * [[B-cell lymphoma, unclassifiable with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma]]
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| ===Other===
| | * [[Lymphadenopathy]] (swollen lymph nodes) |
| Additionally, some researchers separate out lymphomas that appear to result from other immune system disorders, such as [[AIDS-related lymphoma]].
| | * [[Fever]] |
| | * [[Night sweats]] |
| | * [[Weight loss]] |
| | * [[Fatigue]] |
| | * [[Hepatosplenomegaly]] (enlarged liver and spleen) |
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| 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>
| | ==Diagnosis== |
| | Diagnosis of B-cell lymphoma typically involves a combination of: |
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| ==Associated chromosomal translocations==
| | * [[Physical examination]] |
| [[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. | | * [[Blood tests]] |
| | * [[Imaging studies]] such as [[CT scan]] or [[PET scan]] |
| | * [[Lymph node biopsy]] |
| | * [[Immunophenotyping]] and [[flow cytometry]] |
| | * [[Cytogenetic analysis]] |
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| 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
| | ==Treatment== |
| [[Bcl-2]] (on chromosome 18), which gives the fusion protein anti-apoptotic abilities.
| | 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: |
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| ==See also==
| | * [[Chemotherapy]] |
| * [[Richter's transformation]] | | * [[Radiation therapy]] |
| * [[T-cell lymphoma]] | | * [[Immunotherapy]], such as [[rituximab]] |
| | * [[Targeted therapy]] |
| | * [[Stem cell transplantation]] |
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| ==References== | | ==Prognosis== |
| {{reflist}}
| | 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. |
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| == External links == | | ==Related pages== |
| | * [[Non-Hodgkin lymphoma]] |
| | * [[Hodgkin lymphoma]] |
| | * [[Leukemia]] |
| | * [[Immunotherapy]] |
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| * [https://web.archive.org/web/20040920021016/http://dave1.mgh.harvard.edu/ViewFilms.cfm?Film_id=40 Overview and video at harvard.edu]
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| * [http://www.lymphomas.org.uk Lymphoma Association – Specialist UK charity providing free information and support to patients, their families, friends and carers]
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| {{stub}}
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| {{Hematological malignancy histology}}
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| [[Category:Lymphoma]] | | [[Category:Lymphoma]] |
| | [[Category:Hematology]] |
| | [[Category:Oncology]] |
A type of non-Hodgkin lymphoma affecting B cells
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
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
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
The symptoms of B-cell lymphoma can vary depending on the type and stage of the disease. Common symptoms include:
Diagnosis
Diagnosis of B-cell lymphoma typically involves a combination of:
Treatment
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
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
