B-cell lymphoma

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

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:

• Diffuse large B-cell lymphoma (DLBCL)
• Follicular lymphoma
• Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)
• Mantle cell lymphoma
• Burkitt lymphoma
• Marginal zone lymphoma
• Primary mediastinal large B-cell lymphoma

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:

• Lymphadenopathy (swollen lymph nodes)
• Fever
• Night sweats
• Weight loss
• Fatigue
• Hepatosplenomegaly (enlarged liver and spleen)

Diagnosis

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

• Physical examination
• Blood tests
• Imaging studies such as CT scan or PET scan
• Lymph node biopsy
• Immunophenotyping and flow cytometry
• Cytogenetic analysis

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:

• Chemotherapy
• Radiation therapy
• Immunotherapy, such as rituximab
• Targeted therapy
• Stem cell transplantation

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

• Non-Hodgkin lymphoma
• Hodgkin lymphoma
• Leukemia
• Immunotherapy