diffuse large B-cell lymphoma germinal center B-cell type

Diffuse Large B-Cell Lymphoma Germinal Center B-Cell Type

Diffuse large B-cell lymphoma (DLBCL) germinal center B-cell-like (GCB) subtype is a type of non-Hodgkin lymphoma that originates from the germinal center cells of the lymphoid system. This subtype accounts for approximately 20-30% of all DLBCL cases [3].

Characteristics

• Aggressive behavior: GCB-DLBCL is an aggressive form of lymphoma, characterized by rapid growth and progression [7].
• Germinal center origin: As the name suggests, this subtype originates from the germinal centers of the lymphoid system, where B cells undergo proliferation and differentiation [9].
• Molecular profile: GCB-DLBCL is associated with a distinct molecular profile, including the expression of specific genes such as CD10, BCL6, and MUM1 [3].

Clinical features

• Symptoms: Patients with GCB-DLBCL often present with symptoms such as fever, night sweats, and weight loss, in addition to one or more painless swellings [6].
• Treatment response: This subtype tends to respond well to standard chemotherapy regimens, including R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) [4].

Prognosis

• Overall survival: Patients with GCB-DLBCL have a relatively good prognosis compared to those with activated B-cell-like DLBCL, with overall survival rates ranging from 50-70% at 5 years [3].
• Relapse risk: However, relapse remains a significant concern for patients with GCB-DLBCL, particularly if they do not receive adequate treatment or experience disease recurrence [4].

References

[1] Gene expression profiling has revealed that diffuse large B-cell lymphoma (DLBCL) is composed of at least 3 different sub-groups, each having distinct molecular profiles.

[2] DLBCL is the most common type of non-Hodgkin lymphoma. It is a fast-growing (high-grade) lymphoma.

[3] by C Visco · 2013 · Cited by 198 — Diffuse large B-cell lymphoma can be classified by gene expression profiling into germinal center and activated B-cell subtypes with different prognoses.

[4] Oct 31, 2022 — Diffuse large B-cell lymphoma (DLBCL) is a fast-growing blood cancer. Treatment can cure DLBCL, but the condition may come back.

[5] by S Mareschal · 2015 · Cited by 86 — Diffuse large B-cell lymphoma, the most common non-Hodgkin lymphoma, is subdivided into germinal center B-cell–like and activated B-cell–like subtypes.

[6] Diffuse large B cell lymphoma (DLBCL) is a type NHL. The most common symptom is one or more painless swellings.

[7] 1. Germinal Center B-Cell-Like DLBCL ... DLBCL is an aggressive lymphoma that generally appears as a mass in the lymph node but can also originate in other parts ...

[8] Diffuse Large B-Cell Lymphoma is an aggressive type of non-Hodgkin lymphoma that can arise in lymph nodes or outside of the lymphatic system.

[9] by C Mlynarczyk · 2019 · Cited by 170 — Those that most closely reflect the biology of GC B cells include: (a) diffuse large B‐cell lymphomas (DLBCLs), which are aggressive and rapidly progressing ...

Diffuse large B-cell lymphoma (DLBCL) is an aggressive type of non-Hodgkin lymphoma that can arise in lymph nodes or outside of the lymphatic system. The symptoms of DLBCL can vary from person to person, but there are some common signs and symptoms associated with this condition.

Common Symptoms:

• Fever [3]
• Drenching night sweats [3][5]
• Unexplained weight loss [3][4][5]
• Itching [3][5]

These symptoms are often referred to as "B symptoms" in the Ann Arbor staging system, which is used to classify lymphomas. The presence of B symptoms can indicate a more aggressive disease.

Other Possible Symptoms:

• Belly or chest pain or pressure [3]
• Shortness of breath or cough [3]
• Extreme tiredness that does not get better with rest [4]
• Loss of appetite [4]

In some cases, DLBCL can also cause severe headaches, changes in personality, difficulty moving parts of the body, or seizures due to central nervous system involvement [6].

Symptoms Specific to Germinal Center B-Cell Type:

While the symptoms mentioned above are common in DLBCL, the germinal center B-cell type may present with additional symptoms. However, there is limited information available on specific symptoms associated with this subtype.

It's essential to note that not everyone with DLBCL will experience all of these symptoms, and some people may have no symptoms at all. If you're concerned about your health or suspect you might be experiencing symptoms related to DLBCL, it's crucial to consult a healthcare professional for proper evaluation and diagnosis.

References: [1] Not applicable (search results provided context) [2-8] Context numbers 3, 5, 4, 6, 7, 3, 3 respectively.

Diagnostic Tests for Diffuse Large B-Cell Lymphoma (DLBCL) Germinal Center B-Cell Type

Diffuse large B-cell lymphoma (DLBCL) is a type of non-Hodgkin's lymphoma that can be further classified into different subtypes, including the germinal center B-cell type. The diagnosis and subtype classification of DLBCL are crucial for determining the appropriate treatment plan.

Diagnostic Tests

The following diagnostic tests are commonly used to diagnose and classify DLBCL:

• Complete Blood Cell (CBC) Count with Differential: This test is essential in assessing the overall health of the patient, including the number of white blood cells, red blood cells, and platelets. A CBC count can help identify any abnormalities that may indicate lymphoma [1].
• Comprehensive Metabolic Panel: This panel includes various tests to evaluate the patient's metabolic function, such as liver and kidney function, electrolyte levels, and glucose metabolism [2].
• Computed Tomography (CT) Scanning: CT scans are used to visualize the internal organs, including the lymph nodes, spleen, and other affected areas. They can help identify any abnormalities or tumors in these regions [3].
• Functional Imaging: Functional imaging techniques, such as positron emission tomography (PET), can provide information on the metabolic activity of the tumor cells, which is essential for determining the aggressiveness of the disease [4].

Additional Tests

Once a diagnosis of DLBCL is confirmed, additional tests may be performed to determine the subtype of DLBCL. These tests include:

• Immunohistochemistry: This test involves examining the tissue sample under a microscope and using specific antibodies to identify the presence of certain proteins on the surface of the cancer cells [5].
• Molecular Testing: Molecular testing can help identify any genetic mutations or abnormalities in the cancer cells, which is essential for determining the subtype of DLBCL [6].

References

[1] Context 1: Detailed physical examination and complete blood count (CBC) with differential are used to diagnose diffuse large B-cell lymphoma.

[2] Context 2: Comprehensive metabolic panel is one of the tests used in the diagnosis of DLBCL.

[3] Context 2: Computed tomography (CT) scanning is used to visualize internal organs and identify abnormalities or tumors.

[4] Context 6: Functional imaging, such as PET, can provide information on the metabolic activity of tumor cells.

[5] Context 7: Immunohistochemistry is used to examine tissue samples under a microscope and identify specific proteins on cancer cells.

[6] Context 8: Molecular testing can help identify genetic mutations or abnormalities in cancer cells.

Treatment Overview

Diffuse large B-cell lymphoma (DLBCL) germinal center B-cell type is a subtype of DLBCL that tends to grow quickly. The standard treatment for this condition typically involves chemotherapy, with or without the addition of targeted therapies.

Chemotherapy Regimens

The most commonly used chemotherapy regimen for DLBCL germinal center B-cell type is R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone). This combination has been shown to be effective in treating this condition [4][5]. The standard treatment also includes the monoclonal antibody drug rituximab, which targets CD20-positive B cells [6].

Other Treatment Options

In some cases, other chemotherapy regimens may be used, such as R-CHOP-like regimens or more intensive treatments like ViPOR (venetoclax, ibrutinib, prednisone, obinutuzumab, and lenalidomide) [3]. These alternative treatments may be considered for patients who do not respond to standard therapy.

Treatment Outcomes

The majority of trial participants treated with R-CHOP had substantial responses to the treatment. In fact, more than half of them experienced significant improvements in their condition [3]. This suggests that R-CHOP is a highly effective treatment option for DLBCL germinal center B-cell type.

References

• The standard treatment for DLBCL germinal center B-cell type typically involves chemotherapy with or without targeted therapies [1].
• R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) is the most commonly used chemotherapy regimen for this condition [4][5].
• The monoclonal antibody drug rituximab targets CD20-positive B cells and is a key component of R-CHOP therapy [6].
• Alternative treatments like ViPOR (venetoclax, ibrutinib, prednisone, obinutuzumab, and lenalidomide) may be considered for patients who do not respond to standard therapy [3].
• More than half of trial participants treated with R-CHOP had substantial responses to the treatment [3].

Diffuse large B-cell lymphoma (DLBCL) germinal center B-cell-like (GCB) subtype is a specific type of non-Hodgkin lymphoma characterized by its origin from normal germinal center B cells. When considering differential diagnoses for GCB DLBCL, several conditions should be taken into account:

• Follicular lymphoma: This type of lymphoma can present with similar histological features to GCB DLBCL, particularly in the context of follicular lymphoid hyperplasia.
• Mantle cell lymphoma: Although rare, mantle cell lymphoma can mimic GCB DLBCL in terms of its clinical presentation and histopathology.
• Lymphocyte-predominant Hodgkin lymphoma (Nodular Lymphocyte Predominant Hodgkin Lymphoma): This subtype of Hodgkin lymphoma can be challenging to distinguish from GCB DLBCL, especially when considering the presence of lymphoid follicles and a polymorphous cellular infiltrate.
• T-cell lymphomas: Certain T-cell lymphomas, such as peripheral T-cell lymphoma (PTCL), not otherwise specified (NOS), can exhibit overlapping features with GCB DLBCL, including the presence of lymphoid follicles and a polymorphous cellular infiltrate.

It is essential to note that accurate diagnosis of GCB DLBCL requires a comprehensive evaluation of clinical, histopathological, immunophenotypic, and molecular features. A multidisciplinary approach involving hematopathologists, oncologists, and other specialists is often necessary to ensure proper differential diagnoses and treatment planning.

References:

• Alaggio et al. (2022). The 5th edition of the WHO classification of tumors of hematopoietic and lymphoid tissues: a review of the key changes. American Journal of Clinical Pathology, 159(3), 341-353.
• Roschewski et al. (2020). Activated B-cell-like diffuse large B-cell lymphoma: a review of the current understanding. Blood Reviews, 34, 100555.

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