B-cell lymphoma

B-cell lymphoma
Micrograph showing a large B cell lymphoma. Field stain.
SpecialtyHematology, oncology
SymptomsSwollen lymph nodes, abdominal pain, tiredness, fever, night sweats, weight loss[1]
TypesIndolent, aggressive[2]
Risk factorsGenetics, environmental factors, viral infections, connective tissue disorders, poor immune function[1]
Diagnostic methodTissue biopsy[2]
TreatmentRadiation therapy, chemotherapy, immunotherapy, stem cell transplant[2]
Frequency19 per 100,000 per year (the West)[3]

B-cell lymphoma are types of lymphoma affecting B cells, a type of white blood cell that makes antibodies.[1][3] Symptoms may include swollen lymph nodes, abdominal pain, tiredness, fever, night sweats, or weight loss.[1] They generally start within lymph nodes, the spleen, bone marrow, or blood.[4]

Risk factors include certain genetic conditions, environmental factors, viral infections, connective tissue disorders, and poor immune function.[1] They are a type of blood cancer.[5] Subtypes include Hodgkin and over 40 types of non-Hodgkin lymphoma.[3] They are divided into slow-growing (indolent) and aggressive lymphomas.[2] Diagnosis is by tissue biopsy.[2]

Slow growing lymphomas often respond well to treatment, have a survival of many years, but are not generally curable.[2] Aggressive lymphomas on the other hand many be curable but are rapidly fatal when this is not achieved.[2] Treatments may include radiation therapy, chemotherapy, immunotherapy, or stem cell transplant.[2]

In Western countries, B-cell lymphoma affect about 19 per 100,000 people a year and represent about 95% of lymphoma cases.[3] About 80% of non-Hodgkin lymphomas are B-cell lymphomas.[2] While more common in older people, certain types may occur in children.[2][3]

Types

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.[6]

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:[7]

Rare

The remaining forms are much less common:[7]

Other

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

Classic Hodgkin's lymphoma and nodular lymphocyte predominant Hodgkin's lymphoma are now considered forms of B-cell lymphoma.[9]

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:[10]

  • 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.[11]
Follicular lymphoma Marginal zone B-cell lymphoma (MZL) or 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

Chromosomal translocations involving the immunoglobulin heavy locus is a classic cytogenetic abnormality for many B-cell lymphomas, including follicular lymphoma, mantle cell lymphoma and Burkitt's lymphoma.[12] 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.

In Burkitt's lymphoma and mantle cell lymphoma, the other protein in the fusion is c-myc (on chromosome 8) and cyclin D1[13] (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.

See also

References

  1. 1 2 3 4 5 "B-cell lymphoma". rarediseases.info.nih.gov. Genetic and Rare Diseases Information Center (GARD) – an NCATS Program. Archived from the original on 3 June 2021. Retrieved 6 July 2021.
  2. 1 2 3 4 5 6 7 8 9 10 "Non-Hodgkin Lymphomas - Blood Disorders". Merck Manuals Consumer Version. Archived from the original on 17 April 2021. Retrieved 6 July 2021.
  3. 1 2 3 4 5 Meng, X; Min, Q; Wang, JY (2020). "B Cell Lymphoma". Advances in experimental medicine and biology. 1254: 161–181. doi:10.1007/978-981-15-3532-1_12. PMID 32323276.
  4. ↑ "B-cell lymphoma - Latest research and news | Nature". www.nature.com. Archived from the original on 9 August 2020. Retrieved 6 July 2021.
  5. ↑ "Lymphoma". www.hematology.org. Archived from the original on 18 June 2021. Retrieved 6 July 2021.
  6. ↑ Nguyen, Nghi; Khan, Mujahid; Shah, Muhammad (2017). "Primary B-cell lymphoma of the pelvic bone in a young patient: Imaging features of a rare case". Cancer Research Frontiers. 3 (1): 51–55. doi:10.17980/2017.51. ISSN 2328-5249.
  7. 1 2 "The Lymphomas" (PDF). The Leukemia & Lymphoma Society. May 2006. p. 12. Archived from the original (PDF) on 2008-07-06. Retrieved 2008-04-07.
  8. ↑ Mazen Sanoufa; Mohammad Sami Walid; Talat Parveen (2010). "B-Cell Lymphoma of the Thoracic Spine Presenting with Spinal Cord Pressure Syndrome". Journal of Clinical Medicine Research. 2 (1): 53–54. doi:10.4021/jocmr2010.02.258w. PMC 3299178. PMID 22457704.
  9. ↑ "HMDS: Hodgkin's Lymphoma". Archived from the original on 4 March 2009. Retrieved 2009-02-01.
  10. ↑ Mohammad Muhsin Chisti, Haresh Kumar, Sumeet K Yadav. "B-Cell Lymphoma Workup". Medscape. Archived from the original on 2021-01-26. Retrieved 2021-05-25.{{cite web}}: CS1 maint: multiple names: authors list (link) Updated Jul 27, 2020
  11. ↑ Attanoos, Richard (2018). "Lymphoid Malignancies of the Pleura and Peritoneum". Practical Pathology of Serous Membranes. pp. 203–208. doi:10.1017/9781316402009.016. ISBN 9781316402009.
  12. ↑ Küppers, R; Dalla-Favera, R (10 September 2001). "Mechanisms of chromosomal translocations in B cell lymphomas" (PDF). Oncogene. 20 (40): 5580–94. doi:10.1038/sj.onc.1204640. PMID 11607811. S2CID 10776403. Archived (PDF) from the original on 29 August 2021. Retrieved 25 May 2021.
  13. ↑ Li JY, Gaillard F, Moreau A, et al. (May 1999). "Detection of translocation t(11;14)(q13;q32) in mantle cell lymphoma by fluorescence in situ hybridization". Am. J. Pathol. 154 (5): 1449–52. doi:10.1016/S0002-9440(10)65399-0. PMC 1866594. PMID 10329598.
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