B-cell lymphoma

B-cell lymphoma
Classification and external resources
Micrograph showing a large B cell lymphoma. Field stain.
ICD-10	C85.1
ICD-O:	9680/0, 9699/3, 9699/3
eMedicine	med/1358
MeSH	D016393

The B-cell lymphomas are types of lymphoma affecting B cells. Lymphomas are "blood cancers" in the lymph glands. They develop more frequently in older adults and in immunocompromised individuals (such as those with AIDS).

B-cell lymphomas include both Hodgkin's lymphomas and most non-Hodgkins lymphomas. They are often divided into indolent (slow-growing) lymphomas and aggressive lymphomas. Indolent lymphomas respond rapidly 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, but have good prospects for a permanent cure.^[1]

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-reoccurrence. Early-stage aggressive disease is treated with chemotherapy and often radiation, with a 70-90% cure rate.^[1] 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%.^[1]

Types

Micrograph showing Hodgkin lymphoma, a type of B cell lymphoma that is usually considered separate from other B cell lymphomas. Field stain.

There are fourteen kinds of lymphomas involving B cells.

Common

Five account for nearly three out of four patients with non-Hodgkin lymphoma:^[2]

• Diffuse large B cell lymphoma^[3]
• Follicular lymphoma
• Mucosa-Associated Lymphatic Tissue lymphoma (MALT)
• Small cell lymphocytic lymphoma (overlaps with Chronic lymphocytic leukemia)
• Mantle cell lymphoma (MCL)

Rare

The remaining nine are much less common:^[2]

• Burkitt lymphoma
• Mediastinal large B cell lymphoma
• Waldenström macroglobulinemia
• Nodal marginal zone B cell lymphoma (NMZL)
• Splenic marginal zone lymphoma (SMZL)
• Intravascular large B-cell lymphoma
• Primary effusion lymphoma
• Lymphomatoid granulomatosis

Other

Additionally, some researchers separate out lymphomas that appear 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.^[4]

Associated chromosomal translocations

Chromosomal translocations 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. In Burkitt's lymphoma and mantle cell lymphoma, the other protein in the fusion is c-myc (on chromosome 8) and cyclin D1^[5] (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

• Richter's transformation
• T-cell lymphoma

References

1. ^ ^{a b c} Merck Manual home edition, Non-Hodgkin Lymphomas
2. ^ ^{a b} "The Lymphomas" (PDF). The Leukemia & Lymphoma Society. May 2006. p. 12. http://www.leukemia-lymphoma.org/attachments/National/br_1161891669.pdf. Retrieved 2008-04-07. 
3. ^ Mazen Sanoufa, Mohammad Sami Walid, Talat Parveen (2010). "B-Cell Lymphoma of the Thoracic Spine Presenting with Spinal Cord Pressure Syndrome". JOCMR 2 (1): 53–54. doi:10.4021/jocmr2010.02.258w. 
4. ^ "HMDS: Hodgkin's Lymphoma". http://www.hmds.org.uk/hl.html. Retrieved 2009-02-01. 
5. ^ 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. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1866594. 

External links

• Overview and video at harvard.edu
• Lymphoma Association – Specialist UK charity providing free information and support to patients, their families, friends and carers