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Pathology consultation on intermediate-to-large B-cell lymphomas.

Nathan D Montgomery1, Yuri Fedoriw

  • 1Dept of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, CB 7525, Chapel Hill, NC 27599-7525; GFedoriw@unch.unc.edu.

American Journal of Clinical Pathology
|February 12, 2014
PubMed
Summary

Accurate classification of intermediate-to-large B-cell lymphomas is crucial for effective treatment. This review outlines diagnostic features and a stepwise approach for challenging lymphoma cases.

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Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Intermediate-to-large B-cell lymphomas are aggressive and diverse.
  • Differential diagnosis includes diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), and others.
  • Gene expression profiling has advanced understanding of these diseases.

Observation:

  • Clinically relevant DLBCL subtypes and a new unclassifiable category have been identified.
  • Diagnostic challenges arise in differentiating these aggressive lymphomas.
  • A case-based approach highlights clinical decision points.

Findings:

  • A diagnostic algorithm based on WHO criteria is proposed.
  • Salient diagnostic features of various entities are reviewed.
  • Stepwise approach provided for difficult cases.
Keywords:
B-cell lymphomasBurkitt lymphomaDiffuse large B-cell lymphomaGray zone lymphomaHematopathology

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Implications:

  • Correct lymphoma classification impacts prognosis and therapy.
  • Understanding disease-specific criteria is imperative.
  • Pathologic features influencing clinical behavior require careful evaluation.