by Jason Wasserman MD PhD FRCPC
September 18, 2023
Aggressive B cell lymphoma is a descriptive term used to describe a group of immune system cancers made up of cells called B cells.
Aggressive B cell lymphomas include:
Diffuse large B cell lymphoma (DLBCL) is the most common type of aggressive B cell lymphoma.
Aggressive B cell lymphomas are made up of tumour cells that divide (create new tumour cells) much faster than other more indolent (slower growing) types of B cell lymphoma. These lymphomas also tend to spread quickly to other parts of the body.
The diagnosis can only be made when a sample of the tumour is removed and the tissue is examined under a microscope by a pathologist. An additional test called flow cytometry may also be performed.
Because the term aggressive B cell lymphoma describes a group of cancers, the microscopic appearance of the tumour can vary somewhat based on the specific type of cancer present. However, most cancers in this group are made up of medium to large-sized lymphocytes arranged in nests or sheets. The cytoplasm (body of the cell) may appear eosinophilic (pink) or clear and the nucleus (the part of the cell that holds the genetic material) is usually enlarged, and round, and clumps of genetic material called nucleoli are often seen. Mitotic figures (cells dividing to create new cells) and necrosis (dead cells) are common.
When evaluating a potential aggressive B cell lymphoma, a variety of tests including immunohistochemistry (IHC), flow cytometry, fluorescence in situ hybridization (FISH), and next-generation sequencing (NSG) may be performed to confirm the diagnosis. These tests allow pathologists to determine the types of cells present in the tumour and to look for molecular changes to will help them narrow down the diagnosis to a more specific type of lymphoma.