Aggressive B cell lymphoma

by Jason Wasserman MD PhD FRCPC
September 18, 2023

What is an aggressive B cell lymphoma?

Aggressive B cell lymphoma is a descriptive term used to describe a group of immune system cancers made up of cells called B cells.

What types of B cell lymphoma are included in this group?

Aggressive B cell lymphomas include:

What is the most common type of aggressive B cell lymphoma?

Diffuse large B cell lymphoma (DLBCL) is the most common type of aggressive B cell lymphoma.

Why are these cancers described as aggressive?

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.

How is the diagnosis of aggressive B cell lymphoma made?

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.

What does an aggressive B cell lymphoma look like under the microscope?

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.

This picture shows a tumour that was initially diagnosed as an aggressive B cell lymphoma. The final diagnosis was diffuse large B cell lymphoma.
This picture shows a tumour that was initially diagnosed as an aggressive B cell lymphoma. The final diagnosis was diffuse large B cell lymphoma.

What other tests may be performed to confirm the diagnosis?

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.

Related articles

Diffuse large B cell lymphoma (DLBCL)
Burkitt lymphoma
EBV-positive diffuse large B cell lymphoma
Plasmablastic lymphoma

Other helpful resources

American Cancer Society
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