Journal of Integrative Oncology

Voluminous and Vesicular: Diffuse Large B Cell Lymphoma (DLBCL)

Abstract

Anubha Bajaj

Previously chronicled as “Old histiocytic sarcoma” or “Old reticulum cell sarcoma”, Diffuse Large B Cell Lymphoma (DLBCL) is a composite and aggressive non-hodgkin’s lymphoma. An estimated 40% of lymphomas with multi-various disorders comprise the High-Grade B Cell Lymphoma (HGBCL). The mean age of detection may be at 60 years. Extra nodal and DLBCL comprise 40% instances with a half (50%) depicting progressive disease. The World Health Organization (WHO) categorization highlights the specific molecular attributes of the lymphoma such as the genomic rearrangements of the MYC and BCL2 and/or BCL6. Co-existent genetic anomalies may define the aggressive “Double Hit (DH) lymphoma” with a poor prognosis, initially scripted in 1988. DLBCL may emerge in the South Asian subcontinent with the prevalence identical to that of the developed world (30%-40%), though the incidence of the disorder may be enhanced in the Asian countries (60%-70%). The majority (>80%) of the individuals with an aggressive B Cell Double Hit Lymphoma (HGBCL DH) may elucidate concomitant translocations in the MYC and BCL2 genes. The remainder (20%) of the persons may depict concordant MYC and BCL6 translocations along with the enunciation of the BCL2 gene with an absence of the BCL2 translocation which may not influence the disease outcome. The Double Expresser Lymphomas (DE DLBCL), as exemplified by the co-existent MYC and BCL2, may depict a poor outcome, although superior to the “Double Hits (DHs)”. The DE DLBCL may be incorporated as the DLBCL Not Otherwise Specified (DLBCL NOS) by the WHO.