Diffuse Large B-Cell Lymphoma

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL) in the United States and worldwide, accounting for up to one-third of patients with newly diagnosed NHL in the United States.

DLBCL is an aggressive (fast-growing) NHL that affects B-lymphocytes. LymphocytesA type of white blood cell. Lymphocytes, carries along by the lymph fluid, are part of the immune system and fight infection. are one type of white blood cell. B-cells are lymphocytes that make antibodies to fight infections and are an important part of the lymphatic systemThe channels, tissues and organs that store and carry lymphocytes that fight infection and other diseases..

Although it can occur in childhood, the occurrence of DLBCL generally increases with age, and most patients are over the age of 60 at diagnosis.

DLBCL can develop in the lymph nodesSmall bean-shaped glands located in the small vessels of the lymphatic system. There are thousands of lymph nodes located throughout the body, with clusters of them in the neck, under the arms, the chest, abdomen and groin. Lymph nodes filter lymph fluid, trapping and destroying potentially harmful bacteria and viruses. or in “extranodal sites” (areas outside the lymphThe watery fluid in the lymph system that contains white blood cells (lymphocytes). nodes) such as the gastrointestinal tract, testes, thyroid, skin, breast, bone, brain, or essentially any organ of the body. It may be localized (in one spot) or generalized (spread throughout the body). Despite being an aggressive lymphomaLymphomas that are fast growing and generally need to be treated immediately. Also called intermediate-grade or high-grade lymphomas., DLBCL is considered potentially curable.

Subtypes of DLBCL

A number of DLBCLs have been categorized into subtypes which differ with respect to certain characteristics:

  • T-cellA type of white blood cell that participates in immune responses by destroying harmful substances or cells./histiocyte-rich B-cell lymphoma: When viewed under a microscope, this form of DLBCL looks like a few scattered large and atypical B-cells in a background of many normal T cells and histiocytes, which are cells that migrate from bone marrowSpongy material found inside the bones containing stem cells that develop into three types of cells: red blood cells that deliver oxygen to the body and take away carbon dioxide; white blood cells that protect the body from infection; and platelets into tissues.
  • Primary DLBCL of the central nervous system (CNS): This refers to all DLBCLs that originate in either the brain or the eye. Occasionally, patients who do not have this subtype may still develop secondary DLBCL of the CNS, which occurs when the lymphoma moves into the brain or spinal cord at a later time.
  • Primary cutaneous DLBCL, leg type: This type of DLBCL consists of large transformed B-cells that typically appear as red or bluish-red tumors. Despite its name, the disease can involve the trunk, arms, legs, buttocks, or anywhere on the body. These lymphomas can also spread to areas other than just the skin.
  • Epstein-Barr virus (EBV)-positive DLBCL of the elderly: This form of DLBCL usually occurs in patients who are age 50 or older and test positive for EBV.
  • DLBCL not otherwise specified (NOS): When DLBCL doesn’t fall into one of the subtypes listed above, it is classified as DLBCL not otherwise specified (NOS). A large number of diagnoses fall into this category. In western countries, about 25 to 30 percent of NHL cases diagnosed in adults are DLBCL-NOS, and this percentage is higher in developing countries. There are other ways of categorizing cases of DLBCL-NOS into molecular subgroups based on their genetic and immunophenotypic characteristics.

To learn more about DLBCL, download the Diffuse Large B-Cell Lymphoma Fact Sheet.