Diffuse large B-cell lymphoma
Alerts and Notices
Synopsis
DLBCL is more frequent in older individuals (median age is 64 years) and shows a slightly male predominance. Patients with a history of solid organ transplant, immunodeficiency, B-cell-activating autoimmune disorders (systemic lupus erythematosus, Sjögren syndrome, celiac disease), or occupational exposure to agricultural pesticides or ionizing radiation may be at increased risk.
There are many subtypes of DLBCL characterized by distinct morphologies, locations, and/or molecular signatures. A very rare subtype of large B-cell lymphoma is intravascular B-cell lymphoma, which is often difficult to diagnosis due to vague nonspecific symptoms and is usually aggressive. Another uncommon but aggressive subtype is DLBCL, leg type. It usually presents as red or violaceous plaques on the lower leg but can occur at any body location. The lesions may quickly develop into tumors that ulcerate.
Patients may present with nodal or extranodal disease (the most common extranodal site is the gastrointestinal tract) or a mass that is rapidly enlarging. B symptoms (fever, weight loss, night sweats) are present, but asymptomatic presentations can also occur.
Codes
ICD10CM:C83.30 – Diffuse large B-cell lymphoma, unspecified site
SNOMEDCT:
109969005 – Diffuse non-Hodgkin's lymphoma, large cell
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Other lymphomas including Burkitt lymphoma and anaplastic T-cell lymphoma
- Infectious mononucleosis (Epstein-Barr virus [EBV] infection)
- Other infectious lymphadenitis (eg, cat scratch fever)
- Other systemic or indolent infections that present with B symptoms (endocarditis, osteomyelitis, tuberculosis)
- Other cancers (carcinoma, melanoma, sarcoma)
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:08/03/2018
Last Updated:03/15/2021
Last Updated:03/15/2021