Types of Diffuse Large B-Cell Lymphoma

Lymphoma is a type of blood cancer that develops when lymphocytes, a type of white blood cell, change from normal lymphocytes into cancerous lymphocytes (malignant lymphocytes).

In a narrower sense, the term lymphoma is used to refer to cancers in which there is a problem with lymphocytes—that is, cases where lymphoid tumors appear in the form of a mass. When the same type of lymphoid tumor is mainly distributed in the bone marrow and peripheral blood rather than appearing as a mass, the term lymphoblastic leukemia or lymphocytic leukemia is used depending on the stage of development. In some cases, lymphoid tumors in mass form and lymphoid tumors in leukemia form appear at the same time; in such cases, they are referred to as leukemia/lymphoma.

*Types of lymphoma Malignant lymphoma is further divided into many subtypes, and features, treatment methods, prognosis, and more vary greatly depending on the subtype. Lymphoma is first broadly divided into Hodgkin lymphoma and non-Hodgkin lymphoma. Hodgkin lymphoma is relatively rare in Korea, accounting for about 4% of all lymphomas, and most lymphoma patients in Korea have non-Hodgkin lymphoma.

Normal lymphocytes are broadly divided into B-cell and T-cell lineages, and accordingly, lymphomas are also broadly classified into B-cell and T-cell (and NK-cell) lymphomas based on the type of lymphocyte from which they arise. They are also divided according to the stage at which lymphocytes proliferate and mature into precursor cell-derived lymphomas (cells that have not matured enough to perform a given role) and mature cell-derived lymphomas. Lymphomas originating from precursor cells are a disease group similar to acute leukemia, and because the tumor grows quickly, they are classified as very fast-growing lymphomas that require prompt, high-intensity chemotherapy. In contrast, mature cell lymphomas are broadly classified into relatively fast-growing lymphomas that grow quickly and slow-growing lymphomas that grow gradually over a long period of time.

• Diffuse large B-cell lymphoma Diffuse large B-cell lymphoma is the most common type of lymphoma, accounting for about 40% of all non-Hodgkin lymphomas. Although it is a mature cell-derived lymphoma, if left untreated it usually progresses rapidly, and in addition to lymph node lesions, it may be accompanied by various extranodal lesions such as the gastrointestinal tract, bone marrow, breast, kidneys, ovaries, and testes. In the case of primary central nervous system diffuse large B-cell lymphoma occurring in the brain and spinal nervous system, a special treatment strategy is needed.

According to the 2011 National Cancer Registry statistics, a total of 218,017 new cancer cases were registered in 2011, of which 4,626 were lymphomas. Considering that about 40% of all lymphoma patients have diffuse large B-cell lymphoma, it can be estimated that about 1,700 to 1,800 new cases of diffuse large B-cell lymphoma occur in Korea each year. Lymphoma was not among the 10 most common cancers in either men or women separately, but when both sexes were combined, non-Hodgkin lymphoma ranked as the tenth most common cancer incidence proportion.

So far, we have explained the types of diffuse large B-cell lymphoma. In the next part, we will look at the risk factors and symptoms of diffuse large B-cell lymphoma.

Source: Korea Disease Control and Prevention Agency National Health Information Portal