Stomach
Lymphoma
Diffuse large B cell lymphoma
Author: Elliot Weisenberg, M.D.
Last author update: 1 September 2012
Last staff update: 14 June 2021
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: gastric diffuse large b-cell lymphoma
Table of Contents
Definition / general | Prognostic factors | Case reports | Gross description | Microscopic (histologic) description | Positive stains | Differential diagnosisCite this page: Weisenberg E. Diffuse large B cell lymphoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stomachdiffuselargeBcell.html. Accessed April 23rd, 2024.
Definition / general
- High grade B-cell tumor (Am J Surg Pathol 2003;27:790)
- May arise from transformed extranodal marginal zone (MALT) lymphoma
- Usually > age 50 years
- 5 year survival is 65% (related to stage)
- Coexistence of MALT lymphoma and diffuse large B-cell lymphoma: do not report as "high grade MALT" (MALT is usually indolent); report instead as diffuse large B-cell lymphoma with coexisting MALT lymphoma
Prognostic factors
- Cases associated with extranodal marginal zone (MALT) lymphoma have 84% 5 year cause specific survival (Am J Surg Pathol 2001;25:95), better than without coexisting MALT
- Germinal center origin (CD10+, bcl6+, Am J Surg Pathol 2000;24:1641)
Case reports
- 61 year old man with coexisting early gastric carcinoma (Arch Pathol Lab Med 1989;113:419)
Gross description
- Large polypoid or lobulated mass with superficial or deep ulceration; often in distal stomach, but sparing pylorus
Microscopic (histologic) description
- Infiltrative pattern of high grade, centroblast like cells; multinucleated forms may resemble Reed-Sternberg cells
Positive stains
- bcl6 (variable), CD10 (variable), CD35 (variable), keratin (rare, Am J Surg Pathol 1996;20:346)
Differential diagnosis
- Undifferentiated carcinoma: continuity between tumor cells and epithelium, acinar pattern, muscularis mucosa destruction, positive for keratin and mucin
