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WHO Classification of Tumours
Diffuse large B-cell lymphoma (DLBCL), NOS
Colon and rectum


Definition

Diffuse large B-cell lymphoma (DLBCL) is the most frequent type of non-Hodgkin lymphoma, representing 30%-40% of cases. It consists of a diffuse proliferation of large neoplastic B-cells without significant admixture of centrocytes. It affects mainly adults, with a mean age of manifestation in the 7th decade. The majority of DLBCLs originates primarily in lymph nodes, but up to 40% are initially confined to extranodal sites
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Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW (Eds.)
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues
4th Edition
International Agency for Research on Cancer: Lyon 2008



. DLBCLs are aggressive but potentially curable with multiagent chemotherapy.

DLBCL of the colon and rectum
DLBCL is the most frequent malignant lymphoma found in the colon. In contrast to gastric DLBCL, low-grade components are rarely seen and if present may represent a follicular lymphoma component. The lymphoma forms large ulcerating tumours with transmural infiltration by tumour cells. Sporadic DLBCL of the colon shows often centroblastic morphology and its variants (multilobulated, mono morphic, polymorphic). In the setting of immunodeficiency-associated DLBCL, the lymphoma cells are more often immunoblastic or even plasmablastic. Association with EBV is frequent and is investigated by EBV-encoded RNA (EBER) hybridization. These DLBCLs also show an inflammatory component consisting of activated T cells, macrophages, polytypic plasma cells and eosinophils. The phenotype is that of a mature B cell, being positive for CD20 and CD79a.