Diffuse large B-cell lymphoma

What it is

Diffuse large B-cell lymphoma (DLBCL) is an aggressive B cell non-Hodgkin lymphoma made of large B cells with a diffuse pattern of infiltration. Within the subtypes of lymphoma it sits in the aggressive B cell group, beside mantle cell lymphoma t(11;14), Burkitt lymphoma t(8;14) and B-LBL.

Causes and risk

Richter's transformation is the progression of chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) into a more aggressive lymphoma, most commonly DLBCL. About 5% of patients with CLL undergo this transformation.

How it presents

The disease is aggressive, and it can present with primary CNS disease (PCNSL).

When it arises out of CLL as Richter's transformation, the clues are a significant rise in the lymphocyte count, anemia and thrombocytopenia, increased LDH, and new cervical lymph nodes with multiple other lymph nodes on CT.