D i f f u s e L a r g e - C e l l L y m p h o m a
General
• Really a group of similar high-grade lymphomas
• Present with rapidly-progressive lymphadenopathy
• May infiltrate bone marrow, GI tract, spinal cord, other organs
Morphology
• Pattern: Diffuse.
• Cytology: Large cells with prominent nucleoli.
Immunophenotype
• Most cases (80%) are B-cell.
• Rest are T-cell.
Treatment and Prognosis
• The classic treatment is the "CHOP" regimen:
• cyclophosphamide
• hydroxydaunorubicin
• vincristine (Oncovin)
• prednisolone
• Prognostic factors:
• age (older is worse)
• serum LDH (a cellular breakdown product - the higher the LDH, the more
tumor cells the patient has, and the worse the prognosis is)
• bulkiness of disease (major mass >5 cm is bad)
• response to initial treatment (poor treatment response is bad)
• prior history of low-grade disease (bad)
• prior history of AIDS (bad)
• Overall long-term survival is about 65%.
