b-cell lymphoma b-cell lymphoma the b-cell lymphomas are types of lymphoma affecting b cells. lymphomas are "blood cancers" in the lymph nodes. they develop more frequently in older adults and in immunocompromised individuals. b-cell lymphomamicrograph showing a large b cell lymphoma. field stain.specialtyhematology, oncology b-cell lymphomas include both hodgkin's lymphomas and most non-hodgkin lymphomas. they are typically divided into low and high grade, typically corresponding to indolent (slow-growing) lymphomas and aggressive lymphomas, respectively. as a generalisation, indolent lymphomas respond to treatment and are kept under control (in remission) with long-term survival of many years, but are not cured. aggressive lymphomas usually require intensive treatments, with some having a good prospect for a permanent cure. prognosis and treatment depends on the specific type of lymphoma as well as the stage and grade. treatment includes radiation and chemotherapy. early-stage indolent b-cell lymphomas can often be treated with radiation alone, with long-term non-recurrence. early-stage aggressive disease is treated with chemotherapy and often radiation, with a 70–90% cure rate. late-stage indolent lymphomas are sometimes left untreated and monitored until they progress. late-stage aggressive disease is treated with chemotherapy, with cure rates of over 70%. types micrograph showing hodgkin's lymphoma, a type of b cell lymphoma that is usually considered separate from other b cell lymphomas. field stain. ct scan of primary b cell lymphoma in the left ilium, as diffuse cortical and trabecular thickening of the hemipelvis, mimicking paget's disease. there are numerous kinds of lymphomas involving b cells. the most commonly used classification system is the who classification, a convergence of more than one, older classification systems. common five account for nearly three out of four patients with non-hodgkin lymphoma: diffuse large b-cell lymphoma (dlbcl) follicular lymphoma marginal zone b-cell lymphoma (mzl) or mucosa-associated lymphatic tissue lymphoma (malt) small lymphocytic lymphoma (sll, also known as chronic lymphocytic leukemia, cll) mantle cell lymphoma (mcl) rare the remaining forms are much less common: dlbcl variants or sub-types of primary mediastinal (thymic) large b cell lymphoma t cell/histiocyte-rich large b-cell lymphoma primary cutaneous diffuse large b-cell lymphoma, leg type (primary cutaneous dlbcl, leg type) ebv positive diffuse large b-cell lymphoma of the elderly diffuse large b-cell lymphoma associated with chronic inflammation fibrin-associated diffuse large b-cell lymphoma primary testicular diffuse large b-cell lymphoma burkitt's lymphoma lymphoplasmacytic lymphoma, which may manifest as waldenström's macroglobulinemia nodal marginal zone b cell lymphoma (nmzl) splenic marginal zone lymphoma (smzl) intravascular lymphomas variants intravascular large b-cell lymphoma intravascular nk-cell lymphoma intravascular t-cell lymphoma primary effusion lymphoma lymphomatoid granulomatosis primary central nervous system lymphoma alk+ large b-cell lymphoma plasmablastic lymphoma large b-cell lymphoma arising in hhv8-associated multicentric castleman's disease b-cell lymphoma, unclassifiable with features intermediate between diffuse large b-cell lymphoma and burkitt lymphoma b-cell lymphoma, unclassifiable with features intermediate between diffuse large b-cell lymphoma and classical hodgkin lymphoma other additionally, some researchers separate out lymphomas that appear to result from other immune system disorders, such as aids-related lymphoma. classic hodgkin's lymphoma and nodular lymphocyte predominant hodgkin's lymphoma are now considered forms of b-cell lymphoma. diagnosis when a person appears to have a b-cell lymphoma, the main components of a workup (for determining the appropriate therapy and the person's prognosis) are: establishing the precise subtype: initially, an incisional or excisional biopsy is preferred. a core needle biopsy is discouraged except in case a lymph node is not easily accessible. fine-needle aspiration is only acceptable in selected circumstances, in combination with immunohistochemistry and flow cytometry. determining the extent of the disease (localized or advanced; nodal or extranodal) the person's general health status. main immunohistochemistry markers in common types of b-cell lymphoma. follicular lymphoma marginal zone b-cell lymphoma (mzl) or mucosa-associated lymphatic tissue (malt) lymphoma small lymphocytic lymphoma (sll) / chronic lymphocytic leukemia (cll) mantle cell lymphoma (mcl) cd5 - - + + cd10 + - - - cd23 - - + - cyclin d1 - - - + associated chromosomal translocations chromosomal translocations involving the immunoglobulin heavy locus is a classic cytogenetic abnormality for many b-cell lymphomas, including follicular lymphoma, mantle cell lymphoma and burkitt's lymphoma. in these cases, the immunoglobulin heavy locus forms a fusion protein with another protein that has pro-proliferative or anti-apoptotic abilities. the enhancer element of the immunoglobulin heavy locus, which normally functions to make b cells produce massive production of antibodies, now induces massive transcription of the fusion protein, resulting in excessive pro-proliferative or anti-apoptotic effects on the b cells containing the fusion protein. in burkitt's lymphoma and mantle cell lymphoma, the other protein in the fusion is c-myc (on chromosome 8) and cyclin d1 (on chromosome 11), respectively, which gives the fusion protein pro-proliferative ability. in follicular lymphoma, the fused protein is bcl-2 (on chromosome 18), which gives the fusion protein anti-apoptotic abilities.