Subtypes of DLBCL
Primary central nervous system lymphoma
This comprises 1% of lymphomas and 1-2% of brain tumors, though the incidence is rising with no known cause.
- It is important to identify these in time, as a high number of primary DLBCL tumors can be cured using the currently available treatments.
The average age of patients with this type of tumor is 60.
- Clinical manifestations:
- Neurological deficit (over half of patients)
- Behavioral changes
- Symptoms of intracranial hypertension or disorders of the eye
- Tumor lesions are located in the brain (in two-thirds of cases), while in the rest this affects the cerebellum, eyeball, spinal cord, or cerebrospinal fluid.
- Treatment: The treatment of choice is chemotherapy (administration of drugs that pass the blood-brain barrier). The approaches used include high doses of methotrexate and cytarabine.
Primary cutaneous DLBCL
This lymphoma owes its name to the fact that it primarily affects the legs, although 10-15% of cases affect the trunk, head, and arms.
- It represents 20% of cutaneous B-cell lymphomas and develops especially in women over age 70.
T-cell/histiocyte-rich B-cell lymphoma
- Biopsies of these tumors are noteworthy due to the fact that the infiltrate has a high presence of T-lymphocytes and histiocytes together with B-cells.
- This subtype comprises 5% of DLBCL cases and is normally found in middle-aged men.
- The presenting symptoms include fever, malaise, and lymph-node involvement to varying degrees, affecting the spleen, liver, and bone marrow.