The Fellow on Call: The Heme/Onc Podcast Episode 072: Introduction to Diffuse Large B-Cell Lymphoma (DLBCL)
Sep 6, 2023
Dive into the complexities of diffuse large B-cell lymphoma with insights on essential diagnostic techniques like FNA and core biopsy. Discover the nuances of risk stratification, focusing on factors like age and LDH levels. Explore the significance of genetic markers in treatment decisions, including the distinctions between double hit and triple hit classifications. The hosts also share personal touches, discussing their emotional connections with patients and their favorite TV shows, adding a light-hearted break to the serious topic.
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Begin with Exam and FNA
- Perform a physical exam to identify accessible lymph node sites for biopsy.
- Use FNA initially to quickly differentiate between solid tumor and lymphoma.
Identifying Large B-cell Lymphoma
- Large cells with CD10 and CD20 positivity suggest germinal center B-cell origin.
- Increased forward scatter on flow cytometry indicates larger cell size consistent with large B-cell lymphoma.
Essential Diagnostic and Staging Steps
- Obtain an excisional lymph node biopsy for definitive lymphoma diagnosis when feasible.
- Use PET-CT for staging to avoid understaging, and check viral studies, especially Hepatitis B before rituximab.