BZellNonHodgkinLymphome

B-cell non-Hodgkin lymphoma (B-NHL) is a diverse group of lymphoid cancers that arise from mature B lymphocytes. It is one of the two main categories of non-Hodgkin lymphoma, the other being T-cell/NK-cell lymphomas, and includes diseases ranging from indolent to highly aggressive. B-NHL cells typically express B-lineage markers such as CD19 and CD20 on immunophenotyping.

The most common subtypes are diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). Other important forms include mantle cell lymphoma (MCL), Burkitt lymphoma, and marginal zone lymphomas (MZL). The WHO classification groups B-NHL by morphology, immunophenotype, genetic features, and clinical behavior. Extranodal involvement is common, and specific genetic abnormalities, such as translocations, help define subtypes (for example, t(14;18) in FL).

Clinical presentation varies by subtype but often includes painless lymphadenopathy, B symptoms (fever, night sweats, weight loss), and sometimes extranodal masses. Diagnosis requires an adequate biopsy with histology and immunophenotyping; additional tests such as flow cytometry, cytogenetics, and molecular studies aid in subtyping. Staging uses imaging like CT or PET-CT and follows the Ann Arbor system, assessing disease extent, organ function, and performance status.

Treatment is subtype- and stage-dependent. Aggressive B-NHL such as DLBCL is typically treated with chemoimmunotherapy (for example, regimens including rituximab with CHOP) and may include consolidation or CNS-directed therapy. Indolent diseases may be observed initially or treated with rituximab-based regimens. Relapsed or refractory disease may require stem cell transplantation, CAR T-cell therapy, or targeted agents (e.g., BTK inhibitors, BCL2 inhibitors). Prognosis varies by subtype, stage, and patient factors.