The B-cell lymphomas (BCLs) represent 80% to 90% of non-Hodgkin lymphomas in the Western world and include multiple lymphoma subtypes with different biologies, natural histories, morphologic characteristics, immunophenotypes, genetic features, prognoses, and responses to therapy.1 Numerous subtypes of B-cell malignancies are defined according to the World Health Organization (WHO) classification (Table 32-1). Accurate subclassification of these BCLs has always been a challenge for pathologists, resulting in early application of new techniques in genetic analysis to these tumors to improve diagnostic accuracy. Today, the genetic features of BCLs are used not only to aid in rendering an accurate primary diagnosis, but also to predict prognosis, to assess for minimal residual disease after therapy, and even to help determine optimal therapy.
Two types of molecular abnormalities in BCL have commonly been evaluated for clinical purposes,2 those occurring in genes coding for antigen receptor (AgR) molecules and those occurring in oncogenes and tumor suppressor genes. However, it must be noted that the recent development of new research techniques such as micro-array gene expression profiling, comparative genomic hybridization, and proteomics has resulted in such a rapid expansion of new knowledge about the biology of these different BCLs that the list of clinically important molecular markers is likely to change considerably over the next few years, presenting a daunting challenge to clinical molecular laboratories.
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