**8. Conclusion**

*Normal and Malignant B-Cell*

neoplastic cells.

*6.10.2 Treatment and prognosis*

remains roughly constant over time [1, 25, 68].

**7. Staging, prognosis, and treatment**

involvement

*The Ann Arbor staging classification.*

**International Prognostic** 

*International Prognostic Index.*

variants include flame cells with fiery red cytoplasm, Mott cells with multiple grapelike cytoplasmic droplets, and cells containing a variety of other inclusions—Russell bodies (cytoplasmic) or Dutcher bodies (nuclear), including fibrils, crystalline rods, and globules. Peripheral blood smears shows rouleaux formation. Rarely, tumor cells enters the peripheral blood, giving rise to plasma cell leukemia. Plasma cell tumors are positive for CD 38, CD138, and often express CD56, a feature that can be helpful in identifying small populations of

The prognosis is variable but has improved in recent years with new therapeutic approaches. The median survival is 4–7 years. Translocations involving cyclin D1 are associated with a good outcome, whereas deletions of 13q, deletions of 17p, and the t(4;14) are associated with more aggressive course. Hematopoietic stem cell transplantation prolongs life but has not yet proven to be curative. Solitary osseous plasmacytoma almost inevitably progresses to multiple myeloma but can take 10–20 years or longer. In contrast, extraosseous plasmacytomas, particularly those involving the upper respiratory tract, are frequently cured by local resection. About 75% of patients of smoldering myeloma progress to multiple myeloma over a 15-year period. Approximately 1% of patients with MGUS develop asymptomatic plasma cell neoplasm, usually multiple myeloma, per year, a rate of conversion that

The Ann Arbor staging classification (**Table 2**) which was developed for HD in 1971, has been the standard scheme for NHL [69, 70]; however, it does not account for tumor burden and does not correlate well with prognosis. The Prognosis and

Stage II Involvement of two or more lymph node regions on the same side of the diaphragm; localized contiguous involvement of only one extralymphatic site and lymph node region (stage IIE)

**Adverse factors Risk group No. of** 

Performance status = 2 Low 0, 1 Lactate dehydrogenase > normal Low-intermediate 2 Extranodal sites = 2 High-intermediate 3 Stage III and IV disease High 4, 5

**factors**

Stage III Involvement of lymph node regions on both sides of the diaphragm; may include spleen Stage IV Disseminated involvement of one or more extralymphatic organs with or without lymph node

Age >60 years

Stage I Involvement in a single lymph node region or single extralymphatic site

**66**

**Table 3.**

**Table 2.**

**Index**

B-cells though plays a major role in humoral immunity can also lead to various pathologic diseases. B-cell lymphomas are malignant neoplasms that arise from various stages of differentiation of B-cells which are classified based on the cell of origin and behavior. Historically, there has been much controversy in the classification of lymphoid neoplasms, but consensus has been reached through the use of objective molecular diagnostic tools. The current WHO classification uses morphologic, immunophenotypic, genotypic, and clinical features to classify the lymphoid neoplasms into five broad categories as precursor B-cell neoplasms, peripheral B-cell neoplasms, precursor T-cell neoplasms, peripheral T-cell neoplasms and Hodgkin lymphoma. B-cell lymphomas include precursor B-cell neoplasms and peripheral B-cell neoplasms. Hodgkin lymphoma though originates from B-cell has distinctive pathologic features and is treated as a separate entity. B-cell lymphomas range in their clinical behavior from low grade to high grade and also have histological or clinical progression during a patient's clinical course. For these reasons, the WHO classification does not attempt to stratify lymphoid malignancies in terms of grade. Also both morphology and immunophenotype often change over time with the acquisition of additional genetic changes. Hence B-Cell lymphomas are expanding with emerging new entities due to its wide molecular/genetic landscape and are being revised frequently for better understanding and diagnosis which helps in managing with targeted therapies.
