Background: Large B-cell lymphoma (LBCL) encompasses a diverse group of aggressive lymphoid neoplasms, the most common of which is diffuse large B-cell lymphoma (DLBCL). A precise diagnosis is critical for determining prognosis and therapeutic strategies, particularly as new molecular subtypes and classification criteria have been introduced in the 5th edition of the World Health Organization (WHO) classification of hematolymphoid tumors (WHO-HAEM5, 2022). Fine needle aspiration (FNA) cytology is a safe and minimally invasive diagnostic tool for assessing lymphadenopathy and extranodal masses. Summary: The diagnosis of LBCL and the distinction distinguishing between LBCL subtypes—such as germinal center B-cell (GCB) and activated B-cell (ABC) subtypes of DLBCL, primary mediastinal large B-cell lymphoma (PMBL), anaplastic large cell lymphoma (ALCL), and high-grade B-cell lymphoma (HGBL)—requires the integration of cytomorphologic features with ancillary techniques, including immunocytochemistry, flow cytometry, fluorescence in situ hybridization (FISH), and next-generation sequencing (NGS). Key Messages: This review synthesizes the cytologic features, immunophenotypic profiles, molecular signatures, and clinical implications of LBCL subtypes, highlighting recent advances in cytopathology and classification.
Lin et al. (Mon,) studied this question.