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DIAGNOSIS • Diagnosis should be carried out in a reference haematopathology laboratory with expertise in morphological interpretation and the facilities to carry out the full range of phenotypic and molecular investigations. • Surgical biopsy is the optimal method of diagnosis. • Needle-core and endoscopic biopsies should be reserved for patients for whom a surgical approach is impractical or would entail excessive risk. • A fine-needle aspirate should not be used as the sole basis for a diagnosis of DLBCL. • A morphological diagnosis of DLBCL should be confirmed in all cases by immunophenotypic investigations. • If there is doubt in the diagnosis, demonstration of B-cell monoclonality by a PCR-based method should be considered. • Assessment of MYC and BCL2 rearrangement is recommended (whenever technically possible) in newly diagnosed and relapsed patients treated with curative intent, using interphase FISH.

Diffuse large B -Cell Lymphoma ESMO Summary of recommendations