Diffuse large B-cell lymphoma

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Diffuse large B cell lymphoma, abbreviated DLBCL, is a very common lymphoma.

Microscopic

Features:[1]

  • Large cells -- 4-5 times the diameter of a small lymphocytes.
  • Typically have marked cell-to-cell variation in size and shape.
  • Cytoplasm usually basophilic and moderate in abundance.
  • +/-Prominent nucleoli, may be peripheral and/or multiple.

Notes:

  • Large bizarre cells can occasionally mimic Reed-Sternberg cells, seen in Hodgkin lymphoma.

Images:

Differential diagnosis

  • Carcinoma.
  • Anaplastic large cell lymphoma (ALCL).
  • Follicular lymphoma.
    • If a nodular architecture is present it is follicular lymphoma.

IHC

"UHN panel"

  • H&E 2 micrometers.
  • CD20 -- B cells.
  • CD10 -- follicular lymphoma.
  • BCL6 -- follicular lymphoma.
  • BCL2 -- follicular lymphoma.
  • MUM1 -- B cells.
  • CD21 -- highlight FDC networks if present.
  • CD23 -- highlight FDC networks if present.
  • MIB1 -- proliferative rate.
  • EBER -- EBV.
  • CD3 -- T cells.
  • CD5 -- T cells.
  • Unstained x4.

See also

References

  1. Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 676 (???). ISBN 0-7216-0187-1.