Secondary Lymphoid Tissues ›› Lymph Node ›› Neoplastic: Non-Hodgkin Lymphoma

Diffuse Large B-cell Lymphoma*






Microscopic Features:
  • Sheets or clusters of large (>2.5x the size of a mature lymphocyte or equal or > than the size of a histiocyte) abnormal lymphocytes involving lymph node or other tissue
  • As the name suggests, the abnormal lymphocytes diffusely infiltrate the involved tissue (typically lacks a nodular/follicular pattern of growth)
Normal % blood-PB, marrow-BM, lymphoid tissue-LN:
  • PB: N/A
  • BM: N/A
  • LN: N/A
May Resemble:
  • Burkitt Lymphoma
  • Small Lymphocytic Lymphoma
  • Mantle Cell Lymphoma
  • Follicular Lymphoma
  • Non-neoplastic reactive Lymph node
  • Carcinoma
  • Melanoma
Differential Diagnoses:

Mantle cell lymphoma (blastoid variant)
Follicular lymphoma (high grade, e.g. 3B)
Burkitt Lymphoma
Small Lymphocytic Lymphoma (SLL: The CLL equavalent in tissue)
Mantle Cell Lymphoma
Non-neoplastic reactive Lymph node
Hodgkin Lymphoma

Classic Immunophenotype:
  • CD19+
  • CD20+
  • CD10+ (Germinal center phenotype)
  • CD10-/BCL6-/MUM1+ (Non-Germinal Center phenotype)
Misc:
  • Germinal center phenotype (CD10+) has better prognosis (usually responds better to R-CHOP chemotherapy treatment) Many have variable morphology (some with prominent nucleoli, some with high mitotic rate, etc.) and many present as mass lesions