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Clinical history
63-year-old with rapidly enlarging cervical lymphadenopathy and B symptoms.
Specimen
Excisional lymph node biopsy · Stain: H&E and IHC
Microscopic description
Effacement of nodal architecture by a diffuse infiltrate of large cells with vesicular nuclei and prominent nucleoli. High mitotic rate with apoptotic debris.
Diagnostic question
Which immunohistochemical panel would you request and why?
Reveal differential diagnosis
Burkitt lymphoma
Classic Hodgkin lymphoma
Metastatic poorly differentiated carcinoma
Reveal final diagnosis
Diffuse large B-cell lymphoma, not otherwise specified
Learning points
CD20, CD3, CD10, BCL6, MUM1, BCL2, MYC and Ki-67 form a core panel
Hans algorithm assigns cell of origin
MYC and BCL2 rearrangement testing is indicated in selected cases
Self-assessment
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All whole-slide images in this library are anonymised and used under appropriate licence. Cases are provided for education only and must not be used for clinical diagnosis.