18. Diffuse large B-cell lymphoma (DLBCL)

Staining: HE and PAS

Organ: Lymph node (not recognizable)

Description:

No healthy lymph node tissue is visible. The tumor cells form no structures (like glands or nests). The cells are large and show severe atypia/pleiomorphism, almost anaplastic. The cells resemble centroblasts and are therefore said to be centroblastic in appearance or centroblastoid. There is high mitotic activity (many mitotic figures).

On PAS staining are PAS-positive inclusion bodies in the cytoplasm and nuclei visible, so called Russell bodies and Dutcher bodies, respectively. These inclusion bodies are comprised of immunoglobulin.

Diagnosis: Diffuse large B-cell lymphoma.

Causes:

  • Primary type: mutations in
    • Myc
    • BCL2
    • BCL6
  • Secondary type: Richter transformation from CLL, MZL or FL

Theory:

Necrosis is also a common histological finding in DLBCL but it can’t be seen here.

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17. CLL or SLL infiltration in lymph node

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19. Hodgkin lymphoma

2 thoughts on “18. Diffuse large B-cell lymphoma (DLBCL)”

  1. I would only like to point out that the purpose of the PAS slide would be to highlight the intracellular inclusion bodies (looking more eosinophilic). Also they are called Russel bodies if inside cytoplasm & Dutcher bodies if in the nucleus.
    Thank you as always.

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