T-Cell/Histiocyte-Rich Large B-Cell Lymphoma (TCHRLBCL) is characterized by spleen and bone marrow involvement. The morphology is of scattered large B-cells with a predominant background composed of T-cell and Histiocytes. The immunophenotype is variable, and an important differential diagnosis is with Hodgkin lymphoma.
Characteristic Immunophenotype
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Marker
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Comment
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Negative in the lymphoma cells. Stains a majority of the small T-cells in the background.
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Stains scattered large lymphoma cells. The lymphoma cells do not form aggregates or sheets.
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Positive
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A variable number of lymphoma cells may be positive.
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A variable number of lymphoma cells may be positive.
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Negative
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Negative
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Negative
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EBV (EBER)
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Negative. If the lymphoma cells are positive for EBV then such cases should be best classified as EBV+ DLBCL.
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CD21 should show an absence of a residual follicular dendrite cell meshwork. The presence of a dendritic cell meshwork would be more supportive of a Nodular Lymphocyte Predominant Hodgkin Lymphoma.
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References
Parker, A., et. al. “Best Practice in Lymphoma Diagnosis and Reporting.” British Committee for Standards in Haematology, Royal College of Pathologists. April, 2010.
Hematopathology. [edited by] Jaffe, ES. 1st. ed. Elsevier, Inc. © 2011.