Follicular Large B-Cell Lymphoma

Siba El Hussein, MD
2 min readAug 9, 2022

Lessons From the Friday Unknowns

The H&E slides show lymph node with follicular pattern in a partially preserved architecture. The neoplastic follicles are composed of centroblasts but not centrocytes, and there is a loss of mantle zones. The centroblasts display irregular nuclei, dispersed chromatin, and distinct nucleoli. No definitive centrocytes are identified. There are no confluent areas of large cells.

The submitted immunohistochemical stains show the neoplastic cells are positive for CD20, CD10, BCL2, BCL6, PAX5, MUM1 and negative for cyclin D1 and CD30. A small number of neoplastic cells are positive for c-Myc. CD21 and CD23 highlight follicular dendritic meshworks. CD3 and CD5 show increased T cells in a subset of follicles. IgD shows loss of mantle zone cells. Ki67 positivity ranges from 20–50%.

CD20

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Siba El Hussein, MD

Hematopathology | Cytopathology | Molecular pathology | Digital pathology | Data science | Machine learning