Bone
Hematologic neoplasms
Diffuse large B cell lymphoma (DLBCL)

Author: Sheren Younes, M.D. (see Authors page)

Revised: 16 August 2018, last major update May 2014

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed search: diffuse large B cell lymphoma [title] bone

Cite this page: Younes, S. Diffuse large B cell lymphoma (DLBCL). PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bonediffuselargecell.html. Accessed September 25th, 2018.
Definition / general
  • Most common type of lymphoma occurring in bone
  • To be considered a primary bone tumor, must have no evidence of disease elsewhere for 6 months
Sites
  • Long bones, axial skeleton, limb girdles
Clinical features
Radiology description
  • Large area of bone destruction and production, resembling osteomyelitis
Radiology images

Images hosted on PathOut server:

Contributed by Dr. Mark R. Wick:

Distal femur Xray

Shoulder Xray

Case reports
Clinical images

Images hosted on PathOut server:

Contributed by Dr. Mark R. Wick:

Large cell lymphoma, skin and foot

Gross description
  • Pinkish gray tumor in diaphysis or metaphysis of long bone, with patchy cortical and medullary destruction
  • Often soft tissue extension; variable periosteal reaction
Microscopic (histologic) description
  • Similar to morphology at other sites: diffuse growth pattern, infiltrating between bone trabeculae
  • Large atypical cells with abundant cytoplasm
  • Centroblasts, immunoblasts, or large bizarre cells
  • Nuclei show clumped chromatin, prominent nucleoli
  • Component of small lymphocytes is admixed with large cells
  • May have marked spindling and fibrosis
Microscopic (histologic) images

Images hosted on PathOut server:

Contributed by Dr. Mark R. Wick:

Immunoblastic large cell, CD79a

Large cell lymphoma, skin and foot

Various images



Images hosted on other servers:

Various images and stains

Technetium bone scan, H&E, CD20

Cytology description
  • Variable combination of centroblasts, immunoblasts
  • May show large bizarre cells
Peripheral smear description
  • Lymphoma cells are rarely present in peripheral blood; when centroblasts are present, cells are very large and pleomorphic with abundant cytoplasm, often lobulated nucleus containing one or more fairly prominent nucleoli
Positive stains
Negative stains
Flow cytometry description
  • Shows clonal rearrangement, helps determine phenotype
Electron microscopy description
  • Centroblasts have cleaved nuclei, immunoblasts have large round nuclei with coarse chromatin and 1 - 3 prominent nucleoli
  • Rough endoplasmic reticulum with dilated cisternae and prominent Golgi apparatus are also apparent
  • The degree to which these features are present reflects the cellular degree of plasmacytoid differentiation
Molecular / cytogenetics images

Images hosted on other servers:

FISH-MYC gene

Differential diagnosis