Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Advertisement

Bone

Hematologic neoplasms

Diffuse large B cell lymphoma (DLBCL)


Reviewer: Nikhil Sangle, M.D., University of Utah and ARUP Laboratories (see Reviewers page)
Revised: 15 August 2013, last major update February 2011
Copyright: (c) 2001-2013, PathologyOutlines.com, Inc.

Definition
=========================================================================

● 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
=========================================================================

● 75% male, median age 44 years
● Usually good outcome; better prognosis if tumor is of germinal center origin (Am J Surg Pathol 2003;27:1269)

Radiology
=========================================================================

● Large area of bone destruction and production, resembling osteomyelitis

Radiology images
=========================================================================



Distal femur xray - contributed by Dr. Mark R. Wick


Shoulder xray - contributed by Dr. Mark R. Wick

Case reports
=========================================================================

● 70 year old man with iliac bone and rib lesions (Arch Pathol Lab Med 2003;127:e323)

Clinical images
=========================================================================



Large cell lymphoma, skin, foot - contributed by Dr. Mark R. Wick

Gross description
=========================================================================

● Pink-gray tumor in diaphysis or metaphysis of long bone, with patchy cortical and medullary destruction
● Often soft tissue extension; variable periosteal reaction

Micro description
=========================================================================

● Usually centroblastic (well defined cell borders, abundant cytoplasm, prominent nucleoli, often multilobated, Mod Pathol 2001;14:1000)
● Frequent mitotic figures, may have prominent fibrosis

Micro images
=========================================================================



Technetium bone scan, H&E, CD20

   
Various images

   
Large cell lymphoma, skin, foot - contributed by Dr. Mark R. Wick


Contributed by Dr. Mark R. Wick


Immunoblastic large cell, CD79a - contributed by Dr. Mark R. Wick

Positive stains
=========================================================================

● Staining patterns: germinal center is bcl6+/CD10+ (48%), indeterminant is bcl6+/CD10- (31%), post-germinal center is bcl6-/CD10- (21%)
● CD20, CD19, CD22, CD79a, CD45/LCA
● Reticulin surrounds individual cells and groups of cells
● bcl2 (70%); p53 (55%), bcl6 (30%), variable CD30

Negative stains
=========================================================================

● CD138

Differential diagnosis
=========================================================================

Ewing’s sarcoma/PNET: syncytium of smaller cells with minimal cytoplasm, uniform nuclei, no indented nuclei, no prominent nucleoli; negative for B cell markers

End of Bone > Hematologic neoplasms > Diffuse large B cell lymphoma


This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).