Lymphoma and plasma cell neoplasms
B cell lymphoma subtypes
Diffuse large B cell lymphoma - T cell / histiocyte rich

Author: Nikhil Sangle, M.D. (see Authors page)

Revised: 3 April 2017, last major update February 2011

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PubMed Search: T cell / histiocyte rich large B cell lymphoma

Cite this page: T cell / histiocyte rich diffuse large B cell lymphoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphomadiffusetcell.html. Accessed June 29th, 2017.
Definition / general
  • Diffuse large B cell lymphoma subtype with abundant non-neoplastic T cells and histiocytes, that may obscure tumor cells
Clinical features
  • Usually middle age adults, often with advanced stage and involvement of lymph nodes, spleen, bone marrow
  • Morphologic variants include L&H-like, centroblast / immunoblast-like and Reed-Sternberg-like
  • L&H-like cases may be related to nodular lymphocyte predominant Hodgkin lymphoma
Case reports
Gross images

Images hosted on PathOut server:

Case of the Week #317:

37 year old male

Microscopic (histologic) description
  • Neoplastic large B cells (< 10% of cells) scattered among small reactive T cells and histiocytes, in fine fibrillary fibrous background
  • Have diverse morphologic and immunophenotypic features (Am J Surg Pathol 2002;26:1458)
  • L&H-like: pale and indistinct cytoplasm, lobated and vesicular nuclei resembling popcorn cells with small central nucleoli; background of small lymphocytes and often histiocytes, no granulomas
  • Centroblast-like: pale eosinophilic cytoplasm, oval / round nuclei with vesicular chromatin and without nuclear atypia, small basophilic nucleoli adjacent to nuclear membrane
  • Reed-Sternberg-like: large multinucleated cells with abundant amphophilic cytoplasm, pleomorphic nuclei with prominent eosinophilic or amphophilic round/central nucleoli, in background of small lymphocytes and histiocytes; no eosinophils, no neutrophils and no plasma cells
Microscopic (histologic) images

Images hosted on PathOut server:

Case of the Week #317:

Various images


CD3

CD20

PAX5

CD30



Images hosted on other servers:

Various images

Positive stains
  • CD20, CD79a (weaker than CD20), BCL6, EMA (37%, associated with L&H cells) and CD30 (30%, usually stains Reed-Sternberg-like cells)
  • Rarely positive for BCL2 (13%), CD10 (10%)
  • Reactive T cells are CD3+, CD5+
  • Reactive histiocytes are CD68+
Negative stains
Differential diagnosis