Lymphoma Heterogeneity: Three Different Histological Pictures and One Unique Clone

Figure 1

(a) Splenic zone marginal lymphoma. Smz 4x, smz 20x, and smz CD20 100x. Nodular and interstitial bone marrow infiltration by mature small lymphocyte population with a phenotype compatible with splenic marginal zone lymphoma with occasional larger cells (transformed blast cells). With CD20 stain, we observe numerous images of intrasinusoidal infiltration. (b) Nodular sclerosis Hodgkin lymphoma. HL 10x, HL 100x, HL CD30 40x, HL CD15 100x, CD20 20x, and HL CD45 100x. Interaortocaval tumor forms nodules, which are delimited by a hypocellular sclerosing stroma. Each node contains few tumor cells (both Reed-Sternberg and Hodgking type) in an inflammatory background. Tumor cells are CD30+, CD15+ (dot-like staining). CD20+ and CD45−. Morphology and phenotype are diagnostic of classic Hodgkin lymphoma, nodular sclerosis type. (c) Diffuse large B-cell lymphoma. DLBCL pan; DLBCL 20x; DLBCL CD20 20x; DLBCL CD30 40x. Diffuse proliferation of medium/large lymphocytes, mostly with centroblastic habit, which is consistent with DLBCG and which infiltrates adipose tissue. Tumor cells are CD20 positive, with a high proliferative index (Ki67), and non-germinal-center immunophenotype. Inside, we can find occasional CD30+ Sternbergoid cells.

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