Bone Marrow-Liver-Spleen Type of Large B-Cell Lymphoma Associated with Hemophagocytic Syndrome: A Rare Aggressive Extranodal Lymphoma

Figure 2

Histopathologic features. BM biopsy shows patchy interstitial infiltration of large lymphoma cells (arrows) without sinusoidal involvement (H&E; 400x) (a). By immunohistochemistry (IHC), the tumor cells are positive for CD20 (400x) (b) and negative for CD30 (400x) (c). CD34 highlights the capillary endothelial cells and confirms the lack of intravascular involvement by tumor cells (400x) (d). Lymphoma cells are large in size with large nuclei, high nuclear to cytoplasmic ratios, and open chromatin with one to several prominent nucleoli (Wright Geimsa; 100x) (e). BM aspirate smear shows histiocytic hemophagocytosis characterized by RBCs engulfing by histiocytes (Wright Geimsa; 100x) (f).

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